HESI Comprehensive Exam ACTUAL TEST BANK 300
QUESTIONS AND CORRECT ANSWERS 2025 -2026
LATEST GRADED A+
A nurse administers nitroglycerin sublingually to a client diagnosed with angina pectoris who reports chest pain. The medication is ineffective, so the nurse prepares to administer a second dose. Before administering the nitroglycerin, which action does the nurse make a priority?Checking the client's blood pressure Obtaining blood levels of cardiac enzymes Asking the client if experiencing headache Obtaining a 12-lead electrocardiogram (ECG) - CORRECT ANSWER-Checking the client's blood pressure Rationale: Nitroglycerin is a nitrate that dilates the coronary arteries. One adverse effect of the medication is hypotension, and the nurse would assess the blood pressure and apical pulse before administration and periodically after the dose is given. Blood levels of cardiac enzymes are obtained if prescribed, but the priority is checking the client's blood pressure. Headache is a frequent side effect of the medication, mostly early in therapy and usually disappearing with continued treatment. It is not necessary to obtain a 12-lead ECG before administering a second dose of nitroglycerin unless this is prescribed by the primary health care provider. However, the client receiving intravenous nitroglycerin must have continuous ECG monitoring.
Ciprofloxacin hydrochloride is prescribed to a client with a urinary tract infection. The nurse provides instruction about the medication. What does the nurse tell the client about how best to take the medication?With milk With an antacid
- hours after meals
With aluminum hydroxide - CORRECT ANSWER-2 hours after meals Rationale: Ciprofloxacin hydrochloride is an anti-infective in the fluoroquinolone family. It may be taken without regard to meals, but the best dosing time is 2 hours after a meal. Milk may affect absorption. Antacids (here, aluminum hydroxide) may reduce absorption and should be administered 2 hours apart from the ciprofloxacin hydrochloride.
A nurse provides home care instructions to a client with coronary artery disease (CAD) who is being discharged from the hospital. Which statement by the client indicates a need for further instruction?"I need to carry my nitroglycerin with me at all times." "I need to check my pulse before, during, and after exercise." "I need to avoid foods with saturated fats and foods high in cholesterol." 1 / 4
"I need to participate in aerobic and weightlifting exercise three times a week." - CORRECT ANSWER- "I need to participate in aerobic and weightlifting exercise three times a week."
Rationale: There is a need for further instruction if the client states, "I need to participate in aerobic and weightlifting exercise three times a week." The client should avoid activities that involve straining, including weightlifting, push-ups and pull-ups, and straining during bowel movements. The client with CAD should participate in a simple exercise program on a regular basis. The client may begin a simple walking program by walking 400 feet (122 metres) twice a day at a rate of 1 mph (1.6 km/hr) the first week after discharge and increasing the distance and rate as tolerated, usually weekly, until he or she can walk 2 miles (3.2 km) at 3 to 4 mph (4.8 to 6.4 km/hr). The client should always carry nitroglycerin and must comply with dietary restrictions, including avoiding foods with saturated fats and foods high in cholesterol. The nurse instructs the client to take a pulse reading before, halfway through, and after exercise.
A nurse provides information to a client who will be undergoing endoscopic retrograde cholangiopancreatography (ERCP). What does the nurse tell the client?There is no need to fast (NPO status) before the procedure The gallbladder is easily removed during this procedure if gallstones are found The procedure is only performed to visualize the esophagus, stomach, and duodenum Dye may be injected during the procedure to permit visualization of the pancreatic and biliary ducts - CORRECT ANSWER-Dye may be injected during the procedure to permit visualization of the pancreatic and biliary ducts Rationale: The nurse tells the client that dye may be injected to outline the pancreatic and biliary ducts. ERCP involves the oral insertion of an endoscope with a side-viewing tip and a cannula that can be maneuvered into the ampulla of Vater. The procedure may be combined with papillotomy to enlarge the sphincter and release gallstones. However, the gallbladder itself cannot be removed during this procedure. As with any endoscopic procedure, the client must remain NPO for 8 hours before the test.
A client who has undergone knee-replacement surgery will be self-administering enoxaparin sodium at home. The nurse teaches the client about the medication. What does the nurse tell the client?Store the medication in the refrigerator Lie down to administer the subcutaneous injection Inject the medication in the upper outer aspect of the arm Discard the medication if the solution appears pale yellow - CORRECT ANSWER-Lie down to administer the subcutaneous injection Rationale: The client is instructed to lie down to administer the injection and to introduce the entire length of the needle (½ inch [1.25 cm]) into a skin fold held between the thumb and forefinger. Enoxaparin sodium is an anticoagulant that is administered by way of subcutaneous 2 / 4
injection. It is injected into the abdominal wall. The solution, which appears clear and colorless to pale yellow, is stored at room temperature.
