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HESI EXIT EXAM 2

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The nurse should question a prescription for docusate sodium (Colace) for a client with which problem? a. First day post myocardial infarction. b. Two days following a knee replacement. c. Abdomin... al pain of unknown etiology. d. History of liver disease. ____ 2. The nurse working on a medical unit is assigned to care for four clients. Which client should the nurse assess first? a. A client who is quadriplegic and is complaining of a severe headache. b. A client who had a stroke and now has right-sided weakness. c. A client who has a pressure ulcer and now has a temperature of 102.3° F. d. An elderly client who is requesting medication for constipation. ____ 3. A male client is accompanied to the emergency department by the police after trying to jump off a bridge. As the nurse begins the initial evaluation, what is the priority assessment? a. Assess to see if the client is having command hallucinations. b. Determine where the client usually seeks healthcare treatment. c. Assess if the client has a history of aggression. d. Determine if the client has a history of depression. ____ 4. Prior to discharge, the parents of a child with cystic fibrosis are demonstrating chest physiotherapy (CPT) that they will perform for their child at home. Which action requires intervention by the nurse? a. A bronchodilator is administered before starting CPT. b. The child is placed in a supine position to begin percussions. c. A cupped hand is used when percussing the lung fields. d. Plan to perform CPT when the child awakens in the morning. ____ 5. A client at 29-weeks gestation is receiving magnesium sulfate 3 grams/hour for pre-term labor. After administering the loading dose, what assessment finding should the nurse report to the healthcare provider immediately? a. A decrease in respirations from 20 to 17 breaths/minute. b. An increase in temperature from 98.9° to 99.9° F. c. An increase in blood pressure from 110/65 to 120/85. d. A decrease in deep tendon reflexes from 3+ to 1+ [Show More]

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