HESI RN COMPREHENSIVE EXIT EXAM (COMPLETE 2022/2023 REVISED EDITION)
1. . The nurse completes an admission assessment on a patient with asthma. Which information given by patient is indicates a need for a change in therapy?
a. The patient uses albuterol (Ventolin HFA) before aerobic ...
hesi rn comprehensive exit exam complete 20222023 revised edition 1 the nurse completes an admission assessment on a patient with asthma which information given by patient is indicates a
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HESI RN COMPREHENSIVE EXIT EXAM
1. . The nurse completes an admission assessment on a patient with asthma.
Which information given by patient is indicates a need for a change in therapy?
a. The patient uses albuterol (Ventolin HFA) before aerobic exercise.
b. The patient says that the asthma symptoms are worse every spring.
c. The patient’s heart rate increases after using the albuterol (Ventolin HFA) inhaler.
d. The patient’s only medications are albuterol (Ventolin HFAl) and
salmeterol (Serevent).
ANS: D
Long-acting b2-agonists should be used only in patients who also are using an inhaled corticosteroid
for long- term control. Salmeterol should not be used as the first-line therapy for long-term control.
Using a bronchodilator before exercise is appropriate. The other information given by the patient
requires further assessment by the nurse but is not unusual for a patient with asthma.
2. The nurse takes an admission history on a patient with possible asthma who has
new-onset wheezing and shortness of breath. Which information may indicate a need for a
change in therapy?
a. The patient has chronic inflammatory bowel disease.
b. The patient has a history of pneumonia 6 months ago.
c. The patient takes propranolol (Inderal) for hypertension.
d. The patient uses acetaminophen (Tylenol) for
headaches. ANS: C
b-Blockers such as propranolol can cause bronchospasm in some patients with asthma. The other
information will be documented in the health history but does not indicate a need for a change in therapy.
3. A patient newly diagnosed with asthma is being discharged. The nurse anticipates
including which topic in the discharge teaching?
Use of long-acting b-adrenergic medications c. Self-administration of inhaled
corticosteroids a.
b. Side effects of sustained-release theophylline
d. Complications associated with O2
therapy ANS: C
Inhaled corticosteroids are more effective in improving asthma than any other drug and are indicated for
all patients with persistent asthma. The other therapies would not typically be first-line treatments for
newly diagnosed asthma.
4. A patient with cystic fibrosis (CF) has blood glucose levels that are consistently
between 180 to 250 mg/ dL. Which nursing action will the nurse plan to implement?
a. Discuss the role of diet in blood glucose control.
b. Evaluate the patient’s use of pancreatic enzymes.
c. Teach the patient about administration of insulin.
d. Give oral hypoglycemic medications before
1
meals. ANS: C
, The glucose levels indicate that the patient has developed CF-related diabetes, and insulin therapy is
required. Because the etiology of diabetes in CF is inadequate insulin production, oral hypoglycemic
agents are not effective. Patients with CF need a high-calorie diet. Inappropriate use of pancreatic
enzymes would not be a cause of hyperglycemia in a patient with CF.
5. The nurse assesses a patient with a history of asthma. Which assessment finding
indicates that the nurse should take immediate action?
a. Pulse oximetry reading of 91%
b. Respiratory rate of 26 breaths/min
c. Use of accessory muscles in breathing
d. Peak expiratory flow rate of 240
L/min ANS: C
Use of accessory muscle indicates that the patient is experiencing respiratory distress, and rapid
intervention is needed. The other data indicate the need for ongoing monitoring and assessment but do
not suggest that immediate treatment is required.
6. A patient who has been experiencing an asthma attack develops bradycardia and a
decrease in wheezing. Which action should the nurse take first?
a. Notify the health care provider.
b. Document changes in respiratory status.
c. Encourage the patient to cough and deep breathe.
d. Administer IV methylprednisolone (Solu-
Medrol). ANS: A
The patient’s assessment indicates impending respiratory failure, and the nurse should prepare to assist
with intubation and mechanical ventilation after notifying the health care provider. IV corticosteroids
require several hours before having any effect on respiratory status. The patient will not be able to
cough or deep breathe effectively. Documentation is not a priority at this time.
OBJ: Special Questions: Prioritization 36. A patient who is experiencing an acute asthma attack is
admitted to the emergency department. Which assessment should the nurse complete first?
a. Listen to the patient’s breath sounds.
b. Ask about inhaled corticosteroid use.
c. Determine when the dyspnea started.
d. Obtain the forced expiratory volume (FEV)
flow rate. ANS: A
Assessment of the patient’s breath sounds will help determine how effectively the patient is ventilating
and whether rapid intubation may be necessary. The length of time the attack has persisted is not as
important as determining the patient’s status at present. Most patients having an acute attack will be
unable to cooperate with an FEV measurement. It is important to know about the medications the patient
is using but not as important as assessing the breath sounds.
ALL HESI LINKS AVAILABLE
HESI PN MATERNAL NEWBERN OB EXAM (4 2
VERSIONS) / PN HESI MATERNAL NEWBERN OB
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