HESI 799 RN Exit Exam Quizlet

HESI 799 RN Exit Exam Quizlet Related

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A male client with hypertension, who received new antihypertensive prescriptions at his last visit, returns to the clinic two weeks later to evaluate his blood pressure (BP). His BP is 158/106, and he admits that he has not been taking the prescribed medication because the drugs make him 'feel bad'. In explaining the need for hypertension control, the nurse should stress that an elevated BP places the client at risk for which pathophysiological condition?

  • A. Blindness due to cataracts
  • B. Acute kidney injury due to glomerular damage
  • C. Stroke secondary to hemorrhage
  • D. Heart block due to myocardial damage
Correct Answer: C

Rationale: The correct answer is C, 'Stroke secondary to hemorrhage.' Uncontrolled hypertension can lead to the weakening of blood vessels in the brain, increasing the risk of a stroke due to hemorrhage. This can result in serious neurological deficits or even death. Choices A, B, and D are incorrect because while hypertension can have various complications including vision changes, kidney damage, and heart problems, the most immediate and severe risk associated with uncontrolled hypertension is a stroke from cerebral hemorrhage.

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In a client with liver cirrhosis admitted with ascites and jaundice, which laboratory value is most concerning to the nurse?

  • A. Serum albumin of 3.0 g/dl
  • B. Bilirubin of 3.0 mg/dl
  • C. Ammonia level of 80 mcg/dl
  • D. Prothrombin time of 18 seconds
Correct Answer: C

Rationale: An elevated ammonia level of 80 mcg/dl is most concerning in a client with liver cirrhosis because it may indicate hepatic encephalopathy, a serious complication. Serum albumin, though low, is expected in cirrhosis and contributes to ascites. Bilirubin elevation is common in liver disease but may not be the most concerning in this case. Prothrombin time is typically prolonged in liver disease but may not be as acute as an elevated ammonia level suggesting hepatic encephalopathy.

The nurse is assessing a client with left-sided heart failure. Which laboratory value is most concerning?

  • A. Serum creatinine of 1.5 mg/dL
  • B. Serum sodium of 136 mEq/L
  • C. Serum potassium of 5.5 mEq/L
  • D. Hemoglobin of 12 g/dL
Correct Answer: C

Rationale: A serum potassium level of 5.5 mEq/L is most concerning in a client with left-sided heart failure as it indicates hyperkalemia, requiring immediate intervention. Hyperkalemia can lead to life-threatening cardiac arrhythmias, which can exacerbate heart failure. Serum creatinine of 1.5 mg/dL is slightly elevated but not as immediately concerning as hyperkalemia. Serum sodium of 136 mEq/L is within the normal range. Hemoglobin of 12 g/dL is also within the normal range and not directly related to the client's left-sided heart failure.

What is the first action the nurse should implement for a client admitted with acute pancreatitis?

  • A. Administer intravenous fluids as prescribed
  • B. Administer pain medication as prescribed
  • C. Place the client on NPO status
  • D. Assess the client's abdomen for distention
Correct Answer: C

Rationale: Placing the client on NPO status is the priority action for a client with acute pancreatitis. This step is crucial to rest the pancreas, prevent pancreatic stimulation, and decrease enzyme production. By withholding oral intake, the digestive system is given a chance to rest and recover. Administering intravenous fluids may be necessary but should come after placing the client on NPO status. Pain medication can be administered once the client is stabilized. Assessing the client's abdomen for distention is important but is not the initial priority in managing acute pancreatitis.

While performing a skin inspection for a female adult client, the nurse observes a rash that is well circumscribed, has silvery scales and plaques, and is located on the elbows and knees. These assessment findings are likely to indicate which condition?

  • A. Tinea corporis
  • B. Herpes zoster
  • C. Psoriasis
  • D. Drug reaction
Correct Answer: C

Rationale: The correct answer is C, Psoriasis. Psoriasis commonly presents with well-circumscribed, silvery scales and plaques, typically found on extensor surfaces like elbows and knees. Tinea corporis (A) presents as a circular rash, herpes zoster (B) presents as a painful rash following a dermatomal pattern, and drug reactions (D) have variable presentations not specific to elbows and knees with silvery scales and plaques.

The healthcare provider should observe most closely for drug toxicity when a client receives a medication that has which characteristic?

  • A. Low bioavailability
  • B. Rapid onset of action
  • C. Short half-life
  • D. Narrow therapeutic index
Correct Answer: D

Rationale: The correct answer is D, narrow therapeutic index. Narrow therapeutic index (NTI) drugs are defined as those drugs where small differences in dose or blood concentration may lead to serious therapeutic failures or adverse drug reactions. Choices A, B, and C are not directly related to the risk of drug toxicity. Low bioavailability (Choice A) refers to the amount of drug that enters the bloodstream unchanged after administration. Rapid onset of action (Choice B) and short half-life (Choice C) are characteristics related to drug effectiveness and metabolism but do not necessarily indicate a higher risk of drug toxicity.

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