A nurse who has
recently completed
orientation is beginning
work in the labor and
delivery unit for the first
time. When making
assignments, which
client should the charge
nurse assign to this new
nurse?
A.A pr
...
A nurse who has
recently completed
orientation is beginning
work in the labor and
delivery unit for the first
time. When making
assignments, which
client should the charge
nurse assign to this new
nurse?
A.A primigravida who is
8 cm dilated after 14
hours of labor
B.A client scheduled for
a repeat cesarean birth
at 38 weeks' gestation
C.A client being
induced for fetal demise
at 20 weeks' gestation
D.A multiparous client
who is dilated 5 cm and
50% effaced
D
The new nurse should be assigned the least
complicated client to gain experience and
confidence, as well as protect client safety. Of the
clients available for assignment, (D) is progressing
well and is the least complicated. (A, B and C) have
actual or potential complications and should be
assigned to a more experienced nurse.
HESI EXIT - Comprehensive Exam 111019
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A client with human
immunodeficiency virus
(HIV) infection has white
lesions in the oral cavity
that resemble milk
curds. Nystatin
(Mycostatin)
preparation is
prescribed as a swish
and swallow. Which
information is most
important for the nurse
to provide the client?
A.Oral hygiene should
be performed before
the medication.
B.Antifungal
medications are
available in tablet,
suppository, and liquid
forms.
C.Candida albicans is
the organism that
causes the white lesions
in the mouth.
D.The dietary intake of
dairy and spicy foods
should be limited.
A
HIV infection causes depression of cell-mediated
immunity that allows an overgrowth of Candida
albicans (oral moniliasis), which appears as white,
cheesy plaque or lesions that resemble milk curds.
To ensure effective contact of the medication with
the oral lesions, oral liquids should be consumed
and oral hygiene performed before swishing the
liquid Mycostatin (A). (B and C) provide the client
with additional information about the pathogenesis
and treatment of opportunistic infections, but (A)
allows the client to participate in self-care of the
oral infection. Dietary restriction of spicy foods
reduces discomfort associated with stomatitis, but
restriction of dairy products is not indicated (D).
HESI EXIT - Comprehensive Exam 111019
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A client who is admitted
with emphysema is
having difficulty
breathing. In which
position should the
nurse place the client?
A.High Fowler's position
without a pillow behind
the head
B.Semi-Fowler's position
with a single pillow
behind the head
C.Right side-lying
position with the head
of the bed elevated 45
degrees
D.Sitting upright and
forward with both arms
supported on an over
the bed table
D
Adequate lung expansion is dependent on deep
breaths that allow the respiratory muscles to
increase the longitudinal and anterior-posterior size
of the thoracic cage. Sitting upright and leaning
forward with the arms supported on an over the
bed table (D) allows the thoracic cage to expand in
all four directions and reduces dyspnea. A high
Fowler's position does not allow maximum
expansion of the posterior lobes of the lungs (A). A
semi-Fowler's position restricts expansion of the
anterior-posterior diameter of the thoracic cage (B).
Positioning a client on the right side with the head
of the bed elevated (C) does not facilitate lung
expansion.
HESI EXIT - Comprehensive Exam 111019
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A client with chronic
renal insufficiency (CRI)
is taking 25 mg of
hydrochlorothiazide
(HCTZ) PO and 40 mg
of furosemide (Lasix)
PO daily. Today, at a
routine clinic visit, the
client's serum potassium
level is 4 mEq/L. What is
the most likely cause of
this client's potassium
level?
A.The client is
noncompliant with his
medications.
B.The client recently
consumed large
quantities of pears or
nuts.
C.The client's renal
function has affected his
potassium level.
D.The client needs to be
started on a potassium
supplement.
C
The client has a normalized potassium level despite
diuretic use (C). The kidney automatically secretes
90% of potassium consumed, but in chronic renal
insufficiency (CRI), less potassium is excreted than
normal. Therefore, the two potassium-wasting
drugs, a thiazide diuretic and loop diuretic, are not
likely to affect potassium levels. The normal
potassium level is 3.5 to 5 mEq/L, and with a
potassium level of 4 mEq/L, there is no reason to
believe that the client is noncompliant with his
treatment (A). Pears and nuts do not affect the
serum potassium level (B). There is no need for a
potassium supplement (D) because the client's
potassium level is within the normal range.
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