2024 HESI EXIT COMPREHENSIVE REVIEW A+ GRADE LATEST EXAM [NEW GENERATION]
1.The nurse is correct in withholding an older adult client's dose of nifedipine if which assessment finding is obtained?
A. Blood pressure of 90/56 mm Hg
B. Apical pulse rate of 68 beats/min
C. Potassium...
2024 HESI EXIT COMPREHENSIVE REVIEW A+ GRADE LATEST
EXAM [NEW GENERATION]
1. The nurse is correct in withholding an older adult client's dose of
nifedipine if which assessment finding is obtained?
A. Blood pressure of 90/56 mm Hg
B. Apical pulse rate of 68 beats/min
C. Potassium level of 3.3 mEq/L
D. Urine output of 200 mL in 4 hours
Rationale:
Nifedipine is a calcium channel blocker that causes a decrease in blood
pressure. It should be withheld if the blood pressure is lowered, and
90/56 mm Hg is a low blood pressure for an adult male. A pulse rate <60
beats/min is an indication to withhold the drug. A potassium level of 3.3
mEq/L is low (normal, 3.5 to 5.0 mEq/L), but this finding does not affect
the administration of Procardia. Urine output of more than 30 mL/hr, or
120 mL in 4 hours, is normal. Although a 200-mL output in 4 hours is
slightly less than normal and warrants follow-up, it is not an indication
to withhold a nifedipine (Procardia) dose.
2. Until the census on the obstetrics (OB) unit increases, an
unlicensed assistive personnel (UAP) who usually works in labor
and delivery and the newborn nursery is assigned to work on the
postoperative unit. Which client would be best for the charge nurse
to assign to this UAP?
A. An adolescent who was readmitted to the
hospital because of a postoperative
infection
B. A woman with a new colostomy who
requires discharge teaching
C. A woman who had a hip replacement and
may be transferred to the home care unit
, D. A man who had a cholecystectomy and
currently has a nasogastric tube set to
intermittent suction
Rationale:
A hip replacement is considered a clean case, and transferring the client
to another unit is likely to involve physically moving the client and her
belongings. The charge nurse will be responsible for providing a report
to the home care unit if the transfer occurs. The adolescent client is
infected, and an employee who works on an OB unit should be assigned
to clean cases in case the employee is required to return to the OB unit.
This requires the skills of a registered nurse (RN) to do discharge
teaching and provide emotional support. This may require skills beyond
the level of this UAP.
3. A very busy hospital unit has had several discharges and the
census is unusually low. What is the best way for the charge nurse
to use the time of the nursing staff?
A. Encourage staff to participate in online in-
service education.
B. Assign staff to make sure that all
equipment is thoroughly cleaned.
C. Ask which staff members would like to go
home for the remainder of the day.
D. Notify the supervisor that the staff needs
additional assignments.
Rationale:
Online educational programs are available
around the clock, so staff can engage in
continuing education programs when the
opportunity arises, such as during periods
of low census. Option B is not the
responsibility of the nursing staff. Option
C is not the best use of staff and does not
, use the extra time provided by the low
census. The charge nurse should use the
time to improve the unit, and requesting
additional assignments is not necessary.
4. When the administration at a large urban medical center decides to
establish a unit to care for clients with infectious diseases, such as
ebola and the avian flu, several employees express fear related to
caring for these clients. When choosing staff to work on this unit,
which action is best for the nurse-manager to take?
A. Make it clear that no one who is afraid to
care for clients with rare disorders will be
permitted to work on the unit.
B. Conduct an education program about
infectious diseases and then assess the
staff's willingness to work with these
clients.
C. Introduce the staff to the family of a client
who has been treated for SARS and ask the
staff to share their fears with this family.
D. Assign staff based on the needs of the unit,
providing peer counseling for those staff
members who express fear.
Rationale:
Fear is often related to a lack of knowledge and an education program
about the relevant disorders would be appropriate, but after the
education program, the nursing staff should be reassessed regarding their
willingness to work with these clients. Option A is too authoritarian and
does not permit education to play a role in reducing fears. Option C is
likely to be intrusive to the family member. Arbitrary staffing without
education does not reduce staff fears, even with the provision of peer
counseling.
, 5. The nurse is planning a community teaching program regarding the
use of folic acid to prevent neural tube birth defects. Which
community group is likely to benefit most from this program?
A. Parents of children with spina bifida
B. High school girls in a health class
C. Class of people interested in having
children
D. Postpartum women attending a baby care
class
Rationale:
Folic acid is needed early in pregnancy to prevent neural tube defects;
the group most likely to be considering pregnancy is option C. Parents
with children who already have a neural tube defect such as spina bifida
are not as invested in the content as option C. High school age students
may have interest in the topic but as a group are less likely to anticipate
the likelihood that problems could occur in their lives than option C.
Option D may be interested if planning future pregnancies, but have
higher learning priorities during the postpartum period.
6. Staff on a cardiac unit consists of an RN, two practical nurses
(PNs), and one UAP. Team 1's assignment includes two clients
who are both 1 day postangioplasty and two clients with unstable
angina. Team 2's assignment includes all stable clients, but two
clients are bedridden and incontinent. Which staffing plan
represents the best use of available staff?
A. Team 1: RN team leader, PN; team 2: PN
team leader, UAP
B. Team 1: RN team leader, UAP; team 2: PN
team leader, PN
C. Team 1: PN team leader, PN; team 2: RN
team leader, UAP
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