HESI REVIEW #1 BSN 266
Study online at https://quizlet.com/_d0v7d8
1. A client with acute osteomyelitis has undergone surgical debridement of
the diseased bone and asks the nurse how long will antibiotics have to be
administered. Which information should the nurse communicate?
A. Oral antibiotics for 2 to 4 months, then for dental procedure prophylaxis.
B. Parenteral antibiotics for 4 to 6 weeks, then oral antibiotics for up to 1 year.
C. Parenteral antibiotics for 4 to 8 weeks, then oral antibiotics for 4 to 8 weeks.
Parenteral antibiotics for 2 to 3 weeks, then oral antibiotics for 4 weeks: C
Treatment of acute osteomyelitis requires the administration of high doses of par-
enteral antibiotics for 4 to 8 weeks, followed by oral antibiotics for another 4 to 8
weeks
2. In planning care for a client with an acute stroke resulting in right-sided
hemiplegia, which positioning should the nurse should use to maintain opti-
mal functioning?
A. Mid-Fowlers with knees supported.
B. Supine with trochanter rolls to the hips.
C. Sim's position alternated with right lateral position q2 hours.
Left lateral, supine, brief periods on the right side, and prone: D
Rationale
After an acute stroke, a positioning and turning schedule that minimizes lying on
the affected side, which can impair circulation and cause pain, and includes the
prone position to help prevent flexion contractures of the hips, prepares the client
for optimal functioning and ambulation.
3. Which preexisting diagnosis places a client at the greatest risk of develop-
ing superior vena cava syndrome?
A. Carotid stenosis.
B. Steatosis hepatitis.
C. Metastatic cancer.
D. Clavicular fracture.: C
Rationale
Superior vena cava syndrome occurs when the superior vena cava (SVC) is com-
pressed by outside structures, such as a growing tumor that impedes the return
blood flow to the heart. Superior vena cava syndrome is likely to occur with metasta-
tic cancer from a primary tumor in the upper lobe of the right lung that compresses
the superior vena cava.
4. The nurse is giving discharge instructions to a client with chronic prostati-
tis. What instruction should the nurse provide the client to reduce the risk of
spreading the infection to other areas of the client's urinary tract?
A. Wear a condom when having sexual intercourse.
B. Avoid consuming alcohol and caffeinated beverages.
, HESI REVIEW #1 BSN 266
Study online at https://quizlet.com/_d0v7d8
C. Empty the bladder completely with each voiding.
D. Have intercourse or masturbate at least twice a week.: D
Rationale
The prostate is not easily penetrated by antibiotics and can serve as a reservoir for
microorganisms, which can infect other areas of the genitourinary tract. Draining
the prostate regularly through intercourse or masturbation decreases the number
of microorganisms present and reduces the risk for further infection from stored
contaminated seminal fluids
5. During the initial outbreak of genital herpes simplex for a female client, what
should be the nurse's primary focus in planning care?
A. Promotion of comfort.
B. Prevention of pregnancy.
C. Instruction in condom use.
Information about transmission: A
Rationale
The initial outbreak of genital herpes simplex in a woman causes severe discomfort.
Promotion of comfort is the first priority
6. A client who has a chronic cough with blood-tinged sputum returns to the
unit after a bronchoscopy. What nursing interventions should be implemented
in the immediate post-procedural period?
A. Keep the client on bed rest for eight hours.
B. Check vital signs every 15 minutes for two hours.
C. Allow the client nothing by mouth until the gag reflex returns.
D. Encourage fluid intake to promote elimination of the contrast media.: C
Rationale
The nasal pharynx and oral pharynx are anesthetized with local anesthetic spray
prior to bronchoscopy, and the bronchoscope is coated with lidocaine (Xylocaine)
gel to inhibit the gag reflex and prevent laryngeal spasm during insertion. The client
should be NPO until the client's gag reflex returns to prevent aspiration from any
oral intake or secretions.
7. The nurse is assessing a client admitted from the emergency room with
gastrointestinal bleeding related to peptic ulcer disease (PUD). Which physi-
ological factors can produce ulceration? (Select all that apply.)
