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Hesi Comprehensive Exam 3 – Questions And Answers
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A 38-year-old female client is admitted to the mental health unit after a recent manic episode of spending large amounts of money on new furniture, making excessive long-distance phone calls, and not sleeping for three days. During the admission process, the client is wearing a green bathing suit. ...

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  • June 17, 2022
  • 10
  • 2021/2022
  • Exam (elaborations)
  • Questions & answers

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  • hesi comprehensive exam 3 – questions and answers

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Hesi Comprehensive Exam 3 – Questions And
Answers

A 38-year-old female client is admitted to the mental health unit after a recent
manic episode of spending large amounts of money on new furniture, making
excessive long-distance phone calls, and not sleeping for three days. During the
admission process, the client is wearing a green bathing suit. What intervention
should the nurse implement? Correct Ans:- Assess the client's needs for food,
liquids, and rest.

During a group therapy session, a client with hypomania threatens to strike another
client. What intervention is best for the nurse to implement? Correct Ans:- Firmly
inform the client that acting out anger is not acceptable.

A client who is a laboratory technician and has a history of allergic rhinitis, asthma,
and multiple food allergies is scheduled for surgery. Which action should the nurse
implement? Correct Ans:- Document a possible Type I latex allergy.

In reviewing the medical record, the nurse notes that a client's last eye examination
revealed an IOP of 28 mmHg. What information should the nurse ask the client?
Correct Ans:- Use of prescribed eye drops since last exam by ophthalmologist.

Which action should the nurse implement to assess for JVD in a client with HF?
Correct Ans:- Observe the vertical distention of the veins as the client is gradually
elevated to an upright position.

The nurse identifies a client's laboratory results and identifies an elevated serum
ammonia level. Which pathophysiological process contributes to this finding?
Correct Ans:- Failure of the liver to convert ammonia absorbed from the bowel to
urea.

A client with GERD is unconscious and unresponsive to stimuli. The nurse places the
client in a side-lying position. The nurse should monitor for the risk of which
complication? Correct Ans:- Aspiration pneumonia.

A client returns to the unit after abdominal Nissen fundoplication for treatment of
GERD. After 4 hours, the nurse determines the client has no drainage from the NGT
and has absent bowel sounds. What action should the nurse implement? Correct
Ans:- Irrigate the NGT with normal saline.

A male client who is admitted with a bleeding peptic ulcer develops sudden, severe
upper abdominal pain. The client becomes diaphoretic and draws his knees over his
abdomen. Which finding should the nurse report to the healthcare provider?
Correct Ans:- A rigid, boardlike abdomen.

A client returns to the postoperative unit after a gastroduodenostomy (Billroth I) for
treatment of a perforated ulcer. The healthcare provider's prescriptions include
morphine with a patient-controlled analgesia (PCA), nasogastric tube (NGT) to low

, intermittent nasogastric suction, and IV fluids and antibiotics. The client complains
of increasing abdominal pain 12 hours after returning to the surgical unit. The nurse
determines the client has no bowel sounds, and 200 ml of bright red nasogastric
drainage is in the suction canister in the past hour. What is the priority action the
nurse should implement? Correct Ans:- Notify the healthcare provider.

A patient returns from surgery following an abdominal-perineal resection with a
sigmoid colostomy and abdominal and perineal incisions. The colostomy is dressed
with petroleum jelly gauze and dry gauze dressings. The perineal incision is partially
closed and has two drains attached to Jackson-Pratt suction. On the first
postoperative day, the nurse gives the highest priority to
a. teaching about a low-residue diet.
b. monitoring drainage from the stoma.
c. assessing the perineal drainage and incision.
d. encouraging acceptance of the colostomy site. Correct Ans:- Maintain dry
perineal dressings

C Assessing the perineal drainage and incision

What information in a client's history indicates the highest risk factor for hepatitis
C? Correct Ans:- Intravenous drug abuse

A client with advanced cirrhosis and hepatic encephalopathy is manifesting....
Correct Ans:- Apply a pressure-relieving mattress under the client.

A female client arrives at the clinic because her boyfriend.... Correct Ans:-
Gonorrhea is often asymptomatic in women because the infection is not visible.

A patient with comminuted fractures of the tibia and fibula is treated with open
reduction and application of an external fixator. The next day, the patient complains
of severe pain in the leg, which is unrelieved by ordered analgesics. The patient's
toes are pink, but the patient complains of numbness and tingling. The most
appropriate action by the nurse is to
a. notify the patient's health care provider.
b. check the patient's blood pressure.
c. assess the external fixator pins for redness or drainage.
d. elevate the extremity and apply ice over the wound site. Correct Ans:- Notify
the HCP

On the secound day after admission, a client with a fractures pelvis develops chest
pain, tachypnea, and tachycardia. Which additional finding should the nurse identify
that is most likely related to a fat embolism? Correct Ans:- Petechiae of the
anterior chest wall

A client is comatose upon arrival to the emergency room department after falling
from the roof. The client flexes with painful stimuli, and the nurse determines the
client"s Glasgow Coma Scale is 6. Which intervention should the nurse prepare to
implement to maintain the client"s airway? Correct Ans:- A nasopharyngeal tube

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