An intravenous dose of adenosine is prescribed for a client to treat Wolff-Parkinson-White syndrome. Which piece of equipment does the nurse make a priority of obtaining before administering the medication?Pulse oximeter Cardiac monitor Blood-pressure cuff Suction catheter and suction machine - CORRECT ANSWER-Cardiac monitor Rationale: Obtaining a cardiac monitor is the priority. Wolff-Parkinson-White syndrome is an abnormality of cardiac rhythm that is manifested as supraventricular tachycardia. Adenosine is an antidysrhythmic medication used to treat this dysrhythmia. It is administered intravenously. A pulse oximeter and blood pressure cuff will each provide information about the client's cardiovascular status, but neither is the priority. There is no information in the question to indicate that a suction catheter and suction machine are necessary.
A nurse provides information about smoking-cessation measures to a client diagnosed with coronary artery disease (CAD). Which statement by the client indicates a need for further information?"A community support group will help me quit." "I should drink a cup (235 ml) of coffee if I feel the urge to smoke." "Relaxation exercises will help control my urge to smoke." "I can try chewing gum or sucking on hard candy if I feel the urge to smoke." - CORRECT ANSWER-"I should drink a cup (235 ml) of coffee if I feel the urge to smoke." Rationale: The nurse should reinforce education about the hazards of smoking and provide encouragement to clients who are interested in or willing to try smoking cessation. The client should avoid using coffee and other caffeine-containing products, which can cause restlessness and anxiety, increasing the urge to smoke. There are appropriate strategies to assist in smoking cessation. Among these are community support groups, relaxation exercises, and strategies such as chewing gum or sucking on hard candy if the urge to smoke arises.
Captopril is prescribed for a hospitalized client with heart failure. Which action is a priority once the nurse has administered the first dose?Checking the client's apical heart rate Maintaining the client on bed rest for 3 hours Monitoring the client for increased urine output 3 / 4
Checking the client's breath sounds for decreased wheezing - CORRECT ANSWER-Maintaining the client on bed rest for 3 hours
Rationale: The client is closely monitored for hypotension at the start of therapy and is maintained on bed rest for 3 hours after the initial dose. Captopril is an angiotensin-converting enzyme (ACE) inhibitor. Excessive hypotension (first-dose syncope) may occur in the client with heart failure or in the client who is severely salt or volume depleted. Checking the apical heart rate will provide information about the client's cardiac status but is not an intervention specifically related to this medication. Increased urine output and decreased wheezing are expected if the client has received a diuretic.
A client diagnosed with heart failure suddenly experiences profound dyspnea, pallor, audible wheezing, and cyanosis, and the nurse suspects pulmonary edema. What should the nurse do first?Obtain a pulse oximetry reading Raise the head of the client's bed Administer a dose of morphine sulfate Obtain a specimen for an arterial blood gas determination - CORRECT ANSWER-Raise the head of the client's bed Rationale: The nurse would first raise the head of the client's bed and position the client to maximize chest expansion to ease the air hunger that the client is experiencing. Acute pulmonary edema is characterized by profound dyspnea, pallor, audible wheezing, and cyanosis. An arterial blood gas or pulse oximetry reading will reveal the need for supplemental oxygen. Morphine sulfate may be administered because it blunts the sympathetic response and promotes peripheral vasodilation. However, the nurse also needs to contact the primary health case provider to prescribe that medication. On the basis of the options provided, however, the initial action is placing the client in a head-elevated position.
The nurse administers intravenous morphine sulfate to a client in pulmonary edema. For which intended effect of the medication does the nurse monitor the client?Relief of pain Relief of anxiety Decreased urine output Increased blood pressure - CORRECT ANSWER-Relief of anxiety Rationale: Morphine sulfate reduces anxiety in the client in pulmonary edema. It blunts the sympathetic response and increases venous capacitance, thereby decreasing left atrial pressure. It also promotes peripheral vasodilation and causes blood to pool in the periphery. The client receiving morphine sulfate is monitored for signs/symptoms of respiratory depression and extreme decreases in blood pressure, especially when the medication is administered intravenously. Although morphine sulfate is an opioid analgesic and relieves pain, it is not
- / 4