HESI Evolve Comprehensive Exam 2 Questions and Answers 2023 (Verified Answers)
1. A parent whose 12-year-old child has been inhaling paint fumes asks the nurse, "Can he become addicted to paint fumes?" What is the best response for the nurse to provide?
A. Any time you use an illegal substanc...
HESI Evolve Comprehensive Exam 2 Questions and
Answers 2023 (Verified Answers)
1. A parent whose 12-year-old child has been inhaling paint fumes asks the nurse,
"Can he become addicted to paint fumes?" What is the best response for the
nurse to provide?
A. Any time you use an illegal substance, you are abusing drugs.
B. Tell me what you think may have caused him to start inhaling paint fumes.
C. Only hard drugs like cocaine and heroin can cause problems with addiction.
D. Abuse of any of the inhalants can eventually lead to addiction.
D. Abuse of any of the inhalants can eventually lead to addiction.
Any inhalant can become addictive. Any substance that is used to alter perception can
be addictive and is not limited to the common street drugs.
2. A young adult female is brought to the emergency room by family members
who report that she ingested a large quantity of acetaminophen (Tylenol). The
nurse should prepare for which treatment to be implemented?
A. Gastric lavage with normal saline.
B. IV administration of Narcan.
C. Syrup of ipecac per nasogastric tube.
D. Acetylcysteine (Mucomyst) 140 mg/kg.
- Acetylcysteine (Mucomyst) 140 mg/kg.
Mucomyst (D) is the antidote for acute acetaminophen (Tylenol) poisoning and is the
treatment of choice for an overdose. (B) is used for an overdose of narcotics. (C) is
used for ingestion of non-corrosive products such as iron tablets. (A) might also be
implemented, depending on the amount of drugs ingested and the time elapsed since
ingestion.
3. An 8-year-old male client with nephrotic syndrome is in remission following
treatment with prednisone (Deltasone). The nurse should teach the child to check
his urine for which finding?
A. Ketones.
B. Protein.
C. White blood cells.
D. Glucose.
B. Protein.
Children should be taught to check for protein (albumin) (B) in the urine daily, because a
positive reading for protein in the urine is often the only indicator of a relapse of
nephrotic syndrome. (C) is an indication of infection. (A and D) should be assessed
,while the child is receiving corticosteroid therapy, since corticosteroids increase blood
glucose.
4. When making a home visit to a family with a teething 4-month-old, what
information is most important for the nurse to provide the parents?
A. No action is required for the common symptoms associated with teething,
which include drooling, irritability, and poor sleeping.
B. A slight fever is often associated with teething, but a fever lasting more than
three days requires medical attention.
C. Though child development is characterized by individual differences, first teeth
usually erupt during the seventh month.
D. Providing cooled teething toys can help decrease the discomfort associated
with tooth eruption.
B. A slight fever is often associated with teething, but a fever lasting more than three
days requires medical attention.
A slight fever that persists longer than three days is likely to be associated with a
pathological process, not teething, and the parents should seek the attention of their
healthcare provider if it occurs (B). (A, C, and D) provide useful information about
teething, but do not have the priority of (B).
5. To treat cystitis, a 14-day course of treatment with cephalexin (Ceclor) is
prescribed for a client residing in a long-term care facility. Which action is most
important for the nurse to take prior to administering the first dose of this
medication?
A. Take the client's vital signs prior to the first dose and once daily for 14 days.
B. Determine if the client has ever had a hypersensitivity reaction to penicillins.
C. Review the client's fasting blood glucose levels for a hyperglycemic trend.
D. Restrict the use of dairy products in the client's diet for the next 3 weeks.
B. Determine if the client has ever had a hypersensitivity reaction to penicillins.
Most individuals who have an allergy to penicillins (B) are at risk of hypersensitivity to
cephalosporins. To prevent a potential hypersensitivity reaction that could cause a life-
threatening episode of anaphylactic shock, the nurse must determine if the client has a
known penicillin allergy before giving the client a cephalexin (Ceclor) dose. (A, C, and
D) are not required interventions for the administration of cephalexin (Ceclor).
6. A staff member tells the charge nurse that a float nurse assigned to work on
the unit has made several medication errors in the past, but is currently working
with the education department to improve this skill. What action is best for the
charge nurse to take?
A. Arrange for someone to be available to assess and assist the float nurse.
B. Assign the float nurse to function as a UAP for the day.
C. Dismiss the staff nurse's report about the float nurse because it may be just
gossip.
,D. Call the nursing supervisor and request a different employee be sent to the
unit.
