Exam (elaborations)
HESI/SAUNDERS ONLINE REVIEW FOR THE NCLEX-RN EXAMINATION (1 YEAR) QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
HESI/SAUNDERS ONLINE REVIEW FOR THE NCLEX-RN EXAMINATION (1 YEAR) QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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HESI/SAUNDERS ONLINE REVIEW FOR
THE NCLEX-RN EXAMINATION (1 YEAR)
QUESTIONS AND ANSWERS WITH
SOLUTIONS 2024
AWnurseWisWassignedWtoWcareWforWaWclientWwithWchronicWrenalWfailureWwhoWisWundergoingWhemodialysisWt
hroughWanWinternalWarteriovenousW(AV)WfistulaWinWtheWrightWarm.WWhichWofWtheWfollowingWinterventions
WshouldWtheWnurseWimplementWinWcaringWforWtheWclient?WSelectWallWthatWapply.W
A)WAssessingWtheWradialWpulseWinWtheWrightWextremity
B)WUsingWtheWleftWarmWtoWtakeWbloodWpressureWreadings
C)WDrawingWpredialysisWbloodWspecimensWfromWtheWleftWarmWD)WAssessingWtheWareaWoverWtheWAVWfistula
WforWaWbruitWandWthrillWeachWshiftW
E)WPlacingWaWpressureWdressingWoverWtheWsiteWafterWeachWdialysisWtreatment
F)WAdministeringWintravenousW(IV)WfluidsWthroughWtheWvenousWsiteWofWtheWAVWfistulaWasWneededW-
WANSWERWAnswer(s):WA,B,C,D
Rationale:WSeveralWprecautionsWmustWbeWobservedWtoWensureWtheWfunctionWofWanWinternalWAVWfistula.WT
heWnurseWassessesWtheWfistula,WandWtheWdistalWportionWofWtheWextremity,WforWadequateWcirculation;Wche
cksWforWaWbruitWandWaWthrillWbyWmeansWofWauscultationWorWpalpationWoverWtheWaccessWsite;WmonitorsWth
eWradialWpulseWinWtheWextremity;WandWavoidsWtakingWbloodWpressureWreadingsWorWdrawingWbloodWfromWt
heWarmWwithWtheWAVWfistula.WVenipunctureWisWavoidedWinWtheWextremityWbearingWtheWAVWfistula.WBloodW
isWneverWdrawnWfromWtheWAVWfistula,WandWtheWAVWfistulaWisWnotWusedWforWtheWadministrationWofWIVWflui
ds.WTheWAVWfistulaWsiteWisWnotWcoveredWwithWaWpressureWdressingWafterWdialysis.
AWnurseWisWevaluatingWoutcomesWforWaWclientWwithWGuillain-
BarréWsyndrome.WWhichWofWtheWfollowingWoutcomesWdoesWtheWnurseWrecognizeWasWoptimalWrespiratoryW
outcomesWforWtheWclient?WSelectWallWthatWapply.W
A)WNormalWdeepWtendonWreflexes
B)WImprovedWskeletalWmuscleWtone
C)WAbsenceWofWparesthesiasWinWtheWlowerWextremitiesW
D)WClearWsoundsWinWtheWlowerWlungWfieldsWbilaterallyW
E)WPo2WofW85%WandWPco2WofW40WmmWHgW-WANSWERWAnswer(s):WD,E
Rationale:WSatisfactoryWrespiratoryWoutcomesWincludeWclearWbreathWsoundsWonWauscultation,WclearWmen
tation,WspontaneousWbreathing,WnormalWvitalWcapacity,WandWnormalWarterialWbloodWgases.WTheWABGWres
ultsWlistedWhereW—WaWPo2WofW85%WandWaWPco2WofW40WmmWHgW—
,WareWnormal.WTheWpresenceWofWnormalWdeepWtendonWreflexes,WimprovedWskeletalWmuscleWtone,WandWab
senceWofWparesthesiasWinWtheWlowerWextremitiesWreflectWimprovementWinWtheWsymptomsWassociatedWwit
hWGuillain-BarréWbutWareWnotWspecificWtoWaWrespiratoryWoutcome.
AWnurseWonWtheWtelemetryWunitWisWcaringWforWaWclientWwhoWhasWhadWaWmyocardialWinfarctionWandWisWno
wWattachedWtoWaWcardiacWmonitor.WTheWnurse,WmonitoringWtheWclient'sWcardiacWrhythm,WnotesWtheWrhyt
hmWdepictedWinWtheWimage.WWhichWofWtheWfollowingWnursingWactionsWshouldWtheWnurseWtake?
