HESI 2 - practical of hesi questions with solutions 2023-2024
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Which client is at highest risk for chronic kidney disease (CKD) secondary to diabetes mellitus (DM)? Type 1 DM and a serum hemoglobin-A1c of 3.5%. Type 1 DM and retinopathy and mild vis ... ion loss. Type 2 DM and hypertension controlled by metoprolol. Type 2 DM and a history of morbid obesity for 5 years. Rationale Diabetic retinopathy and nephropathy are related to prolonged hyperglycemia and hypertension which damage the microvasculature of the eyes and kidneys, so a client with Type 1 DM and retinopathy is most likely to develop nephropathy and CKD. The client with hemoglobin A1C of 3.5% is demonstrating compliance with therapy (H-A1c target level is no greater than 7%), which indicates tight glucose control and reduces the risk for microvascular complications. The client with controlled hypertension is less likely to develop CKD, although metoprolol, a beta adrenergic receptor https://hesi-preparation-suite.elsevier.com/#/hesiPracticeTestResults/2804503/10BWJMKDNWZ 1/64 antagonist, can mask the signs of hypoglycemia. A client with Type 2 DM is more likely at risk for complications associated with chronic obesity. Which clinical finding should the nurse identify in a client who is admitted with cardiac cirrhosis? Jaundice. Vomiting. Peripheral edema. Left upper quadrant pain. Rationale Four types of cirrhosis include alcoholic, post-necrotic, biliary, and cardiac cirrhosis, which are associated with severe right-sided heart failure (HF), so peripheral edema is most consistent with right-sided HF. Although jaundice and vomiting can occur in all types of cirrhosis, the most defining characteristic of cardiac cirrhosis is related to HF. Hepatic engorgement can occur in a client with HF or cirrhosis and cause right upper quadrant pain, not left sided quadrant pain. [Show More]
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