A. Arrange for someone to be available to assess and assist the float nurse.
The float nurse is receiving education, but careful assessment of her or his skills and
assistance, as needed, is still warranted, so (A) is the best choice. Though the staff
member's report may indeed be gossip, failure to pay attention to the information could
constitute negligence on the part of the charge nurse (C). (D) is not the best way to
manage the unit. (B) is not the best use of a licensed person and would also eliminate
the float nurse's opportunity to improve medication administration skills.
7. The blood pressure readings obtained by a unlicensed assistive personnel
(UAP) are consistently different from those obtained by other staff members.
What action should the charge nurse take first?
A. Ask the education department to provide additional training for the UAP.
B. Observe the UAP performing blood pressure measurements.
C. Make staff members aware of the possible errors in blood pressure readings.
D. Counsel the UAP about the inaccurate blood pressure readings.
B. Observe the UAP performing blood pressure measurements.
The charge nurse should first observe the UAP's performance (B), then take appropriate
action, which might include (A, C and D).
8. A client at 13-weeks' gestation is scheduled for an amniocentesis in one week.
The nurse knows that the primary reason for conducting this procedure is to
obtain what information?
A. Quantification of alpha-fetoprotein levels.
B. Level of fetal lung maturity.
C. Presence of genetic disorders.
D. Determination of gestational age.
C. Presence of genetic disorders.
Amniocentesis is done at 14 to 16 weeks' gestation to determine chromosomal, genetic,
and metabolic disorders (C). Amniocentesis in the third trimester assesses fetal lung
maturity (B) by evaluating the lecithin/sphingomyelin (L/S) ratio and the presence of
phosphatidylglycerol (PG). Amniocentesis is performed to quantify alpha-fetoprotein
levels (A) after abnormal maternal serum alpha-fetoprotein levels (done at 15 to 18
weeks) are found. While specific levels of creatinine, bilirubin, and lipid cells are present
in amniotic fluid only after 35 to 36 weeks' gestation, gestational age (D) is commonly
evaluated by ultrasound.
9. A hospitalized 5-year-old boy recovering from surgery refuses to drink fluids.
Which intervention is best for the nurse to implement?
A. Ask the parents to participate in encouraging the child's fluid intake.
B. Offer the child a popsicle and allow him to pick the flavor he prefers.
C. Tell the child he can go outside after he drinks a full glass of water.
, D. Make a game of seeing who can finish a glass of water first--the nurse or the
child.
B. Offer the child a popsicle and allow him to pick the flavor he prefers.
Fluids in popsicle form (B) are an excellent choice for a child, and small children react
best when they are provided with possible choices, such as choosing a flavor. (D) is a
good intervention, but (B) is better. (C) is manipulative and the nurse must be careful
not to make promises that may not be possible. Although (A) may be useful, it may also
be manipulative and is not as likely as (B) to obtain the ultimate goal of increasing fluids.
10. An overweight adolescent girl has been to the school nurse three times in the
last two months complaining of vaginal and urinary tract infections. What action
should the nurse take first?
A. Counsel the girl regarding hygiene.
B. Ask if she is going to the bathroom frequently.
C. Teach the girl the importance of practicing safe sex.
D. Encourage the girl to see the school counselor.
B. Ask if she is going to the bathroom frequently.
All actions might be implemented, depending on further assessment findings. However,
based on the data presented, the nurse should ask questions directed toward
symptoms of diabetes (B). Recurrent vaginal and urinary tract infections are often an
early sign of IDDM. (A, C, and D) require further assessment data to support their
implementation.
11. About mid-morning, a 10-year-old child reports to the school nurse
complaining of nausea, dizziness, and chills. Further assessment reveals that this
child is sweating profusely and has a blood glucose level of 57 mg/dl. Based on
these assessment findings, which food is best for the nurse to encourage the
child to eat?
A. A piece of bubble gum.
B. Peanut butter crackers.
C. A chocolate bar.
D. A soft drink.
B. Peanut butter crackers.
Peanut butter crackers (B) provide a complex carbohydrate, plus protein and fat. This
child is exhibiting signs and symptoms of mild to moderate hypoglycemia and needs to
eat about 15 grams of carbohydrates to increase the blood sugar level. Complex
carbohydrates are broken down more slowly and are slower acting than simple sugars,
so they prevent the blood glucose level from peaking and then dropping precipitously.
(A, C, and D) contain only simple sugars.
12. When examining the wound of a client who had abdominal surgery yesterday,
the nurse finds that the wound edges are close together, there is no sign of
redness, and there is a slight amount of bright red blood oozing from the incision.
What action should the nurse take?
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