(RhythmWisWcontinuousWupWandWdownWinWpic)
A)WCallingWtheWrapidWresponseWteamW
B)WPreparingWtheWclientWforWcardioversionW
C)WAskingWtheWclientWtoWbearWdownWandWcough
D)WPreparingWtoWadministerWdiltiazemW(Cardiazem)W-WANSWERWAnswer:WA
Rationale:WThisWpatternWindicatesWventricularWfibrillationW(VF).WClientsWwhoWhaveWsustainedWaWmyocardi
alWinfarctionWareWatWgreatWriskWforWVF.WWithWtheWonsetWofWVFWtheWclientWfeelsWfaint,WthenWimmediatelyWl
osesWconsciousnessWandWbecomesWpulselessWandWapneic.WThereWisWnoWbloodWpressure,WandWheartWsoun
dsWareWabsent.WTheWgoalsWofWtreatmentWareWtoWterminateWVFWpromptlyWandWconvertWitWtoWanWorganize
dWrhythm.WBecauseWdefibrillationWisWtheWimmediateWtreatment,WtheWnurseWmustWcallWtheWrapidWrespons
eWteamWandWinitiateWcardiopulmonaryWresuscitation.WTheWclientWwouldWnotWbeWableWtoWbearWdownWorWc
ough.WCardioversionWisWaWsynchronizedWcountershockWthatWmayWbeWperformedWinWemergenciesWforWuns
tableWventricularWorWsupraventricularWtachydysrhythmiasWorWelectivelyWforWstableWtachydysrhythmiasWth
atWareWresistantWtoWmedicalWtherapiesWsuchWasWtheWadministrationWofWdiltiazemW(Cardiazem).
AWnurseWdevelopingWaWplanWofWcareWforWaWclientWwithWaWspinalWcordWinjuryWincludesWmeasuresWtoWpreve
ntWautonomicWdysreflexiaW(hyperreflexia).WWhichWofWtheWfollowingWinterventionsWdoesWtheWnurseWincor
porateWintoWtheWplanWtoWpreventWthisWcomplication?
A)WKeepingWaWfanWrunningWinWtheWclient'sWroom
B)WKeepingWtheWlinensWwrinkle-freeWunderWtheWclientW
C)WLimitingWbladderWcatheterizationWtoWonceWeveryW12Whours
D)WAvoidingWtheWadministrationWofWenemasWandWrectalWsuppositoriesW-WANSWERWAnswer:WB
Rationale:WTheWmostWfrequentWcausesWofWautonomicWdysreflexiaWareWaWdistendedWbladderWandWimpacte
dWfecesWinWtheWrectum.WStraightWcatheterizationWshouldWbeWperformedWeveryW4WtoW6Whours,WandWtheWF
oleyWcatheterWshouldWbeWcheckedWfrequentlyWtoWpreventWkinksWinWtheWtubing.WConstipationWandWfecalWi
mpactionWareWotherWcauses,WsoWmaintainingWbowelWregularityWisWimportant.WOtherWcausesWincludeWstim
ulationWofWtheWskinWbyWtactile,Wthermal,WorWpainfulWstimuli.WTheWnurseWrendersWcareWinWsuchWaWwayWasW
toWminimizeWriskWinWtheseWareas.
,AWnurseWprovidesWhomeWcareWinstructionsWtoWaWclientWwhoWhasWbeenWfittedWwithWaWhaloWdeviceWtoWtre
atWaWcervicalWfracture.WWhichWstatementWbyWtheWclientWindicatesWtheWneedWforWfurtherWinstruction?
A)W"IWneedWtoWgetWmoreWfluidsWandWfiberWintoWmyWdiet."
B)W"IWshouldWcutWmyWfoodWintoWsmallWpiecesWbeforeWIWeat."
C)W"IWneedWtoWputWpowderWunderWtheWvestWtwiceWaWdayWtoWpreventWsweating."W
D)W"IWhaveWtoWcheckWtheWpinWsitesWeveryWdayWandWwatchWforWsignsWofWinfection."W-WANSWERWAnswer:WC
Rationale:WTheWclientWshouldWcleanseWtheWskinWunderWtheWlambs-
woolWlinerWeachWdayWtoWpreventWrashesWorWsores.WPowderWorWlotionsWshouldWbeWusedWonlyWsparinglyWo
rWnotWatWallWbecauseWtheyWmayWcake,WresultingWinWskinWirritation.WTheWclientWshouldWincreaseWintakeWofW
fluidWandWfiberWtoWhelpWpreventWconstipation.WFoodWshouldWbeWcutWintoWsmallWpiecesWtoWfacilitateWche
wingWandWswallowing.WTheWclientWshouldWalsoWuseWaWstrawWforWdrinking.WTheWpinWsitesWshouldWbeWchec
kedWdailyWforWsignsWofWinfection.
AWnurseWisWcaringWforWclientWwithWincreasedWintracranialWpressureW(ICP).WInWwhichWpositionWshouldWtheW
nurseWmaintainWtheWclient?
