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NGN RN EXIT HESI Comprehensive Evolve Exam 2024 |Expert Verified Questions & Answers (Rated A+)
VERSION 2
The nurse is teaching the parents of a 10-year-old child with rheumatoid arthritis measures to help reduce the pain associated with the disease. Which instruction should the nurse provide to these parents?
- Administer a nonsteroidal anti-inflammatory drug (NSAID) to the child prior to
- Perform passive range of motion exercises every evening before bed.
- Warm the child with an electric blanket prior to getting the child out of bed.
- Immobilize swollen joints during acute exacerbations until function returns.
getting the child out of bed in the morning.
C Early morning stiffness and pain are common symptoms of rheumatoid arthritis.Warming the child in the morning helps reduce these symptoms. Although moist heat is best, an electric blanket could also be used to help relieve early morning discomfort.Option A on an empty stomach is likely to cause gastric discomfort. Passive range of motion exercises keeps the joints mobile. Option D is contraindicated, because joints should be exercised, not immobilized.Which situation demonstrates proper application of client confidentiality requirements for the Health Insurance Portability and Accountability Act
(HIPAA)?
A Clients' names are not used while they are in a public waiting room.BNurses should not recommend any community self-help groups by specific name, such as Alcoholics Anonymous.CClients must pick up their filled prescriptions from a pharmacy in person with a 1 / 4
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2 photo identification card.DOld medical records are kept in a locked file cabinet in the department.D Past medical records must be "secured" and "reasonably protected" from inadvertent viewing. A locked room or file cabinet can serve this purpose, and when any protected health information (PHI) is discarded, it must be shredded. A person's name only (without his or her diagnosis or treatment) is not considered confidential or PHI. Nurses may suggest categories of community resources, with examples, such as Alcoholics Anonymous, but cannot market a specific program in which they have a financial interest. Others can pick up a client's filled prescriptions.A 40-year-old office worker who is at 36 weeks' gestation presents to the occupational health clinic complaining of a pounding headache, blurry vision, and swollen ankles. What is the priority nursing action for this client?
A Check the client's blood pressure.BTeach her to elevate her feet when sitting.CObtain a 24-hour diet history.DAssess the fetal heart rate.A The blood pressure should be assessed first. Preeclampsia is a multisystem disorder, and women older than 35 years and who have chronic hypertension are at increased risk. Classic signs include headache, visual changes, edema, recent rapid weight gain, and elevated blood pressure. Options B, C, and D can be done if the blood pressure is normal.At which point should the nurse encourage a laboring client to begin pushing?
A When the cervix is completely effaced
BWhen the client describes the need to have a bowel movement 2 / 4
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CWhen the cervix is completely dilated
DWhen the anterior or posterior lip of the cervix is palpable C
Pushing begins with the second stage of labor, when the cervix is completely dilated at 10 cm. If pushing begins before the cervix is completely dilated, the cervix can become edematous and may never dilate completely, necessitating an operative delivery. The most effective pushing occurs when the cervix is completely dilated and the woman feels the urge to push (Ferguson reflex).The nurse is preparing assignments for the day shift. Which client should be assigned to the staff RN rather than a PN?
A A client with an admitting diagnosis of menorrhagia who is now 24 hours' post- vaginal hysterectomy
BA client admitted with a myocardial infarction 4 days ago who was transferred from the intensive care unit (ICU) the previous day
CA client admitted during the night with depression following a suicide attempt with an overdose of acetaminophen (Tylenol)
DA 4-year-old admitted the previous evening with gastrointestinal rotavirus who is receiving IV fluids and a clear liquid diet C Option C requires communication skills and assessment skills beyond the educational level of a PN or UAP. Establishing a therapeutic, one-on-one relationship with a depressed client is beyond the scope of practice for a PN. In addition, Tylenol is 3 / 4
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4 extremely hepatotoxic, and careful assessment is essential. Options A, B, and D could all be cared for by a PN under the supervision of the RN.Because of census overload, the charge nurse of an acute care medical unit must select a client who can be transferred back to a residential facility. Which client will the charge nurse select for transfer?A A stage III sacral pressure ulcer, with colonized methicillin- resistant Staphylococcus aureus (MRSA) BPneumonia, with a sputum culture of gram-negative bacteria CUrinary tract infection, with positive blood cultures DCulture of a diabetic foot ulcer shows gram-positive cocci A The client with colonized MRSA is the most stable client, because colonization does not cause symptomatic disease. The gram-negative organisms causing pneumonia are typically resistant to drug therapy, which makes recovery very difficult. Positive blood cultures indicate a systemic infection. Poor circulation places the diabetic with an infected ulcer at high risk for poor healing and bone infection.A 5-year-old is in Bryant's traction for intervention for a fractured femur. Which finding would require a nursing action?
A The parents are at the bedside reading a book with the child.
BThe child's hips are in 90-degree flexion
.CThe child's hips are gently resting on the bed.
DThe child is consuming 120 mL of grape juice.
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