HESI Comprehensive Exit Exam
,Enalapril maleate is prescribed for a hospitalized client. Which assessment does the
nurse perform as a priority before administering the medication?
Checking the client's blood pressure Checking
the client's peripheral pulses Checking the most
recent potassium level
Checking the client's intake-and-output record for the last 24 hours
(ANS- Checking the client's blood pressure
Rationale: Enalapril maleate is an angiotensin-converting enzyme (ACE) inhibitor used to
treat hypertension. One common side effect is postural hypotension.
Therefore the nurse would check the client's blood pressure immediately before
administering each dose. Checking the client's peripheral pulses, the results of the most
recent potassium level, and the intake and output for the previous 24 hours are not
specifically associated with this mediation.
A client is scheduled to undergo an upper gastrointestinal (GI) series, and the nurse
provides instructions to the client about the test. Which statement by the client indicates
a need for further instruction?
"The test will take about 30 minutes."
"I need to fast for 8 hours before the test."
"I need to drink citrate of magnesia the night before the test and give myself a Fleet enema
on the morning of the test."
"I need to take a laxative after the test is completed, because the liquid that I'll have to
drink for the test can be constipating."
(ANS- "I need to drink citrate of magnesia the night before the test and give myself a Fleet
enema on the morning of the test."
Rationale: No special preparation is necessary before a GI series, except that NPO
(nothing by mouth) status must be maintained for 8 hours before the test. An upper GI
,series involves visualization of the esophagus, duodenum, and upper jejunum
, by means of the use of a contrast medium. It involves swallowing a contrast medium
(usually barium), which is administered in a flavored milkshake. Films are taken at
intervals during the test, which takes about 30 minutes. After an upper GI series, the
client is prescribed a laxative to hasten elimination of the barium.
Barium that remains in the colon may become hard and difficult to expel, leading to
fecal impaction.
A nurse on the evening shift checks a primary health care provider's prescriptions and
notes that the dose of a prescribed medication is higher than the normal dose. The nurse
calls the primary health care provider's answering service and is told that the primary
health care provider is off for the night and will be available in the morning. What should
the nurse do next?
Call the nursing supervisor
Ask the answering service to contact the on-call primary health care provider Withhold
the medication until the primary health care provider can be reached in the morning
Administer the medication but consult the primary health care provider when he
becomes available
(ANS- Ask the answering service to contact the on-call primary health care provider
Rationale: The nurse has a duty to protect the client from harm. A nurse who believes
that a primary health care provider's prescription may be in error is responsible for
clarifying the prescription before carrying it out. Therefore the nurse would not
administer the medication; instead, the nurse would withhold the medication until the
dose can be clarified. The nurse would not wait until the next morning to obtain
clarification. It is premature to call the nursing supervisor.
An emergency department (ED) nurse is monitoring a client with suspected acute
myocardial infarction (MI) who is awaiting transfer to the coronary intensive care unit.
The nurse notes the sudden onset of premature ventricular contractions (PVCs) on the
monitor, checks the client's carotid pulse, and determines that the PVCs are not
perfusing. What is the nurse's most appropriate action?
,Enalapril maleate is prescribed for a hospitalized client. Which assessment does the
nurse perform as a priority before administering the medication?
Checking the client's blood pressure Checking
the client's peripheral pulses Checking the most
recent potassium level
Checking the client's intake-and-output record for the last 24 hours
(ANS- Checking the client's blood pressure
Rationale: Enalapril maleate is an angiotensin-converting enzyme (ACE) inhibitor used to
treat hypertension. One common side effect is postural hypotension.
Therefore the nurse would check the client's blood pressure immediately before
administering each dose. Checking the client's peripheral pulses, the results of the most
recent potassium level, and the intake and output for the previous 24 hours are not
specifically associated with this mediation.
A client is scheduled to undergo an upper gastrointestinal (GI) series, and the nurse
provides instructions to the client about the test. Which statement by the client indicates
a need for further instruction?
"The test will take about 30 minutes."
"I need to fast for 8 hours before the test."
"I need to drink citrate of magnesia the night before the test and give myself a Fleet enema
on the morning of the test."
"I need to take a laxative after the test is completed, because the liquid that I'll have to
drink for the test can be constipating."
(ANS- "I need to drink citrate of magnesia the night before the test and give myself a Fleet
enema on the morning of the test."
Rationale: No special preparation is necessary before a GI series, except that NPO
(nothing by mouth) status must be maintained for 8 hours before the test. An upper GI
,series involves visualization of the esophagus, duodenum, and upper jejunum
, by means of the use of a contrast medium. It involves swallowing a contrast medium
(usually barium), which is administered in a flavored milkshake. Films are taken at
intervals during the test, which takes about 30 minutes. After an upper GI series, the
client is prescribed a laxative to hasten elimination of the barium.
Barium that remains in the colon may become hard and difficult to expel, leading to
fecal impaction.
A nurse on the evening shift checks a primary health care provider's prescriptions and
notes that the dose of a prescribed medication is higher than the normal dose. The nurse
calls the primary health care provider's answering service and is told that the primary
health care provider is off for the night and will be available in the morning. What should
the nurse do next?
Call the nursing supervisor
Ask the answering service to contact the on-call primary health care provider Withhold
the medication until the primary health care provider can be reached in the morning
Administer the medication but consult the primary health care provider when he
becomes available
(ANS- Ask the answering service to contact the on-call primary health care provider
Rationale: The nurse has a duty to protect the client from harm. A nurse who believes
that a primary health care provider's prescription may be in error is responsible for
clarifying the prescription before carrying it out. Therefore the nurse would not
administer the medication; instead, the nurse would withhold the medication until the
dose can be clarified. The nurse would not wait until the next morning to obtain
clarification. It is premature to call the nursing supervisor.
An emergency department (ED) nurse is monitoring a client with suspected acute
myocardial infarction (MI) who is awaiting transfer to the coronary intensive care unit.
The nurse notes the sudden onset of premature ventricular contractions (PVCs) on the
monitor, checks the client's carotid pulse, and determines that the PVCs are not
perfusing. What is the nurse's most appropriate action?
