HESI RN EVOLVE Fundamentals Practice Exam
The nurse observes that a male client has removed the covering form an ice pack applied to his knee.
What action should the nurse take first?
Observe the appearance of the skin under the ice pack.
The nurse mixes 50mg of Niproide in 250ml of D5W and pl...
hesi rn evolve fundamentals practice exam the nurse observes that a male client has removed the covering form an ice pack applied to his knee what action should the nurse take first observe the app
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HESI RN EVOLVE Fundamentals Practice Exam
The nurse observes that a male client has removed the covering form an ice pack applied to his knee.
What action should the nurse take first?
Observe the appearance of the skin under the ice pack.
The nurse mixes 50mg of Niproide in 250ml of D5W and plans to administer the solution at a rate of
5mcg/kg/min to a client weighing 182lbs. Using a drip factor of 60gtt/ml, how many drops permin
should the client receive?
124gtt/min
lbs to kg
182/2.2 = 82.73kg
Dosage for the client
5mcg X 82.73 =413mcg/min
mcg / ml
250/50000mcg =200 mcg/ml
2.07ml/min with a drip factor of 60gtt/ml
60 x 2.07 =124.28gtt/min
A healthcare provider prescibes an IV infusion of 1000ml of Riger's Lactate with 30 units of Pitocin to run
in over 4hrs for a client who has just delievered a 10lbs infant via cesarean section. The tubing has been
changed to a 20gtt/ml administration set. The nurse plans to set the flow rate to how many gtt/min?
83 gtt/min
20gtt/ml x 1000 ml/4hrs x 1hr/60mins = 83gtt/min
,Wich assessment data provides the most accurate determination of proper placement of a nasogastric
tube?
Chest x-ray
Three days following surgery, a male client observes his colostomy for the first time. He becomes quite
upset and tells the nurse that it is much bigger than he expected. What is the best response by the
nurse?
Instruct the client that the stoma will become smaller when the initial swelling diminishes
A female client with a nasogastric tube attached to low suction states that she is nauseated. The nurse
assesses that there has been no drainage through the nasogastric tube in the last two hours. What
action should the nurse take first?
A. Irrigate the nasogastric tube with sterile normal saline.
B. Reposition the client on her side.
C. Advance the nasogastric tube an additional five centimeters.
D. Administer an intravenous antiemetic prescribed for PRN use.
Reposition the client on her side
A hospitalized male client is receiving nasogastric tube feeding via a small-bore tube and a continuous
pump infusion. He reports that he had a bad bout of severe coughing a few minutes ago, but feels fine
now. What action is best for the nurse to take?
After clearing the tube with 30ml of air, check the pH of fluid withdrawn from the tube.
A male client tells the nurse that he does not know where he is or what year it is. What data should the
nurse document that is most accurate?
Is disorientated to place and time
A client with chronic kidney disease (CKD) selects a scrambled egg for his breakfast. What action should
the nurse take?
Commend the client for selecting a high biologic value protein.
, When assisting an 82-year-old client to ambulate, it is important for the nurse to realize that the center
of gravity for an elderly person is the
A. Arms.
B. Upper torso.
C. Head.
D. Feet.
Upper Torso
In developing a plan of care for a client with dementia, the nurse should remember that confusion in the
elderly
Often follows relocation to new surroundings
A postoperative client will need to perform daily dressing changes after discharge. Which outcome
statement best demonstrates the client's readiness to manage his would care after discharge?
The client demonstrates the wound care procedure correctly.
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A client who is 5'5" tall and weighs 200 pounds is scheduled for surgery the next day. What question is
most important for the nurse to include during the preoperative assessment?
What vitamin and mineral supplements do you take?
During the initial morning assessment, a male client denies dysuria but reports that his urine appears
dark amber. Which intervention should the nurse implement?
A. Provide additional coffee on the client's breakfast tray.
B. Exchange the client's grape juice for cranberry juice.
C. Bring the client additional fruit at mid-morning.
D. Encourage additional oral intake of juices and water.
Encourage additional oral intake of juices and water.
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