HESI RN
HESI RN Exit Exam 2024 Quizlet Capstone
1. When a pediatric client is taking the beta-adrenergic blocking agent propranolol, what signs of overdose should the nurse instruct the parents to report?
- A. Seizures
- B. Increased respiratory rate
- C. Bradycardia
- D. Irritability
Correct answer: C
Rationale: When a pediatric client is taking propranolol, the nurse should instruct the parents to report signs of overdose, including bradycardia. Propranolol is a beta-blocker that can lead to dangerously slow heart rate as a sign of overdose. While increased respiratory rate, seizures, and irritability may occur in some cases, bradycardia is the most critical symptom indicating an overdose of this medication.
2. Inevitable abortion occurs when:
- A. The ovum dies in utero and the decidua capsularis remains intact.
- B. The cervix is open, and the products of conception are about to be expelled.
- C. The products of conception are expelled before the 20th week of gestation.
- D. The fetus dies and is expelled in the first trimester.
Correct answer: B
Rationale: Inevitable abortion occurs when the cervix is open, and the products of conception are about to be expelled. This is a critical point in the process of spontaneous abortion, indicating that expulsion of the products of conception is imminent. Choice A is incorrect as it describes a missed abortion where the ovum dies but the decidua capsularis remains intact. Choice C is incorrect as it describes an incomplete abortion where the products of conception are expelled before the completion of 20 weeks of gestation. Choice D is incorrect as it describes a missed abortion where the fetus dies and is expelled in the first trimester.
3. A client with chronic kidney disease is receiving peritoneal dialysis. Which assessment finding should the nurse report to the healthcare provider immediately?
- A. The client's weight increases by 1 kg in 24 hours.
- B. The client's peritoneal effluent is cloudy.
- C. The client's blood pressure is 140/90 mm Hg.
- D. The client's peritoneal effluent is clear and pale yellow.
Correct answer: B
Rationale: Cloudy peritoneal effluent (B) is a sign of infection and should be reported to the healthcare provider immediately. It indicates the presence of peritonitis, a severe complication that requires prompt intervention. Weight gain (A) may indicate fluid overload but is not as urgent as a potential infection. Elevated blood pressure (C) is a common finding in clients with kidney disease and needs monitoring but does not require immediate reporting. Clear and pale yellow effluent (D) is a normal finding and does not raise immediate concerns.
4. Nalidixic acid (NegGram) is prescribed for a client with a urinary tract infection. On review of the client's record, the nurse notes that the client is taking warfarin sodium (Coumadin) daily. Which prescription should the nurse anticipate for this client?
- A. Discontinuation of warfarin sodium (Coumadin)
- B. A decrease in the warfarin sodium (Coumadin) dosage
- C. An increase in the warfarin sodium (Coumadin) dosage
- D. A decrease in the usual dose of nalidixic acid (NegGram)
Correct answer: B
Rationale: Nalidixic acid can intensify the effects of oral anticoagulants by displacing these agents from binding sites on plasma proteins. When an oral anticoagulant, like warfarin sodium (Coumadin), is combined with nalidixic acid, a decrease in the anticoagulant dosage may be necessary to avoid excessive anticoagulation and potential bleeding risks. Therefore, the correct action for the nurse to anticipate in this situation is a decrease in the warfarin sodium (Coumadin) dosage. Choice A is incorrect because discontinuing warfarin sodium abruptly can lead to thrombosis or embolism. Choice C is incorrect as increasing the warfarin sodium dosage can potentiate the anticoagulant effect, leading to bleeding complications. Choice D is incorrect as reducing the dose of nalidixic acid would not directly address the interaction with warfarin sodium.
5. Following admission for cardiac catheterization, the nurse is providing discharge teaching to the parents of a 2-year-old toddler with tetralogy of Fallot. What instruction should the nurse give the parents if their child becomes pale, cool, and lethargic?
- A. Encourage oral electrolyte solution intake
- B. Assist the child to a recumbent position
- C. Contact their healthcare provider immediately
- D. Provide a quiet time by holding or rocking the toddler
Correct answer: C
Rationale: If a child with tetralogy of Fallot becomes pale, cool, and lethargic, these symptoms may indicate a hypoxic episode or worsening condition. It is crucial to contact the healthcare provider immediately for further evaluation and management to ensure the child's safety and well-being. Option A is incorrect because electrolyte solution intake is not the immediate action needed for these symptoms. Option B is incorrect as positioning alone may not address the underlying issue. Option D is incorrect as providing a quiet time is not appropriate if the child is experiencing concerning symptoms that require prompt medical attention.