HESI HEALTH ASSESSMENT 246 EXAM QUESTIONS

PDF Download

HESI HEALTH ASSESSMENT 246 EXAM QUESTIONS

Actual Qs and Ans - Expert-Verified Explanation -Guaranteed passing score -50 Questions and Answers

-Format: Multiple-choice / Flashcard

Question 1: The registered nurse (RN) is caring for a client with tuberculosis (TB) who is taking a combination drug regimen. The client complains about taking "so many pills." What information should the RN provide to the client about the prescribed treatement?The development of resistant strains of TB are decreased with a combination of drugs.Compliance to the medication regimen is challenging but should be maintained.Side effects are minimized with the use of a single medication but is less effective.The treatment time is decreased from 6 months to 3 months with this standard regimen.

Answer:

The development of resistant strains of TB are decreased with a combination of drugs.Rationale Combination therapy is necessary to decrease the development of resistant strains of TB and ensure treatment efficacy.Question 2: The registered nurse (RN) is caring for an older client who recently experienced a fractured pelvis from a fall. Which assessment finding is most important for the RN to report the healthcare provider?Lower back pain.Headache of 7 on scale 1 to 10.Blood pressure of 140/98.Dyspnea.

Answer:

Dyspnea.Rationale A client with a large bone fracture is at risk for intramedullary fat leaking into the blood stream and becoming embolic. Dyspnea is an indication of fat embolism to the lungs and should be reported to the healthcare provider immediately.

Question 3: The registered nurse (RN) assesses a client's results for arterial blood gases who has emphysema. Which finding is consistent with respiratory acidosis?pH 7.32, pCO2 46 mmHg, HCO3 24 MEq/L.pH 7.45 , pCO2 37 mmHg, HCO3 24 mEq/L.pH 7.34, pCO2 36 mmHg, HCO3 21 mEq/L.pH 7.46, pCO2 35 mmHg, HCO3 28 mEq/L.

Answer:

pH 7.32, pCO2 46 mmHg, HCO3 24 MEq/L.Rationale Normal ABG ranges are pH 7.35 to 7.45; pCO2 35 to 45 mmHg; HCO3 21 to 28 mEq/L, and pO2 80 to 100 mmHg. An ABG of pH 7.32, pCO2 46 mmHg, HCO3 24 MEq/L represents a client with respiratory acidosis which is characterized by: low pH, pCO2higher than normal, and HCO3 within normal limits.Question 4: *A client in an ambulatory clinic describes awaking in the middle of the night with difficulty breathing and shortness of breath related to paroxysmal nocturnal dyspnea. Which underlying condition should the registered nurse (RN) identify in the client's history?Chronic bronchitis.Gastroesophageal reflux disease (GERD).Heart failure (HF).Chronic pancreatitis.

Answer:

Heart failure (HF).Rationale Paroxysmal nocturnal dyspnea is classic sign of heart failure and is secondary to fluid overload associated with heart failure which causes pulmonary edema.Question 5: After a liver biopsy is performed at the bedside, the registered nurse (RN) is assigned the care of the client. Which nursing intervention is most important for the RN to implement?Position client on left side with pillow placed under the costal margin.Assist the client with voiding immediately after the procedure.Evaluate vital signs q10 to 20 minutes for 2 hours after procedure.Ambulate client 3 times in first hour with pillow held at abdomen.

Answer:

Evaluate vital signs q10 to 20 minutes for 2 hours after procedure.Rationale Vital signs should be checked every 10 to 20 minutes to assess for bleeding after biopsy of the liver, which is highly vascular. The client should be positioned on the right sidewith a pillow or sandbag under the costal margin and supporting the biopsy site. The client should be maintained on bedrest for several hours to decrease the risk of bleeding from the biopsy site.

Question 6: *The registered nurse (RN) recognizes which client group is at the greatest risk for developing a urinary tract infection (UTI)? (Rank from highest risk to lowest risk.)

Answer:

• Older Female

• School age female

• Older male

• Adolescent male

Rationale Hypoestrogenism and alkalotic urine are other age-related factors put older women at the highest risk for UTIs. School age girls (6 to 12 years) are at risk for UTIs due to a higher prevalence to taking baths instead of showers, but these risks can be controlled in this population as well as hypoestrogenism and alkalotic urine. Older men are at risk due to possible obstruction of the bladder due to benign prostatic hypertrophy (BPH). Adolescent males (12 to 19 years) are the lowest at risk for a UTI.All individuals regardless of gender and/or age are at risk if the following conditions exist: vesicoureteral reflux, neuromuscular conditions, like Parkinson's disease, previous brain attacks, or the use of anticholinergic medications can all cause incomplete bladder emptying which can create bacterial overgrowth. Fecal and urinary incontinence contributes to poor perineal hygiene and bacterial growth.Question 7: While caring for a client who has esophageal varices, which nursing intervention is most important for the registered nurse (RN) to implement?Monitor infusing IV fluids and any replacement blood products.Prepare for esophagogastroduodenoscopy (EGD).Maintain the client on strict bedrest.Insert a nasogastric tube (NGT) for intermittent suction.

Answer:

Monitor infusing IV fluids and any replacement blood products.Rationale Maintaining hemodynamic stability in a client with esophageal varicescan precipitatea life-threatening crisis if esophageal varies leak or rupture and can result in hemorrhage. The priority is assessing and monitoring infusions of IV fluids and any replacement blood products.Question 8: *The registered nurse (RN) is evaluating a client who presents with symptoms of viral gastroenteritis. Which assessment finding should the RN report to the healthcare provider?Dry mucous membranes and lips.Rebound abdominal tenderness over right lower quadrant.Dizziness when client ambulates from a sitting position.Poor skin turgor over client's wrist.

Answer:

Rebound abdominal tenderness over right lower quadrant.

Rationale RLQ rebound abdominal tenderness may be related to acute appendicitis and should be reported to the healthcare provider.Question 9: The registered nurse (RN) is caring for a client who has a closed head injury from a motor vehicle collision. Which finding should the RN assess the client for the risk of diabetes insipidus (DI)?High fever.Low blood pressure.Muscle rigidity.Polydipsia.

Answer:

Polydipsia.Rationale A characteristic finding of DI is excretion of large quantities of urine (5 to 20L/day), and most clients compensate for fluid loss by drinking large amounts of water (polydipsia). DI can occur when there has been damage or injury to the pituitary gland or hypothalamus as a result of head trauma, tumor or an illness such as meningitis. This damage interrupts the ADH production, storage and release causing the excessive urination and thirst.Question 10: A client with chest pain, dizziness, and vomiting for the last 2 hours is admitted for evaluation for Acute Coronary Syndrome (ACS). Which cardiac biomarker should the registered nurse (RN) anticipate to be elevated if the client experienced myocardial damage?Creatine Kinase (CK-MB).Serum troponin.Myoglobin.Ischemia modified albumin.

Answer:

Serum troponin.Troponin is the most sensitive and specific test for myocardial damage. Troponin elevation is more specific than CK-MB.Question 11: * The registered nurse (RN) is administering haloperidol 0.5 mg IM PRN to a client for the first time. What side effects should the RN assess the client for during the initial dose?Bradykinesia.Dystonia.Somatization.Akathisia.

Answer:

Dystonia.Rationale Dystonia can be a sudden adverse reaction to this psychotropic medication which should be