2025 CRITICAL CARE HESI EXIT EXAM (V1) TEST BANK
GUIDE 100% CORRECT ANSWERS GUARANTEED A+
A 56-year-old female client is receiving intracavitary radiation via a
radium implant.
Which
nurse should be assigned to care for this client?
A. The nurse who is caring for another client receiving intracavitary
radiation.
B. A nurse with Marfan's syndrome who is postmenopausal.
C. A nurse with oncology experience who may be pregnant.
D. The nurse who is caring for another client who has Clostridium
difficile. -
E. Answer-B. A nurse with Marfan's syndrome who is postmenopausal.
RATIONALE:
A client receiving intracavity radiation poses a radiation hazard as long
as the intracavity radiation source is in place. A nurse's ability to care of
this client is not affected by Marfan's
syndrome (B), which is a hereditary disorder of connective tissues,
bones, muscles, ligaments
and skeletal structures. The goal is to limit any one staff member's
exposure to the calculated
time span based on the half-life of radium, such as the number of
minutes at the bedside per day,
so (A) should not be assigned. (C) should not be exposed to the radiation
due to the possible
effect on the fetus. A radiation exposure decreases the immune response
in the client who should
not be exposed to the potential inadvertent transmission of an infectious
organism (D).
1.A client who has active tuberculosis (TB) is admitted to the
medical unit. What action is most
important for the nurse to implement?
A. Fit the client with a respirator mask.
B. Assign the client to a negative air-flow room.
C. Don a clean gown for client care.
,D. Place an isolation cart in the hallway -
E. Answer-Assign the client to a negative air- flow room
RATIONALE:
Active tuberculosis requires implementation of airborne precautions, so
the client should be
assigned to a negative pressure air-flow room (D). Although (A and C)
should be implemented
for clients in isolation with contact precautions, it is most important that
air flow from the room
is minimized when the client has TB. (B) should be implemented when
the client leaves the
isolation environment.
,2.A client is receiving atenolol (Tenormin) 25 mg PO after a
myocardial infarction. The nurse
determines the client's apical pulse is 65 beats per minute. What
action should the nurse
impleme
nt next?
A. Measure the blood pressure.
B. Reassess the apical pulse.
C. Notify the healthcare provider.
D. Administer the medication. -
E. Answer-Administer the medication RATIONALE:
Atenolol, a beta-blocker, blocks the beta receptors of the sinoatrial node
to reduce the heart rate,
so the medication should be administered (C) because the client's apical
pulse is greater than 60.
(A, B, and D) are not indicated at this time.
3. Thenurse is assessing a client and identifies a bruit over the thyroid.
This finding is consistent
with which interpretation?
A. Hypothyroidism.
B. Thyroid cyst.
C. Thyroid cancer.
D. Hyperthyroidism -
E. Answer-Hyperthyroidism
Rationale:Hyperthyroidism (D) is an enlargement of the thyroid gland,
often referred to as a goiter, and a
bruit may be auscultated over the goiter due to an increase in glandular
vascularity which
increases as the thyroid gland becomes hyperactive. A bruit is not
common with (A, B, and C).
A 6-year-old child is alert but quiet when brought to the emergency
center with periorbital ecchymosis and ecchymosis behind the ears.
The nurse suspects potential child abuse and continues to assess the
child for additional manifestations of a basilar skull fracture. What
assessment finding would be consistent with a basilar skull fracture?
, A. Hematemesis and abdominal distention.
B. Asymmetry of the face and eye movements.
C. Rhinorrhoea or otorrhoea with Halo sign.
D. Abnormal position and movement of the arm. -
E. Answer-Rhinorrhoea or otorrhoea with Halo sign.
RATIONALE:
Raccoon eyes (periorbital ecchymosis) and Battle's sign (ecchymosis
behind the ear over the
GUIDE 100% CORRECT ANSWERS GUARANTEED A+
A 56-year-old female client is receiving intracavitary radiation via a
radium implant.
Which
nurse should be assigned to care for this client?
A. The nurse who is caring for another client receiving intracavitary
radiation.
B. A nurse with Marfan's syndrome who is postmenopausal.
C. A nurse with oncology experience who may be pregnant.
D. The nurse who is caring for another client who has Clostridium
difficile. -
E. Answer-B. A nurse with Marfan's syndrome who is postmenopausal.
RATIONALE:
A client receiving intracavity radiation poses a radiation hazard as long
as the intracavity radiation source is in place. A nurse's ability to care of
this client is not affected by Marfan's
syndrome (B), which is a hereditary disorder of connective tissues,
bones, muscles, ligaments
and skeletal structures. The goal is to limit any one staff member's
exposure to the calculated
time span based on the half-life of radium, such as the number of
minutes at the bedside per day,
so (A) should not be assigned. (C) should not be exposed to the radiation
due to the possible
effect on the fetus. A radiation exposure decreases the immune response
in the client who should
not be exposed to the potential inadvertent transmission of an infectious
organism (D).
1.A client who has active tuberculosis (TB) is admitted to the
medical unit. What action is most
important for the nurse to implement?
A. Fit the client with a respirator mask.
B. Assign the client to a negative air-flow room.
C. Don a clean gown for client care.
,D. Place an isolation cart in the hallway -
E. Answer-Assign the client to a negative air- flow room
RATIONALE:
Active tuberculosis requires implementation of airborne precautions, so
the client should be
assigned to a negative pressure air-flow room (D). Although (A and C)
should be implemented
for clients in isolation with contact precautions, it is most important that
air flow from the room
is minimized when the client has TB. (B) should be implemented when
the client leaves the
isolation environment.
,2.A client is receiving atenolol (Tenormin) 25 mg PO after a
myocardial infarction. The nurse
determines the client's apical pulse is 65 beats per minute. What
action should the nurse
impleme
nt next?
A. Measure the blood pressure.
B. Reassess the apical pulse.
C. Notify the healthcare provider.
D. Administer the medication. -
E. Answer-Administer the medication RATIONALE:
Atenolol, a beta-blocker, blocks the beta receptors of the sinoatrial node
to reduce the heart rate,
so the medication should be administered (C) because the client's apical
pulse is greater than 60.
(A, B, and D) are not indicated at this time.
3. Thenurse is assessing a client and identifies a bruit over the thyroid.
This finding is consistent
with which interpretation?
A. Hypothyroidism.
B. Thyroid cyst.
C. Thyroid cancer.
D. Hyperthyroidism -
E. Answer-Hyperthyroidism
Rationale:Hyperthyroidism (D) is an enlargement of the thyroid gland,
often referred to as a goiter, and a
bruit may be auscultated over the goiter due to an increase in glandular
vascularity which
increases as the thyroid gland becomes hyperactive. A bruit is not
common with (A, B, and C).
A 6-year-old child is alert but quiet when brought to the emergency
center with periorbital ecchymosis and ecchymosis behind the ears.
The nurse suspects potential child abuse and continues to assess the
child for additional manifestations of a basilar skull fracture. What
assessment finding would be consistent with a basilar skull fracture?
, A. Hematemesis and abdominal distention.
B. Asymmetry of the face and eye movements.
C. Rhinorrhoea or otorrhoea with Halo sign.
D. Abnormal position and movement of the arm. -
E. Answer-Rhinorrhoea or otorrhoea with Halo sign.
RATIONALE:
Raccoon eyes (periorbital ecchymosis) and Battle's sign (ecchymosis
behind the ear over the
