HESI RN EXIT > HESI > HESI ASSESSMENT TEST EXAM UPDATED QUESTIONS AND ACCURATE ANSWERS VERIFIED THE NEWEST ACTUAL EXAM C (All)
HESI ASSESSMENT TEST EXAM UPDATED QUESTIONS AND ACCURATE ANSWERS VERIFIED THE NEWEST ACTUAL EXAM COMPLETE FOR EXAM PREPARATION 2024-2025
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HESI ASSESSMENT TEST EXAM UPDATED QUESTIONS AND ACCURATE ANSWERS VERIFIED THE NEWEST ACTUAL EXAM COMPLETE FOR EXAM PREPARATION 2024-2025 The nurse is assessing an ulcer on a client's lower ext... remity, which is likely the result of either venous or arterial insufficiency. Which assessment technique should the nurse use to differentiate the pathophysiology causing the ulcer? A. Measure the degree of join range of motion in the extremity. B. Compare the skin turgor of the client's upper and lower leg. C. Observe the specific location and appearance of the ulceration. D. Note any change in the color of the ulcer when the leg is moved - ANSWER-Correct answer is C. Location and appearance of the ulcer would give us the type (venous vs arterial) Venous: develop on the inner lower leg, shallow wounds that are large and irregular edges that slope, red with granular tissue, discoloration with yellow slough present, shiny skin warm or scaly Arterial: occur most often on the foot, on the heels and around lateral malleolus, round shaped, well-defined edges, yellow, brown or black in color, skin pale and non granulating, deep but may also appear shallow in early stages, skin is thin, smooth, taut, and dry. Loss of hair on the leg is also common The nurse is assessing a client for goiter and is unable to observe the thyroid gland. Which action should the nurse take? A. Defer the thyroid exam and observe the client for signs of myxedema. B. Document that thyroid gland size is normal with no visible goiter. C. Ask the client to swallow while palpating along the sides of the trachea. D. Palpate deeply and firmly over the location of the thyroid gland. - ANSWER-Correct answer is C. To palpate a client thyroid gland: Use one hand to slightly retract the sternocleidomastoid muscle while using the other to palpate the thyroid. Have the patient swallow a sip of water as you palpate, feeling for the upward movement of the thyroid gland While completing an admission assessment for a client with gastrointestinal bleeding, the nurse inspects the perineal area and anus. Which findings indicates a normal appearance of the anus? A. Increased pigmentation and coarse skin. B. Flap of tissue at sphincter. C. Hypotonic tone of the anal sphincter. D. Dimpled area above anus. - ANSWER- Correct answer is A [Show More]
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