HESI Comprehensive Exit

HESI Comprehensive Exit Exam 1-Enalapril maleate (Vasotec) is prescribed for a hospitalized client. Which assessment does the nurse perform as a priority before administering the medication?

• Checking the client's blood pressure
• Checking the client's peripheral pulses
• Checking the most recent potassium level
• Checking the client's intake-and-output record for the last 24 hours - ANSWER
• Checking the client's blood pressure

Checking the client's blood pressure Enalapril maleate is an angiotensin-converting enzyme (ACE) inhibitor used to treat hypertension. One common side effect is postural hypotension. Therefore the nurse would check the client's blood pressure immediately before administering each dose. Checking the client's peripheral pulses, the results of the most recent potassium level, and the intake and output for the previous 24 hours are not specifically associated with this mediation.2-A client is scheduled to undergo an upper gastrointestinal (GI) series, and the nurse provides instructions to the client about the test. Which statement by the client indicates a need for further instruction?

• "The test will take about 30 minutes." 1 / 4

• "I need to fast for 8 hours before the test."
• "I need to drink citrate of magnesia the night before the test and give myself a

Fleet enema on the morning of the test."

• "I need to take a laxative after the test is completed, because the liquid that I'll

have to drink for the test can be constipating." - ANSWER

• "I need to drink citrate of magnesia the night before the test and give myself a

Fleet enema on the morning of the test." An upper GI series involves visualization of the esophagus, duodenum, and upper jejunum by means of the use of a contrast medium. It involves swallowing a contrast medium (usually barium), which is administered in a flavored milkshake.Films are taken at intervals during the test, which takes about 30 minutes. No special preparation is necessary before a GI series, except that NPO status must be maintained for 8 hours before the test. After an upper GI series, the client is prescribed a laxative to hasten elimination of the barium. Barium that remains in the colon may become hard and difficult to expel, leading to fecal impaction.3-A nurse on the evening shift checks a physician's prescriptions and notes that the dose of a prescribed medication is higher than the normal dose. The nurse calls the physician's answering service and is told that the physician is off for the

night and will be available in the morning. The nurse should:

• Call the nursing supervisor
• Ask the answering service to contact the on-call physician
• Withhold the medication until the physician can be reached in the morning
• Administer the medication but consult the physician when he becomes

available - ANSWER B. Ask the answering service to contact the on-call physician 2 / 4

4.An emergency department (ED) nurse is monitoring a client with suspected acute myocardial infarction (MI) who is awaiting transfer to the coronary intensive care unit. The nurse notes the sudden onset of premature ventricular contractions (PVCs) on the monitor, checks the client's carotid pulse, and determines that the PVCs are not resulting in perfusion. The appropriate action by

the nurse is:

• Documenting the findings
• Asking the ED physician to check the client
• Continuing to monitor the client's cardiac status
• Informing the client that PVCs are expected after an MI - ANSWER
• Asking the ED physician to check the client

5.NPO status is imposed 8 hours before the procedure on a client scheduled to undergo electroconvulsive therapy (ECT) at 1 p.m. On the morning of the procedure, the nurse checks the client's record and notes that the client routinely

takes an oral antihypertensive medication each morning. The nurse should:

• Administer the antihypertensive with a small sip of water
• Withhold the antihypertensive and administer it at bedtime
• Administer the medication by way of the intravenous (IV) route
• Hold the antihypertensive and resume its administration on the day after the

ECT - ANSWER A. Administer the antihypertensive with a small sip of water

• A client who recently underwent coronary artery bypass graft surgery comes to

the physician's office for a follow-up visit. On assessment, the client tells the nurse that he is feeling depressed. Which response by the nurse is therapeutic? 3 / 4

• "Tell me more about what you're feeling."
• "That's a normal response after this type of surgery."
• "It will take time, but, I promise you, you will get over this depression."
• "Every client who has this surgery feels the same way for about a month." -

ANSWER A. "Tell me more about what you're feeling."

• A client in labor experiences spontaneous rupture of the membranes. The nurse

immediately counts the fetal heart rate (FHR) for 1 full minute and then checks the amniotic fluid. The nurse notes that the fluid is yellow and has a strong odor.Which of the following actions should be the nurse's priority?

• Contacting the physician
• Documenting the findings
• Checking the fluid for protein
• Continuing to monitor the client and the FHR - ANSWER
• Contacting the physician Correct
• A nurse has assisted a physician in inserting a central venous access device into

a client with a diagnosis of severe malnutrition who will be receiving parenteral nutrition (PN). After insertion of the catheter, the nurse immediately plans to:

• Call the radiography department to obtain a chest x-ray
• Check the client's blood glucose level to serve as a baseline measurement
• Hang the prescribed bag of PN and start the infusion at the prescribed rate
• Infuse normal saline solution through the catheter at a rate of 100 mL/hr to

maintain patency - ANSWER A. Call the radiography department to obtain a chest x-ray

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