HESI_Exit_Exam_3 2011.
TEST 3
Multiple Choice
Identify the letter of the choice that best completes the statement or answers the question.
1. A vegetarian client is being discharged with a prescription for warfarin (Coumadin). What instruction is essential for the nurse to include in the...
hesiexitexam3 2011 test 3 multiple choice identify the letter of the choice that best completes the statement or answers the question 1 a vegetarian client is being discharged with a prescr
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Name: Class: Date: ID: A
HESI_Exit_Exam_3 2011.
TEST 3
Multiple Choice
Identify the letter of the choice that best completes the statement or answers the question.
1. A vegetarian client is being discharged with a prescription for warfarin (Coumadin). What
instruction is essential for the nurse to include in the client's discharge teaching?
a. Avoid excessive intake of green leafy vegetables.
b. Eliminate the intake of highly-processed food items.
c. Include a protein-rich fluid supplement in your diet daily.
d. Incorporate herbal teas to ensure adequate micro-nutrient intake.
2. A male client with Parkinson's disease is newly diagnosed with benign prostatic hypertrophy.
When reviewing the client's medication history, which antiparkinsonian medication is most
likely to exacerbate his urologic symptoms?
a. Benztropine (Cogentin), an anticholinergic.
b. Levodopa (L-dopa), an antiparkinsonian agent.
c. Amantadine (Symmetrel), an antiparkinsonian agent.
d. Bromocriptine (Parlodel), a dopamine receptor agonist.
3. To prevent the transmission of Hepatitis A, the nurse should wear gloves during which
procedure?
a. Starting an intravenous (IV) catheter.
b. Administering a rectal suppository.
c. Emptying a Foley catheter.
d. Giving an intramuscular (IM) injection.
4. A client with gestational diabetes is undergoing a non-stress test (NST) at 34-weeks gestation.
The baseline fetal heart rate (FHR) is 144 beats/minute. The client is instructed to mark the
fetal monitor paper by pressing a button attached to the fetal monitor each time the baby
moves. After 20 minutes, the nurse evaluates the fetal monitor strip. Which outcome indicates
a reactive NST?
a. The mother perceives and marks at least four fetal movements.
b. Fetal movements must be elicited with a vibroacoustic stimulator.
c. Two FHR accelerations of 15 bpm X 15 seconds are recorded.
d. No FHR late decelerations occur in response to fetal movement.
5. A 2-year-old with sickle cell anemia has an axillary temperature of 102° F. In planning care
for this child, which nursing diagnosis has the highest priority?
a. Potential activity intolerance related to anemia.
b. High risk for infection related to low platelet count.
c. High risk for fluid volume deficit related to temperature elevation.
d. Alteration in urinary elimination related to renal damage from disease.
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,Name: ID: A
6. To evaluate for side effects that occur as a result of the administration of intravenous mannitol
(Osmitrol) for acute angle closure glaucoma, the nurse should monitor which lab values?
a. Serum glucose.
b. Liver enzymes.
c. Serum electrolytes.
d. Platelets and a PTT.
7. What statement by a client indicates the best understanding of the purpose of postoperative
incisional splinting?
a. "Increasing pressure on the incision will help reduce my discomfort when
coughing."
b. "The splints on my incision are there to keep the incision from opening until it is
well healed."
c. "Splinting my incision will reduce the need for me to cough as frequently."
d. "A splint will secure my wound dressing when moving about in bed or
ambulating."
8. The nurse is preparing to administer a scheduled dose of a sulfonamide to a client with
pneumonia and notes that the client has allergies to cephalosporins and penicillins. What
action should the nurse take?
a. Hold the scheduled dose of sulfonamide until the healthcare provider makes
rounds.
b. Review the sputum culture and sensitivity report before calling the healthcare
provider.
c. Contact the healthcare provider regarding a prescription for a PRN antihistamine.
d. Administer the scheduled dose of the sulfonamide as prescribed.
9. The charge nurse working the day shift notices an increased number of client complaints
regarding poor pain control during the night shift. What is the most effective way for the
charge nurse to improve the pain management issue on the unit?
a. During an evening shift report, request that night staff nurses assess pain levels
and improve pain management.
b. At the next unit employee meeting, encourage staff to increase attentiveness to
pain management needs of clients.
c. Develop and implement a unit-wide project to improve client satisfaction with
pain management.
d. Post a bulletin asking nurses to anticipate and meet each assigned client's pain
management needs.