A)WSupine,WwithWtheWheadWextended
B)WSide-lying,WwithWtheWneckWflexed
C)WSupine,WwithWtheWheadWturnedWtoWtheWside
D)WHeadWmidlineWandWelevatedW30WtoW45WdegreesW-WANSWERWAnswer:WD
Rationale:WTheWclientWwithWincreasedWICPWshouldWbeWpositionedWwithWtheWheadWinWaWneutralWmidlineWp
osition.WItWisWtheWresponsibilityWofWtheWnurseWtoWensureWthatWallWthoseWdeliveringWcareWtoWtheWclientWm
aintainWtheWproperWpositioning.WTheWclientWshouldWavoidWflexingWorWextendingWtheWneckWorWturningWthe
WneckWsideWtoWside.WTheWheadWofWtheWbedWshouldWbeWraisedWtoW30WtoW45Wdegrees.WUseWofWproperWposi
tioningWpromotesWvenousWdrainageWfromWtheWcraniumWtoWkeepWICPWdown.
AWclientWwithWaWbasilarWskullWfractureWhasWclearWfluidWleakingWfromWtheWears.WTheWnurseWshould:
A)WAssessWtheWclearWfluidWforWprotein
B)WCheckWtheWclearWfluidWforWtheWpresenceWofWglucoseW
C)WPlaceWcottonWballsWorWdryWgauzeWlooselyWinWtheWears
D)WUseWanWotoscopeWtoWassessWtheWtympanicWmembraneWforWruptureW-WANSWERWAnswer:WB
Rationale:WLeakageWofWcerebrospinalWfluidW(CSF)WfromWtheWearsWorWnoseWmayWaccompanyWbasilarWskullW
fracture.WCSFWcanWbeWdistinguishedWfromWotherWbodyWfluidsWbecauseWitWwillWseparateWintoWbloodyWandW
, yellowWconcentricWringsWonWdressingWmaterial,WaWphenomenonWreferredWtoWasWtheWhaloWsign.WItWalsoWte
stsWpositiveWforWglucose.WCSFWdoesWnotWcontainWprotein.WTheWpresenceWofWCSFWindicatesWaWdisruptionWi
nWtheWintegrityWofWtheWcranium.WThereforeWinsertingWcottonWballs,Wgauze,WorWanWotoscopeWintoWtheWear
WputsWtheWclientWatWriskWforWinfection.
AWnurseWisWcaringWforWaWclientWwhoWhasWjustWundergoneWcardioversion.WWhichWofWtheWfollowingWinterve
ntionsWisWtheWnurse'sWpriorityWafterWthisWprocedure?
A)WAdministeringWoxygenW
B)WMonitoringWtheWbloodWpressure
C)WAdministeringWantidysrhythmicWmedicationsW
D)WMonitoringWtheWclient'sWlevelWofWconsciousnessW-WANSWERWAnswer:WA
Rationale:WNursingWresponsibilitiesWafterWcardioversionWincludeWmaintenanceWofWaWpatentWairway,Woxyg
enWadministration,WassessmentWofWvitalWsignsWandWlevelWofWconsciousness,WandWdetectionWofWdysrhythm
ias.WTheWpriorityWnursingWinterventionWhereWisWadministeringWoxygen.
AWclientWwithWdiabetesWmellitusWwhoWisWscheduledWtoWhaveWbloodWdrawnWforWdeterminationWofWtheWgly
cosylatedWhemoglobinW(HbA1C)WlevelWasksWtheWnurseWwhyWtheWtestWisWnecessaryWifWheWisWperformingWbl
oodWglucoseWmonitoringWatWhome.WTheWnurseWtellsWtheWclientWthatWthisWtestWisWusedWspecificallyWto:
A)WDetectWdiabeticWcomplications
B)WAssessWlong-termWglycemicWcontrolW
C)WDetermineWwhetherWtheWclientWisWatWriskWforWhypoglycemia
D)WDetermineWwhetherWtheWprescribedWinsulinWdosageWisWadequateW-WANSWERWAnswer:WB
Rationale:WTheWHbA1CWreadingWprovidesWanWindicationWofWglycemicWcontrolWoverWtheWprecedingW3Wmon
ths.WAnWHbA1CWvalueWofWlessWthanW7%WindicatesWgoodWglycemicWcontrol.WWhenWincreasesWinWtheWblood
WglucoseWoccur,WsomeWglucoseWmoleculesWattachWthemselvesWtoWredWbloodWcellsW(RBCs)WandWremainWth
ereWforWtheWlifeWofWtheWRBCs.WThereforeWaWhighWvalueWonWthisWtestWisWcorrelatedWwithWaWhighWbloodWglu
coseWlevel,WindicatingWpoorWlong-
termWcontrolWofWbloodWglucose,WwhichWoftenWleadsWtoWtheWdevelopmentWofWcomplicationsWinWtheWclient
WwithWdiabetesWmellitus.WTheWotherWoptionsWareWnotWpurposesWforWthisWtest.
AWnurseWcaringWforWaWclientWwithWAIDSWisWmonitoringWtheWclientWforWsignsWofWcomplications.WWhichWofWt
heWfollowingWfindingsWwouldWcauseWtheWnurseWtoWsuspectWinfectionWwithWPneumocystisWjiroveci?WSelect
WallWthatWapply.
A)WDiarrheaW