ASN 100 HESI Review EXIT EXAM 2 (over 700+

QUESTIONS) – Concorde career College

• Following discharge teaching, a male client with duodenal ulcer tells the nurse

the he will drink plenty of dairy products, such as milk, to help coat and protect

his ulcer. What is the best follow-up action by the nurse?

• Review with the client the need to avoid foods that are rich in milk and

cream

• 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?

• Stroke secondary to hemorrhage

• The nurse observes an unlicensed assistive personnel (UAP) positioning a newly

admitted client who has a seizure disorder. The client is supine and the UAP is

placing soft pillows along the side rails. What action should the nurse

implement?

• Instruct the UAP to obtain soft blankets to secure to the side rails instead

of pillows.

• An adolescent with major depressive disorder has been taking duloxetine

(Cymbalta) for the past 12 days. Which assessment finding requires immediate

follow-up?

• Describes life without purpose

• A 60-year-old female client with a positive family history of ovarian cancer has

developed an abdominal mass and is being evaluated for possible ovarian cancer.

Her Papanicolau (Pap) smear results are negative. What information should the

nurse include in the client’s teaching plan?

• Further evaluation involving surgery may be needed

• A client who recently underwear a tracheostomy is being prepared for discharge

to home. Which instructions is most important for the nurse to include in the

discharge plan?

• Teach tracheal suctioning techniques

• In assessing an adult client with a partial rebreather mask, the nurse notes that

the oxygen reservoir bag does not deflate completely during inspiration and the

client’s respiratory rate is 14 breaths / minute. What action should the nurse

implement?

• Document the assessment data

• Rational: reservoir bag should not deflate completely during inspiration

and the client’s respiratory rate is within normal limits.

• During shift report, the central electrocardiogram (EKG) monitoring system

alarms. Which client alarm should the nurse investigate firs?

• Respiratory apnea of 30 seconds

• During a home visit, the nurse observed an elderly client with diabetes slip and

fall. What action should the nurse take first?

• Check the client for lacerations or fractures

• At 0600 while admitting a woman for a schedule repeat cesarean section (CSection), the client tells the nurse that she drank a cup a coffee at 0400 because

she wanted to avoid getting a headache. Which action should the nurse take first?

• Inform the anesthesia care provider

• After placing a stethoscope as seen in the picture, the nurse auscultates S1 and S2

heart sounds. To determine if an S3 heart sound is present, what action should

the nurse take first?

• Listen with the bell at the same location

• A 66-year-old woman is retiring and will no longer have a health insurance

through her place of employment. Which agency should the client be referred to

by the employee health nurse for health insurance needs?

• Medicare

• A client who is taking an oral dose of a tetracycline complains of gastrointestinal

upset. What snack should the nurse instruct the client to take with the

tetracycline?

• Toasted wheat bread and jelly