10. The nurse is assessing a client following a thoracotomy and left lung pneumonectomy. What
assessment finding should the nurse anticipate?
a. Diminished breath sounds auscultated bilaterally.
b. Absent breath sounds on the left side of the chest.
c. Crackles and wheezes auscultated in the right lung fields.
d. Decreased breath sounds on the left, clear breath sounds on the right.
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,Name: ID: A
11. A female client with genital herpes is taking acyclovir (Zovirax). Which client statement
indicates to the nurse that the client understands the teaching provided?
a. "In order to be cured, I need to take all the prescribed doses even if I am not
having any symptoms."
b. "Even though I am taking this medication my partner should always use a condom
when we have intercourse."
c. "Taking this medication every day for the rest of my life will be costly, but is
necessary to control the disease."
d. "I will come to the clinic for my weekly injections until I feel comfortable giving
them to myself."
12. A client has a new prescription for the alpha-beta adrenergic blocker carvedilol (Coreg). It is
most important for the nurse to determine if the client has a history of which problem prior to
administering the medication?
a. High cholesterol.
b. Osteoporosis.
c. Hypertension.
d. Bronchial asthma.
13. A medication is prescribed to be given QID. What schedule should the nurse use to administer
this prescription?
a. 0800, 1200, 1600, 2000.
b. 0800.
c. Every other day at 0800.
d. 0800, 1200, 1600, 2000, 0000, 0400.
14. When planning care for a client with chemotherapy-induced stomatitis, the nurse recognizes
that the client is at high risk for which problem?
a. Diminished aspiration.
b. Altered tissue perfusion.
c. Ineffective airway clearance.
d. Altered nutrition, less than body requirements.
15. The nurse who is working in the newborn nursery notes that an infant girl has a lacy blue
appearance to her skin. What sequela should concern the nurse?
a. Hypoglycemia.
b. Hyperbilirubinemia.
c. Intestinal obstruction.
d. Failure to thrive.
16. The nurse is assessing a 2-year-old boy who is admitted to the Emergency Department with a
thick greenish discharge coming from his left nostril that has a strong and bad odor. He is
fussy and continually picks at his nose. His mother denies any recent fever or other cold
symptoms. Based on these assessment findings, what is the most likely cause of these
symptoms?
a. A foreign object in the left nares.
b. Infection of the left maxillary sinus.
c. Chronic rhinitis from allergies.
d. Deviation of the nasal septum.
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, Name: ID: A
17. A client with schizophrenia prepares to leave the mental health unit on a day pass with the
case manager. Before the client leaves the unit, which nursing intervention is most important
to implement?
a. Advise client to stay with the case manager.
b. Prepare all medications to take on pass.
c. Assess for suicidal or homicidal ideation.
d. Obtain and document morning vital signs.
18. The nurse is reviewing the diagnostic tests of a client with a medical diagnosis of chronic renal
failure (CRF), or end-stage renal disease (ESRD). Which group of laboratory results should
the nurse anticipate that this client will exhibit?
a. Decreased sodium, decreased phosphate, and decreased white blood cell count.
b. Increased blood urea nitrogen, increased creatinine, and decreased serum calcium.
c. Increased red blood cell count, increased creatinine clearance, and increased
serum ammonia.
d. Decreased potassium, decreased magnesium, and decreased platelets.
19. The home health nurse has determined that an 80-year-old client has a priority nursing
diagnosis of, "Altered nutrition, less than body requirements." To assess the client's
functional ability related to this diagnosis, which action should the nurse implement?
a. Observe the client preparing a meal at home.
b. Record the percent of diet eaten in 24 hours.
c. Review the client's weekly budget for food.
d. Assess the client's food likes and dislikes.
20. After a client experiences spontaneous rupture of the membranes during labor, the nurse notes
a visible prolapse of the umbilical cord. What intervention should the nurse implement
immediately?
a. Administer oxygen by face mask at 6 L/min.
b. Prepare the client for a cesarean delivery.
c. Push the presenting part off the cord.
d. Turn the client to a supine position.
21. When is the best time for the nurse to schedule a client's single daily dose of an ophthalmic
ointment?
a. Early morning.
b. With other routine meds at 0900.
c. Mid-afternoon.
d. Bedtime.
22. The mother of an 8-year-old boy tells the nurse that he fell out of a tree and hurt his arm and
shoulder. Which assessment finding is the most significant indicator of possible child abuse?
a. The child looks at the floor when answering the nurse's questions.
b. The mother refuses to answer questions about family history.
c. The child has several abrasions on the chest and legs.
d. The mother's version of the injury is different from the child's version.
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