a male client with impaired renal function who takes ibuprofen daily for chronic arthritis is admitted with gastrointestinal gi bleeding after adminis
Logo

Nursing Elites

HESI RN

HESI 799 RN Exit Exam

1. A male client with impaired renal function who takes ibuprofen daily for chronic arthritis is admitted with gastrointestinal (GI) bleeding. After administering IV fluids and a blood transfusion, his blood pressure is 100/70, and his renal output is 20 ml/hour. Which intervention should the nurse include in care?

Correct answer: B

Rationale: Evaluating daily renal laboratory studies is crucial in this scenario. The client has impaired renal function, recent GI bleeding, and is at risk for further kidney damage due to ibuprofen use. Monitoring renal labs helps assess kidney function and detect any progressive elevations, guiding further interventions. Option A is not directly related to renal function monitoring. Option C focuses more on urine appearance than renal function assessment. Option D mentions polyuria, which is excessive urine output, but the question describes a client with reduced renal output.

2. A client who recently underwent a tracheostomy is being prepared for discharge to home. Which instruction is most important for the nurse to include in the discharge plan?

Correct answer: B

Rationale: The most important instruction for a client who recently underwent a tracheostomy is to teach tracheal suctioning techniques. Suctioning helps clear secretions and maintain an open airway, which is critical for the client's respiratory function and overall well-being. While communication tools, self-care, and cleaning the tracheostomy site are important aspects of care, ensuring proper suctioning techniques is crucial for preventing complications and ensuring the client's safety.

3. A client with a history of hypertension is admitted with a blood pressure of 200/110 mmHg. Which intervention should the nurse implement first?

Correct answer: D

Rationale: The correct answer is to obtain an arterial blood gas (ABG) sample. In a client with severe hypertension, it is essential to assess for metabolic or respiratory acidosis which can be done through an ABG sample. Administering antihypertensive medication without assessing the acid-base status of the client can lead to potential complications. Monitoring urine output and administering oxygen therapy are important interventions but are not the priority in this situation where the focus should be on assessing acidosis.

4. A client with chronic kidney disease (CKD) is admitted with hyperkalemia. Which intervention should the nurse implement first?

Correct answer: B

Rationale: The correct answer is to administer intravenous insulin and glucose first. This intervention helps drive potassium back into the cells, lowering serum levels effectively. Administering intravenous calcium gluconate (choice A) is used to stabilize cardiac membranes in severe hyperkalemia but does not address the underlying cause. Administering intravenous sodium bicarbonate (choice C) is used in metabolic acidosis, not hyperkalemia. Administering a loop diuretic (choice D) can help eliminate potassium but is not the first-line treatment for hyperkalemia in CKD.

5. A female client reports that her hair is becoming coarse and breaking off, the outer part of her eyebrows has disappeared, and her eyes are all puffy. Which follow-up question is best for the nurse to ask?

Correct answer: D

Rationale: The correct answer is D because the manifestations reported by the client, such as coarse hair, missing eyebrows, and puffy eyes, are indicative of hypothyroidism. Changes in the fingernails, such as brittle or pitted nails, can also be associated with hypothyroidism. Option A is incorrect as female baldness is not directly related to the reported symptoms. Option B is less relevant as stress typically does not cause these specific symptoms. Option C is also less relevant as exposure to hazardous chemicals would present with different symptoms.

Similar Questions

A client with a history of chronic kidney disease is scheduled for a CT scan with contrast. Which laboratory value should the nurse review before the procedure?
The healthcare provider is assessing a client with chronic kidney disease (CKD) who is receiving erythropoietin therapy. Which clinical finding is most concerning?
Which nursing intervention has the highest priority for a multigravida who delivered an hour ago?
When a client with a history of atrial fibrillation is admitted with a new onset of confusion, which diagnostic test should the nurse anticipate preparing the client for first?
A client with a history of type 1 diabetes is admitted with diabetic ketoacidosis (DKA). Which intervention is most important?

Access More Features

HESI RN Basic
$69.99/ 30 days

  • 5,000 Questions with answers
  • All HESI courses Coverage
  • 30 days access

HESI RN Premium
$149.99/ 90 days

  • 5,000 Questions with answers
  • All HESI courses Coverage
  • 30 days access

Other Courses