HESI 799 RN Exit Exam Quizlet

HESI 799 RN Exit Exam Quizlet Related

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A client with chronic heart failure is receiving furosemide (Lasix). Which laboratory value requires immediate intervention?

  • A. Serum potassium of 3.0 mEq/L
  • B. Serum sodium of 135 mEq/L
  • C. Serum creatinine of 1.5 mg/dl
  • D. Blood glucose of 200 mg/dl
Correct Answer: A

Rationale: A serum potassium level of 3.0 mEq/L requires immediate intervention in a client receiving furosemide. Furosemide can cause potassium loss, leading to hypokalemia, which can be dangerous, especially in patients with heart failure. Hypokalemia can predispose the client to cardiac dysrhythmias, weakness, and other complications. Therefore, prompt intervention is necessary to prevent these adverse effects.

Choice B (Serum sodium of 135 mEq/L) is within the normal range and does not require immediate intervention. Choice C (Serum creatinine of 1.5 mg/dl) may indicate kidney dysfunction but does not pose an immediate threat to the client's safety. Choice D (Blood glucose of 200 mg/dl) may suggest hyperglycemia, which is important but not as urgent as addressing hypokalemia in a client with heart failure receiving furosemide.

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The nurse is assessing a client with chronic obstructive pulmonary disease (COPD) who is receiving supplemental oxygen. Which finding requires immediate intervention?

  • A. Oxygen saturation of 90%
  • B. Respiratory rate of 24 breaths per minute
  • C. Use of accessory muscles
  • D. Blood pressure of 110/70 mmHg
Correct Answer: C

Rationale: The correct answer is C. The use of accessory muscles indicates increased work of breathing and may signal respiratory failure in a client with COPD, requiring immediate intervention. Oxygen saturation of 90% is within an acceptable range for COPD patients on supplemental oxygen. A respiratory rate of 24 breaths per minute is slightly elevated but not an immediate concern. A blood pressure of 110/70 mmHg is within the normal range and does not require immediate intervention in this scenario.

A client with a history of rheumatoid arthritis is prescribed prednisone. Which assessment finding requires immediate intervention?

  • A. Increased joint pain
  • B. Weight gain of 2 pounds in 24 hours
  • C. Blood glucose level of 150 mg/dl
  • D. Fever of 100.4°F
Correct Answer: B

Rationale: The correct answer is B. Weight gain of 2 pounds in 24 hours is concerning in a client with rheumatoid arthritis on prednisone as it may indicate fluid retention or worsening heart failure. Increased joint pain, blood glucose level of 150 mg/dl, and fever of 100.4°F are important assessments but do not require immediate intervention compared to the potential severity of rapid weight gain.

An adult female client is admitted to the psychiatric unit with a diagnosis of major depressive disorder. After starting medication therapy, the nurse notices the client has more energy, is giving away her belongings, and has an elevated mood. Which intervention is best for the nurse to implement?

  • A. Support the client by telling her what wonderful progress she is making.
  • B. Ask the client if she has had any recent thoughts of harming herself.
  • C. Reassure the client that the antidepressant drugs are apparently effective.
  • D. Tell the client to keep her belongings because she will need them at discharge.
Correct Answer: B

Rationale: When a client with major depressive disorder shows signs of increased energy, giving away belongings, and an elevated mood, it could indicate a shift towards suicidal behavior. Therefore, the best intervention for the nurse is to ask the client if she has had any recent thoughts of harming herself. This is crucial to assess the client's risk for suicide and provide necessary interventions. Choices A, C, and D are incorrect because they do not address the potential risk of harm to the client and do not prioritize the immediate assessment required in this situation.

In caring for a client receiving the aminoglycoside antibiotic gentamicin, what diagnostic test should the nurse prioritize monitoring?

  • A. Urinalysis
  • B. Serum creatinine
  • C. Serum osmolarity
  • D. Liver enzymes
Correct Answer: B

Rationale: The correct answer is B: Serum creatinine. Aminoglycosides, such as gentamicin, are known to cause nephrotoxicity, which can lead to kidney damage. Monitoring serum creatinine levels is crucial in assessing renal function and detecting any potential kidney problems early. Choices A, C, and D are incorrect because urinalysis primarily assesses urine composition, serum osmolarity measures the concentration of solutes in the blood, and liver enzymes are not directly impacted by aminoglycoside antibiotics like gentamicin.

One day after abdominal surgery, an obese client complains of pain and heaviness in the right calf. What action should the nurse implement?

  • A. Observe for unilateral swelling
  • B. Administer pain medication
  • C. Elevate the leg and apply a warm compress
  • D. Notify the healthcare provider
Correct Answer: A

Rationale: The correct action for the nurse to implement is to observe for unilateral swelling. Unilateral swelling could indicate a deep vein thrombosis (DVT), which is a serious complication that requires immediate assessment. Administering pain medication or applying warm compress may not address the underlying cause of the symptoms. Notifying the healthcare provider should be done after assessing and identifying the issue of unilateral swelling.

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