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Exam (elaborations)

HESI PN MEDICAL SURGICAL 2024 TEST BANK /MEDICAL SURGICAL HESI EXIT 2024 TEST BANK

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HESI PN MEDICAL SURGICAL 2024 TEST BANK /MEDICAL SURGICAL HESI EXIT 2024 TEST BANK

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  • October 8, 2024
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  • 2024/2025
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  • HESI PN MEDICAL SURGICAL
  • HESI PN MEDICAL SURGICAL
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Terms in this set (223)


TEST D. Sodium 132 mEq/L
A nurse is caring for a
client who is taking lithium Rationale:
and reports persistent
nausea and vomiting for 2 The nurse should identify that a sodium level of 132
days. Which of the mEq/L is not within the expected reference range of
following laboratory 136 to 145 mEq/L. This finding indicates hyponatremia,
values should the nurse which can lead to lithium accumulation and places the
report to the provider? client at risk for lithium toxicity. The nurse should
report this finding to the provider.
a) Potassium 4.0 mEq/L
b) Lithium 0.9 mEq/L
c) BUN 12 mg/dL
d) Sodium 132 mEq/L

,A nurse is caring for a A. Cleanse the client's toothbrush with hydrogen
client who has cancer and peroxide.
has a WBC count of
4,000/mm3. Which of the Rationale:
following
actions should the nurse A WBC count of 4,000/mm3 is considered low and is
take? known as leukopenia. A low WBC count can be
caused by cancer or cancer treatment. The nurse
a) Cleanse the client's should instruct the client to cleanse their toothbrush
toothbrush with hydrogen with hydrogen peroxide. People with leukemia or
peroxide. leukopenia should avoid using disposable razors,
b) Instruct the client to use which can cause cuts and bleeding that can lead to
a disposable razor to infections. Instead, they recommend using an electric
shave. razor to reduce the risk of injury. Encouraging the
c) Decrease the client's client to eat unpasteurized dairy products is not
protein intake. recommended as they can contain harmful bacteria
d) Encourage the client to that can cause infections. Decreasing the client's
eat unpasteurized dairy protein intake is not recommended as protein is
products. important for wound healing and immune function

,TEST C. Assist the client to a nearby common area.
A nurse enters a client's
room and sees smoke Rationale:
coming from the
bathroom. Which of the use
following actions should Rescue
the nurse take first? Alarm
Contain
a) Activate the fire alarm Extinguish
system.
b) Use a fire extinguisher
at the source of the
smoke.
c) Assist the client to a
nearby common area.
d) Close the doors to the
room and to the
bathroom.

, TEST A. Apply foam handles to the client's eating utensils.
A nurse is contributing to
the plan of care for a Rationale:
client who reports
difficulty eating due to To help a client with chronic arthritis who experiences
chronic arthritis. Which of difficulty eating, applying foam handles to the eating
the following interventions utensils can provide a larger, more comfortable grip
should the nurse include and reduce strain on the joints. Asking for a puree diet
in the plan? may not be necessary unless swallowing difficulties
are present. Having an assistive personnel feed the
a) Apply foam handles to client may not promote independence. While
the client's eating utensils. obtaining a referral for physical therapy may be
b) Obtain a referral for beneficial for overall mobility, it does not directly
physical therapy. address the client's difficulty with eating.
c) Have an assistive
personnel feed the client.
d) Ask the provider for a
prescription for a pureed
diet.

C. "Face in the direction of the client's movement."
A nurse is providing
directions to an assistive
Rational:
personnel about moving a
client up in bed.
When moving a client up in bed, it is important for the
nurse to face in the direction of the client's movement
a. "Place a pillow under
to maintain proper body mechanics and ensure safe
the client's head prior to
transfer.
repositioning."
b. "Keep your feet close
1)Adjust the head of the bed to a flat position.
together while moving the
2)Remove all pillows from under the client.
client"
3)Position the UAP on the side opposite the nurse.
c "Face in the direction of
4)Place a friction-reducing sheet under the client.
the client's movement"
5)Ask the client to bend the legs and place the chin
d. "Move the client's arms
on the chest.
to his sides prior to
6)Grasp the sheet and move the client on the count of
repositioning."
three.

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