HESI RN
Community Health HESI Quizlet
1. The healthcare provider is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH). Which intervention is most important?
- A. Restrict fluids to 1,000 mL per day.
- B. Administer a vasopressin antagonist.
- C. Monitor intake and output.
- D. Encourage a high-sodium diet.
Correct answer: B
Rationale: Administering a vasopressin antagonist is the most critical intervention for a client with SIADH. SIADH is characterized by excessive release of antidiuretic hormone (ADH), leading to water retention and dilutional hyponatremia. A vasopressin antagonist helps manage the symptoms by blocking the effects of ADH, promoting water excretion, and restoring electrolyte balance. Restricting fluids (choice A) may exacerbate hyponatremia, monitoring intake and output (choice C) is important but not the most critical intervention, and encouraging a high-sodium diet (choice D) is contraindicated in SIADH due to the risk of worsening hyponatremia.
2. A client with DM is taking regular and NPH insulin every morning. The nurse should provide which instruction to the client?
- A. Take the regular insulin first, then the NPH insulin.
- B. Take the NPH insulin first, then the regular insulin.
- C. Mix the insulins in a separate syringe.
- D. Take the regular insulin first and immediately follow it with the NPH insulin.
Correct answer: A
Rationale: The correct instruction for the client is to take the regular insulin first, then the NPH insulin. Regular insulin should be administered before NPH insulin to prevent contamination and maintain the potency of each insulin type. Choice B is incorrect because NPH insulin should not be taken before regular insulin. Mixing the insulins in a separate syringe, as suggested in choice C, is not recommended as it may alter the effectiveness of the insulins. Choice D is also incorrect as taking the regular insulin first and immediately following it with NPH insulin is not the recommended administration sequence.
3. The nurse is teaching a client with asthma to use a peak expiratory flow rate (PEFR) meter to manage asthma at home. The nurse knows the client understands the proper use of the meter when the client:
- A. Inhales as rapidly as possible when using the meter
- B. Records the highest of three readings
- C. Uses the meter after taking a bronchodilator
- D. Blows out forcefully into the meter after taking a deep breath
Correct answer: B
Rationale: The correct answer is B: 'Records the highest of three readings.' When using a peak expiratory flow rate (PEFR) meter, the client should record the highest of three readings to ensure an accurate measurement of their peak expiratory flow rate. Inhaling rapidly, using the meter after taking a bronchodilator, or blowing out forcefully into the meter after a deep breath are not correct techniques for using a PEFR meter and may lead to inaccurate results.
4. A client with hyperparathyroidism is preparing for surgery. Which preoperative lab finding is most important to report?
- A. Elevated serum calcium.
- B. Decreased serum albumin.
- C. Elevated serum potassium.
- D. Elevated serum magnesium.
Correct answer: A
Rationale: The correct answer is A: Elevated serum calcium. In hyperparathyroidism, elevated calcium levels can lead to complications such as kidney stones, bone pain, and fractures. During surgery, high calcium levels can affect neuromuscular function, cardiac function, and blood clotting. Therefore, it is crucial to report elevated serum calcium levels preoperatively to prevent potential surgical complications. Choices B, C, and D are not directly associated with hyperparathyroidism and are less likely to impact the surgical outcome in this scenario.
5. A client with end-stage renal disease (ESRD) is scheduled for hemodialysis. Which laboratory value should the nurse report to the healthcare provider immediately?
- A. Serum potassium of 5.5 mEq/L
- B. Serum calcium of 8 mg/dL
- C. Serum creatinine of 2.0 mg/dL
- D. White blood cell count of 10,000/mm³
Correct answer: A
Rationale: A serum potassium level of 5.5 mEq/L is concerning in a client with ESRD scheduled for hemodialysis as it indicates hyperkalemia, requiring immediate intervention. Hyperkalemia can lead to serious cardiac arrhythmias, especially during hemodialysis. Serum calcium, serum creatinine, and white blood cell count, while important, do not pose immediate life-threatening risks like hyperkalemia.