Select all that apply
A. Vagal stimulation.
B. An increased level of stress.
C. Decreased duodenal inhibition.
D. Hypersecretion of hydrochloric acid.
An increased number of parietal cells: D,E
, HESI REVIEW #1 BSN 266
Study online at https://quizlet.com/_d0v7d8
Rationale
Hypersecretion of gastric juices and an increased number of parietal cells that
stimulate secretion are most often the causes of ulceration. Vagal stimulation and
decreased duodenal inhibition also increase the secretion of caustic fluids.
8. The nurse is caring for a client with non-Hodgkin's lymphoma who is re-
ceiving chemotherapy. Laboratory results reveal a platelet count of 10,000/ml.
What action should the nurse implement?
A. Encourage fluids to 3000 ml/day.
B. Check stools for occult blood.
C. Provide oral hygiene every 2 hours.
Check for fever every 4 hours: B
Rationale
Platelet counts less than 100,000/mm3 are indicative of thrombocytopenia, a com-
mon side effect of chemotherapy. A client with thrombocytopenia should be as-
sessed frequently for occult bleeding in the emesis, sputum, feces, urine, nasogas-
tric secretions, or wounds.
9. Which action should the nurse implement on the scheduled day of surgery
for a client with type 1 diabetes mellitus (DM)?
A. Obtain a prescription for an adjusted dose of insulin.
B. Administer an oral anti-diabetic agent.
C. Give an insulin dose using parameters of a sliding scale.
Withhold insulin while the client is NPO: A
Rationale
Stressors, such as surgery, increase serum glucose levels. A client with type 1 DM
who is NPO for scheduled surgery should receive a prescribed adjusted dose of
insulin.
10. The nurse should explain to a client with lung cancer that pleurodesis is
performed to achieve which expected outcome?
A. Prevent the formation of effusion fluid.
B. Remove fluid from the intrapleural space.
C. Debulk tumor to maintain patency of air passages.
Relieve empyema after pneumonectomy: A
Rationale
Instillation of a sclerosing agent to create pleurodesis is aimed at preventing the
formation of a pleural effusion by causing the pleural spaces sealed together,
thereby preventing the accumulation of pleural fluid.
11. The nurse obtains a client's history that includes right mastectomy and
radiation therapy for cancer of the breast 10 years ago. Which current health
problem should the nurse consider is a consequence of the radiation thera-
, HESI REVIEW #1 BSN 266
Study online at https://quizlet.com/_d0v7d8
py?
A. Asthma.
B. Myocardial infarction.
C. Chronic esophagitis with gastroesophageal reflux.
Pathologic fracture of two ribs on the right chest: D
Rationale
The ribs lie in the radiation pathway and lose density over time, becoming thin and
brittle, so the occurence of two right-sided ribs with pathological fractures resulting
without evidence of trauma is related to radiation damage
12. Three weeks after discharge for an acute myocardial infarction (MI), a client
returns to the cardiac center for follow-up. When the nurse asks about sleep
patterns, the client tells the nurse that he sleeps fine but that his wife moved
into the spare bedroom to sleep when he returned home. He states, "I guess
we will never have sex again after this." Which response is best for the nurse
to provide?
A. Sexual intercourse can be strenuous on your heart, but closeness and
intimacy, such as holding and cuddling, can be maintained with your wife.
B. Sexual activity can be resumed whenever you and your wife feel like it
because the sexual response is more emotional rather than physical.
C. You should discuss your questions about your sexual activity with your
healthcare provider because sexual activity may be limited by your heart
damage.
D. Sexual activity is similar in cardiac workload and energy expenditure as
climbing two flights of stairs and may be resumed like other activities: D
Rationale
Sexual intercourse after an MI, or acute coronary syndrome, has been found to
require no more energy expenditure or cardiac stress than walking briskly up two
flights of stairs, so if you do not experience shortness of breath or chest discomfort
doing the stairs then you should be okay to resume sexual activity
13. The nurse is caring for a client scheduled to undergo insertion of a percu-
taneous endoscopic gastrostomy (PEG) tube. The client asks the nurse to ex-
plain how a PEG tube differs from a gastrostomy tube (GT). Which explanation
best describes how they are different?
