HESI NCLEX-PN REMEDIATION QUESTIONS AND ANSWERS WITH RATIONALES

HESI NCLEX-PN REMEDIATION QUESTIONS AND ANSWERS WITH RATIONALES

A male client reports dysuria, nocturia, and difficulty starting the urinary stream. A
cystoscopy and biopsy of the prostate gland have been scheduled. After the
procedure the client reports an inability to void. What should the nurse do?
Rationale: Palpate above the pubic symphysis
A full bladder is palpable with urinary retention and distention, which are common
problems after a cystoscopy because of urethral edema. Fluids dilute the urine and reduce
the chance of infection after cystoscopy and should not be limited. Although urinary
retention can occur, it is not expected; the nurse must assess the extent of bladder
distention and discomfort. More conservative nursing methods, such as running water or
placing a warm cloth over the perineum, should be attempted to precipitate voiding;
catheterization carries a risk of infection.
• A nurse is obtaining a health history from the mother of a 15-month-old toddler
with celiac disease. The nurse expects the mother to indicate what about her
toddler?
Rationale: Has bulky, foul, frothy stools
Steatorrhea (fatty, foul-smelling, frothy, bulky stools) occurs with celiac disease because
of an intolerance to gluten; toxic substances, which can damage the intestinal mucosal
cells, accumulate and cause diarrhea. Drinking large amounts of fluid is a response to
dehydration. With celiac disease some thirst may occur, but it is not continuous. Although
infants with celiac disease are irritable, this sign is too vague for accurate evaluation.
Irritability is symptomatic of a variety of problems, ranging from cutting of teeth to
leukemia. Concentrated urine is associated with a urinary tract infection or dehydration;
this sign is too vague to permit accurate evaluation.
• A client with an ileal conduit is being prepared for discharge. As part of the
discharge teaching, what does the nurse instruct the client to do?
Rationale: Maintain fluid intake of at least 2L daily
High-fluid intake flushes the ileal conduit and prevents infection and obstruction caused
by mucus or uric acid crystals. Alcohol is not contraindicated with an ileal conduit.
Notifying the health care provider if the stoma size decreases is expected; as edema
decreases, the stoma will become smaller. Soap and water on the peristomal area help
prevent irritation from waste products.

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