HESI Exit Completed Version 2, With Combined Questions and Answers for 2023-2024

Grave's disease signs and symptoms - ANSWER--Enlarged thyroid -Acceleration of body process: weight loss, increased appetite, diarrhea, heat intolerance, tachycardia, palpitations, increased BP, diaphoresis, nervousness ...

Grave's disease signs and symptoms - ANSWER--Enlarged thyroid -Acceleration of body process: weight loss, increased appetite, diarrhea, heat intolerance, tachycardia, palpitations, increased BP, diaphoresis, nervousness, insomnia -Exopthalamos -Increased T3 and T4 levels -Low TSH levels Grave's disease test - ANSWER--Radioactive Iodine Uptake to detect how the thyroid is working -Ultrasound -Bloodwork -Imaging tests Grave's disease treatment - ANSWER--Goal: inhibit production of thyroid hormones and block effect on the body -Radioactive iodine therapy: destroys overactive thyroid cells over time -Propylthiouracil, methimazole -Betablockers -Subtotal or full thyroidectomy (risk of damaging vocal cords and parathyroid glands) Nursing interventions for a pt with COPD - ANSWER--Sit upright (positioning) -Pursed lip breathing -Diaphragmatic breathing -HOB up -Not too much O2: decreases stimulus to breathe -O2 is not first choice! Considerations when choosing an IV site - ANSWER--Avoid restricted extremities (fistula, breast CA (mastectomy/lymphedema), cellulitis) -If no upper extremities available, can use legs -Infiltration is a problem, dont reinstill IV access; keep IV in but start a new line Pheochromocytoma - ANSWER--Tumor on the adrenals that causes release of catecholamines (epi and norepi) -Can cause hypertensive crisis (above 240) -Monitor BP frequently -Mosly cardio sx: increased HR and BP General teaching points for pt taking meds - ANSWER--Take the full dose of antibiotics (can build resistance) -Pay attention to timing and whether you take with food or on an empty stomach Describe post-surgical nursing assessment - ANSWER--VITALS!! -Take VS first to give you "the lay of the land" and plan further treatment -Watch for shock and hemorrhaging -Make sure BP is above 90 -Give O2 if decreased sat -Look/ask about pain if HR increased Describe Lupus and pt education - ANSWER--*Autoimmune disorder -Could have a decreased WBC count; increased risk for infection -Avoid crowds, avoid sick people, avoid sunlight (trigger) Explain safe insulin administration practice and how to teach another nurse - ANSWER--Give in SubQ fat, rotate spots -Sliding scale dose is based on most recent glucose level -Check orders in the computer if forget dose/med -Clean area with alcohol -Make sure you have the right pt Assessment points for pt with constipation - ANSWER--Assess current medications -Check measures that they're currently taking (daily enemas, laxatives, etc) -Assessment: no bowel sounds, abd distention -Make a doctors appointment -Assess current nutrition, diet, and exercise -Drink more water Osteomalacia and implications for pt teaching - ANSWER--Focus on nutritional support -Sunlight is a good source of vitamin D -Vitamin D is important to absorb calcium and phosphorous -Check vitamin D levels Osteomyelitis - ANSWER--Bone infection -Treat with antibiotics -Poor healing, injury entered the bone UTI - ANSWER--Pt doesn't always report sx! -Urine sample is foul smelling and cloudy -Send sample to lab for urinalysis -Order a secondary test (culture and sensitivity) to choose the correct tx Assessment and nursing interventions for hip fx - ANSWER--Assess for pain -Hip fracture sometimes shortens the leg/rotates it -Treat like its a hip fracture even if no testing done yet -Assess circulation (pulse, cap refill, feeling, movement, wiggle toes, color) -Don't elevate the leg -No extra motion until hip is stabilized -Assess skin and circulation if in traction Care and assessment for adrenalectomy - ANSWER--Pt at risk for electrolyte abnormalities -Put on telemetry -Daily serum electrolytes -Monitor VS -Watch for dysrhythmias Tracheostomy pt teaching - ANSWER--Maintain airway: suctioning -Communicate with white boards -Cough and suction on the way out -No more than 10 seconds Steps of the chain of infection - ANSWER--Causative agent -Reservoir -Portal of exit: ex: wound, dressing change -Mode of transmission: nurse could be mode if they wear a gown in the hallway -Portal of entry -Susceptible host: decreased immune system, also have wounds (entry site) *Ways to block transmission: precautions, wash hands Aseptic handwashing - ANSWER--Wash clean to dirty -Point arms down so dirty water runs from clean to dirty Chrones Diet - ANSWER--Low fat -High-calorie: dried fruit increases calories and nutrients -High nutrient foods -Ex: eggs w/o yolk, lean meat, fish, seafood, chicken Heart Failure Diet - ANSWER--No canned/processed food -No cheese or salami -Limit sodium (fluid retention) -Vegetables and fruits Mormon Diet - ANSWER--No alcohol -No caffeine -Give milk, juice, or water -If diabetic, no juice -Church = latter day saints Muslim Diet - ANSWER--Ramadan: fast for one month each year from dawn till after dark