5 Sets of V3 Exams - (5 Sets of V3 Exams) HESI RN EXIT Comprehensive...

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HESI RN Exit Comprehensive V3 (5 Sets of V3 Exams)

HESI RN EXIT Comprehensive V3 Exam Set 1

• Which change in sleep patterns is most likely to occur in an older adult

ANS - Has a decline in stage 4 sleep

• The nurse is developing the plan of care for an older client who is immobile

and at risk for pressure ulcers. Which contributing factor should the nurse in- clude in the nursing diagnosis, "risk for altered skin integrity?"

ANS tissue ischemia

Prolonged, intense pressure affects cellular metabolism by impeding capillary blood 1 / 4

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flow to tissue over weight-bearing bony prominences, resulting in tissue ischemia, skin breakdown, and tissue death

• A male client tells the nurse that he is frequently constipated. Which finding

should the nurse identify as a common dietary cause of the complication

ANS In- adequate intake of dietary fiber and fluids

• The nurse is obtaining a client's consent for a paracentesis. What informa-

tion should a nurse provide to ensure the client understands the purpose of the procedure

ANS A needle is inserted to remove excessive fluid from the abdominal peritoneal cavity.

• The nurse is teaching a client with Addison's disease about this new diag-

nosis. what pathophysio explanation should the nurse share with the client

ANS c. Adrenal insufficiency is an autoimmune dysfunction that results from white blood cells damaging the adrenal cortex

• The nurse is caring for a client with diabetic ketoacidosis (DKA) who is

manifesting rapid and deep rests. Which resp pattern should the nurse docu- 2 / 4

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ment

ANS Kussmaul respirations

• The nurse is teaching a client who is newly diagnosed with Type 1 diabetes

mellitus about diet and insulin. The client should be instructed to perform glucose self-monitoring when which symptoms occur after exercising ANS Shak- iness

• Which action should the nurse implement when providing nasogastric (NG)

feeding to an unresponsive client

ANS Check residual volume every four hours.

• The healthcare provider prescribes digital evacuation a focal impaction for

an older client who is admitted for a closed head injury after falling out of bed. As a part of the procedure policy, the nurse applies a topical anesthetic gel to the rectum. What rationale best supports the use of the anesthetic gel

ANS Decrease risk for bradycardia

• What nursing intervention should the nurse include in the plan of care for

a client following a bone marrow aspiration 3 / 4

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ANS Use of a compression dressing for firm pressure to the site

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