A. Method of insertion.
B. Location of the tubes.
C. Diameter of the tubes.
D. Procedure for feedings.: A
Rationale
The best explanation of how a PEG tube differs from a GT is by the method of
Study online at https://quizlet.com/_d0v7d8
1. A client with acute osteomyelitis has undergone surgical debridement of
the diseased bone and asks the nurse how long will antibiotics have to be
administered. Which information should the nurse communicate?
A. Oral antibiotics for 2 to 4 months, then for dental procedure prophylaxis.
B. Parenteral antibiotics for 4 to 6 weeks, then oral antibiotics for up to 1 year.
C. Parenteral antibiotics for 4 to 8 weeks, then oral antibiotics for 4 to 8 weeks.
Parenteral antibiotics for 2 to 3 weeks, then oral antibiotics for 4 weeks: C
Treatment of acute osteomyelitis requires the administration of high doses of par-
enteral antibiotics for 4 to 8 weeks, followed by oral antibiotics for another 4 to 8
weeks
2. In planning care for a client with an acute stroke resulting in right-sided
hemiplegia, which positioning should the nurse should use to maintain opti-
mal functioning?
A. Mid-Fowlers with knees supported.
B. Supine with trochanter rolls to the hips.
C. Sim's position alternated with right lateral position q2 hours.
Left lateral, supine, brief periods on the right side, and prone: D
Rationale
After an acute stroke, a positioning and turning schedule that minimizes lying on
the affected side, which can impair circulation and cause pain, and includes the
prone position to help prevent flexion contractures of the hips, prepares the client
for optimal functioning and ambulation.
3. Which preexisting diagnosis places a client at the greatest risk of develop-
ing superior vena cava syndrome?
A. Carotid stenosis.
B. Steatosis hepatitis.
C. Metastatic cancer.
D. Clavicular fracture.: C
Rationale
Superior vena cava syndrome occurs when the superior vena cava (SVC) is com-
pressed by outside structures, such as a growing tumor that impedes the return
blood flow to the heart. Superior vena cava syndrome is likely to occur with metasta-
tic cancer from a primary tumor in the upper lobe of the right lung that compresses
the superior vena cava.
4. The nurse is giving discharge instructions to a client with chronic prostati-
tis. What instruction should the nurse provide the client to reduce the risk of
spreading the infection to other areas of the client's urinary tract?
A. Wear a condom when having sexual intercourse.
B. Avoid consuming alcohol and caffeinated beverages.
, HESI REVIEW #1 BSN 266
Study online at https://quizlet.com/_d0v7d8
C. Empty the bladder completely with each voiding.
D. Have intercourse or masturbate at least twice a week.: D
Rationale
The prostate is not easily penetrated by antibiotics and can serve as a reservoir for
microorganisms, which can infect other areas of the genitourinary tract. Draining
the prostate regularly through intercourse or masturbation decreases the number
of microorganisms present and reduces the risk for further infection from stored
contaminated seminal fluids
5. During the initial outbreak of genital herpes simplex for a female client, what
should be the nurse's primary focus in planning care?
A. Promotion of comfort.
B. Prevention of pregnancy.
C. Instruction in condom use.
Information about transmission: A
Rationale
The initial outbreak of genital herpes simplex in a woman causes severe discomfort.
Promotion of comfort is the first priority
6. A client who has a chronic cough with blood-tinged sputum returns to the
unit after a bronchoscopy. What nursing interventions should be implemented
in the immediate post-procedural period?
A. Keep the client on bed rest for eight hours.
B. Check vital signs every 15 minutes for two hours.
C. Allow the client nothing by mouth until the gag reflex returns.
D. Encourage fluid intake to promote elimination of the contrast media.: C
Rationale
The nasal pharynx and oral pharynx are anesthetized with local anesthetic spray
prior to bronchoscopy, and the bronchoscope is coated with lidocaine (Xylocaine)
gel to inhibit the gag reflex and prevent laryngeal spasm during insertion. The client
should be NPO until the client's gag reflex returns to prevent aspiration from any
oral intake or secretions.
7. The nurse is assessing a client admitted from the emergency room with
gastrointestinal bleeding related to peptic ulcer disease (PUD). Which physi-
ological factors can produce ulceration? (Select all that apply.)
