HERZING UNIVERSITY HESI Comprehensive
Exit Exam (And Rationale) Questions With
Complete Solutions
The nurse is planning care for a client who is having abdominal
surgery. To achieve desired postoperative outcomes, the nurse
includes interventions that promote progressive mobilization,
such as turn, cough, deep breathe, and early ambulation. Which
additional intervention should the nurse include?
a. Explain the rationale for each postoperative exercise and
intervention.
b. Praise client when actively participating in postoperative
exercises.
c. Administer analgesics prior to encouraging progressive
activities and ambulation.
d. Advise client about complications related to inactivity in the
postoperative period. Correct Answers C
(Effective pain management in the postoperative period
promotes the client's participation in exercises that promote
optimal healing and prevent complications, so the client should
be given an analgesic prior to mobilization. Although explaining
reason for moving promotes client understanding, it is more
important that the client's pain is managed to promote
cooperation and compliance in the care plan. Giving positive
feedback is helpful but is not as useful if the client is in pain.
Talking about complications may unduly scare the client.)
,The nurse is planning to conduct nutritional assessments and
diet teaching to clients at a family health clinic. Which
individual has the greatest nutritional and energy demands?
a. A pregnant woman.
b. A teenager beginning puberty.
c. A 3-month-old infant.
d. A school-aged child. Correct Answers A
A pregnant woman's metabolic demands are 20 to 24% more
than the basic metabolic rate. The other clients require only 15
to 20% more than the basic metabolic rate.
The nurse is preparing a client for a scheduled surgical
procedure. What client statement should the nurse report to the
healthcare provider?
a. Expresses fear about the surgical procedure.
b. Recalls drinking a glass of juice after midnight.
c. Reports a history of hives after eating shellfish.
d. States has a history of post-operative nausea. Correct
Answers B
(The risk of aspiration while under general anesthesia is
increased when the stomach is not empty prior to a surgical
procedure, so the client's intake of juice after midnight should be
reported the healthcare provider. Preoperative fear and anxiety
are common and should be further explored by the nurse.
Allergy to shellfish should be communicated using allergy
identification tags on the client's records and bracelets on the
client's wrist. Post-op nausea is a common and expected side
effect of perioperative medications.)
,The nurse is preparing to administer a high volume saline enema
to a client. Which information is most important for the nurse to
obtain prior to administering the enema?
a. History of inflammatory bowel disorders.
b. Reason for administering the enema.
c. Feelings about having an enema.
d. Allergies to medications. Correct Answers A
(Enemas should be avoided or administered with extreme
caution to clients with inflammatory bowel disorders, so
obtaining this historical information has the highest priority.
Reason for the enema and feelings about it also provide valuable
information, but are not of the same priority as history of IBS.
Allergies are not necessary prior to enema administration.)
The nurse is preparing to administer a prescribed dose of
acetylcysteine (Mucomyst) 600 mg PO. The 10 ml vial is
labeled "Mucomyst 20% solution (20 grams/100 ml)." What
volume of medication in milliliters should the nurse administer?
(Enter numeric value only.) Correct Answers 3
20 grams is equivalent to 20,000 mg.
20,000 mg/100 ml = 200 mg/1 ml.
Using Desired/Have X Volume:
600 mg/200 mg X 1 ml = 3 ml.
or
(Ordered over dispensed)
600mg/20000mg =0.03mg
, 0.03mg x 100ml= 3ml
A 9-year-old is hospitalized for neutropenia and is placed in
reverse isolation. The child asks the nurse, "Why do you have to
wear a gown and mask when you are in my room?" How should
the nurse respond?
a. "There are many forms of bacteria and germs in the hospital."
b. "To protect you because you can get an infection very easily."
c. "After taking medication for 24 hours a gown and mask won't
be needed."
d. "Your condition could be spread to staff and other clients in
the hospital." Correct Answers B
(Reverse isolation precaution implement measures to protect the
client from exposure to microorganisms from others. Although
microbes are prevalent in all environments, informing the child
about germs in hospital does not adequately answer the child's
question. Reverse isolation should be implemented until the
client's white blood cell increases. Neutropenia in this child does
not place others at risk for infection.)
A child is receiving maintenance intravenous (IV) fluids at the
rate of 1000 ml for the first 10 kg of body weight, plus 50 ml/kg
per day for each kilogram between 10 and 20. How many
milliliters per hour should the nurse program the infusion pump
for a child who weighs 19.5 kg?
(Enter numeric value only. If rounding is required, round to the
nearest whole number.) Correct Answers 61
The formula for calculating daily fluid requirements is:
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