HESI EXIT EXAM 4 A client is receiving furosemide (Lasix) to relieve edema. The nurse should monitor the client for which response to the medication? 1 Retention of sodium ions 2 Negative nitrogen balance Correct3 Excessive loss of potassium ions 4 Increase in the urine specific gravity Furosemide ...
hesi exit exam 4 a client is receiving furosemide lasix to relieve edema the nurse should monitor the client for which response to the medication 1 retention of sodium ions 2 negative nitrogen bal
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HESI EXIT EXAM 4
A client is receiving furosemide (Lasix) to relieve edema. The nurse should monitor the client for which
response to the medication?
1
Retention of sodium ions
2
Negative nitrogen balance
Correct3
Excessive loss of potassium ions
4
Increase in the urine specific gravity
Furosemide is a potent diuretic used to provide rapid diuresis; it acts in the loop of Henle and causes depletion of
electrolytes, such as potassium and sodium. Furosemide inhibits the reabsorption, not retention, of sodium.
Furosemide does not affect protein metabolism. With edema, the specific gravity of the fluid more likely will be
low.
Test-Taking Tip: Pace yourself when taking practice quizzes. Because most nursing exams have specified time
limits, you should pace yourself during the practice testing period accordingly. It is helpful to estimate the time that
can be spent on each item and still complete the examination in the allotted time. You can obtain this figure by
dividing the testing time by the number of items on the test. For example, a 1-hour (60-minute) testing period with
50 items averages 1.2 minutes per question. The NCLEX exam is not a timed test. Both the number of questions and
the time to complete the test varies according to each candidate's performance. However, if the test taker uses the
maximum of 5 hours to answer the maximum of 265 questions, each question equals 1.3 minutes.
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5. 140407851
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5.
A routine urinalysis is prescribed for a client. What should the nurse do if the specimen cannot be sent
immediately to the laboratory?
1
Take no special action.
Correct2
Refrigerate the specimen.
3
Store it in the dirty utility room and send it later.
4
Discard the specimen and collect another specimen later.
,Refrigeration retards the growth of bacteria and may preserve the specimen for several hours. Growth of bacteria
will alter the pH and the glucose and protein levels in the urine; it must be refrigerated to retard growth. Discarding
the specimen and collecting another specimen later represents an unnecessary waste of time, effort, and money.
Test-Taking Tip: Being emotionally prepared for an examination is key to your success. Proper use of this text over
an extended period of time ensures your understanding of the mechanics of the examination and increases your
confidence about your nursing knowledge. Your lifelong dream of becoming a nurse is now within your reach! You
are excited, yet anxious. This feeling is normal. A little anxiety can be good because it increases awareness of
reality; but excessive anxiety has the opposite effect, acting as a barrier and keeping you from reaching your goal.
Your attitude about yourself and your goals will help keep you focused, adding to your strength and inner conviction
to achieve success.
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7. 140350078
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7.
A nurse is notified that the latest potassium level for a client in acute renal failure is 6.2 mEq. What action
should the nurse take?
1
Alert the cardiac arrest team
2
Call the laboratory to repeat the test
Correct3
Take vital signs and notify the primary health care provider
4
Obtain an ECG strip and obtain an antiarrhythmic medication
Vital signs monitor the cardiopulmonary status; the health care provider must treat this hyperkalemia to prevent
cardiac dysrhythmias. The cardiac arrest team responds to a cardiac arrest; there is no sign of arrest in this client. A
repeat laboratory test will take time and probably reaffirm the original results; the client needs medical attention.
Obtaining an ECG strip and having an antiarrhythmic available are correct interventions if available, but
the priority is medical attention and the health care provider should be notified immediately.
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8. 130049918
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8.
A client with a diagnosis of uncontrolled diabetes began receiving Lasix (Furosemide) two days ago. The
nurse reviews the morning lab results and discovers that the client's potassium level is 2.8 mEq/L. What is
the most appropriate action for the nurse to take?
,1
Hold the morning dose of the diuretic and have the lab repeat the test.
2
Continue to monitor the level to ensure that it stays within the normal limits.
Correct3
Notify the primary healthcare provider of the result, which is critically low.
4
Anticipate a prescription for an increase in the dosage of the Lasix.
The physician should be notified because a potassium level of 2.8 mEq/L is low. Normal range for serum potassium
is 3.5 to 5 mEq/L. Clients who are on diuretics require monitoring of serum electrolytes, especially potassium and
sodium, because they also are excreted with water. The nurse should not hold the diuretic or repeat the lab test
unless advised by the physician. The client's serum potassium level is critically below the normal limit and the
physician should be notified. An increase in Lasix would cause an increased loss of potassium.
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9.
Which is the most serious complication for which the nurse must monitor a client with kidney failure?
1
Anemia
2
Weight loss
Correct3
Hyperkalemia
4
Platelet dysfunction
Decreased glomerular filtration leads to hyperkalemia, which may cause lethal dysrhythmias such as cardiac arrest.
Anemia may occur, but is not the most serious complication and should be treated in relation to the client's clinical
manifestation; erythropoietin and iron supplements usually are used. Weight loss alone is not life threatening.
Platelet dysfunction may occur because of decreased cell surface adhesiveness, but it is not as life threatening as
hyperkalemia.
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11.
, An obese client who is mildly hypertensive is hospitalized with a diagnosis of ureteral colic and
hematuria. What is the immediate focus of nursing care for this client?
Correct1
Pain
2
Weight
3
Hematuria
4
Hypertension
Sharp, severe pain (renal colic) radiating toward the genitalia and thigh is caused by ureteral distention and smooth
muscle spasm; relief from pain is the priority. Although the client is overweight and weight loss is desirable, it is a
long-term goal. Although hematuria needs to be monitored, blood loss usually is not massive with ureteral colic.
Mild hypertension is not the priority when a client is in severe pain.
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1.
A client in a nursing home is diagnosed with urethritis. What should the nurse plan to do before initiating
antibiotic therapy prescribed by the health care provider?
1
Prepare for urinary catheterization.
Incorrect2
Teach the client how to perform perineal care.
3
Start a 24-hour urine collection.
Correct4
Obtain a urine specimen for culture and sensitivity.
The causative organism should be isolated before starting antibiotic therapy. Catheterization is not a routine
intervention for urethritis. Although client teaching is important, it is not the priority at this time. A 24-hour urine
test will not determine the infective organism causing the problem.
Test-Taking Tip: Practicing a few relaxation techniques may prove helpful on the day of an examination.
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