Select all that apply
A. Vagal stimulation.
B. An increased level of stress.
C. Decreased duodenal inhibition.
D. Hypersecretion of hydrochloric acid.
An increased number of parietal cells: D,E
, HESI REVIEW #1 BSN 266
Study online at https://quizlet.com/_d0v7d8
Rationale
Hypersecretion of gastric juices and an increased number of parietal cells that
stimulate secretion are most often the causes of ulceration. Vagal stimulation and
decreased duodenal inhibition also increase the secretion of caustic fluids.
8. The nurse is caring for a client with non-Hodgkin's lymphoma who is re-
ceiving chemotherapy. Laboratory results reveal a platelet count of 10,000/ml.
What action should the nurse implement?
A. Encourage fluids to 3000 ml/day.
B. Check stools for occult blood.
C. Provide oral hygiene every 2 hours.
Check for fever every 4 hours: B
Rationale
Platelet counts less than 100,000/mm3 are indicative of thrombocytopenia, a com-
mon side effect of chemotherapy. A client with thrombocytopenia should be as-
sessed frequently for occult bleeding in the emesis, sputum, feces, urine, nasogas-
tric secretions, or wounds.
9. Which action should the nurse implement on the scheduled day of surgery
for a client with type 1 diabetes mellitus (DM)?
A. Obtain a prescription for an adjusted dose of insulin.
B. Administer an oral anti-diabetic agent.
C. Give an insulin dose using parameters of a sliding scale.
Withhold insulin while the client is NPO: A
Rationale
Stressors, such as surgery, increase serum glucose levels. A client with type 1 DM
who is NPO for scheduled surgery should receive a prescribed adjusted dose of
insulin.
10. The nurse should explain to a client with lung cancer that pleurodesis is
performed to achieve which expected outcome?
A. Prevent the formation of effusion fluid.
B. Remove fluid from the intrapleural space.
C. Debulk tumor to maintain patency of air passages.
Relieve empyema after pneumonectomy: A
Rationale
Instillation of a sclerosing agent to create pleurodesis is aimed at preventing the
formation of a pleural effusion by causing the pleural spaces sealed together,
thereby preventing the accumulation of pleural fluid.
11. The nurse obtains a client's history that includes right mastectomy and
radiation therapy for cancer of the breast 10 years ago. Which current health
problem should the nurse consider is a consequence of the radiation thera-
, HESI REVIEW #1 BSN 266
Study online at https://quizlet.com/_d0v7d8
py?
A. Asthma.
B. Myocardial infarction.
C. Chronic esophagitis with gastroesophageal reflux.
Pathologic fracture of two ribs on the right chest: D
Rationale
The ribs lie in the radiation pathway and lose density over time, becoming thin and
brittle, so the occurence of two right-sided ribs with pathological fractures resulting
without evidence of trauma is related to radiation damage
12. Three weeks after discharge for an acute myocardial infarction (MI), a client
returns to the cardiac center for follow-up. When the nurse asks about sleep
patterns, the client tells the nurse that he sleeps fine but that his wife moved
into the spare bedroom to sleep when he returned home. He states, "I guess
we will never have sex again after this." Which response is best for the nurse
to provide?
A. Sexual intercourse can be strenuous on your heart, but closeness and
intimacy, such as holding and cuddling, can be maintained with your wife.
B. Sexual activity can be resumed whenever you and your wife feel like it
because the sexual response is more emotional rather than physical.
C. You should discuss your questions about your sexual activity with your
healthcare provider because sexual activity may be limited by your heart
damage.
D. Sexual activity is similar in cardiac workload and energy expenditure as
climbing two flights of stairs and may be resumed like other activities: D
Rationale
Sexual intercourse after an MI, or acute coronary syndrome, has been found to
require no more energy expenditure or cardiac stress than walking briskly up two
flights of stairs, so if you do not experience shortness of breath or chest discomfort
doing the stairs then you should be okay to resume sexual activity
13. The nurse is caring for a client scheduled to undergo insertion of a percu-
taneous endoscopic gastrostomy (PEG) tube. The client asks the nurse to ex-
plain how a PEG tube differs from a gastrostomy tube (GT). Which explanation
best describes how they are different?
A. Method of insertion.
B. Location of the tubes.
C. Diameter of the tubes.
D. Procedure for feedings.: A
Rationale
The best explanation of how a PEG tube differs from a GT is by the method of
