A female client with major depressive disorder tells the nurse she feels worthless and can't see how her life will ever get better. What is the best response by the nurse?

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HESI RN Exit Exam 2023 Questions

Question 1 of 5

A female client with major depressive disorder tells the nurse she feels worthless and can't see how her life will ever get better. What is the best response by the nurse?

Correct Answer: C

Rationale: Choice C is the best response because it directly addresses the client's expressed hopelessness and assesses the risk for self-harm. When a client with major depressive disorder expresses feeling worthless and unable to see improvement, it is essential to assess suicidal ideation to ensure their safety. Choices A, B, and D provide empathy and support, which are important but addressing suicidal ideation is the priority in this situation.

Question 2 of 5

The nurse notes that a client who has undergone a thoracotomy has an increase in a large amount of dark red blood in the chest tube collection chamber. What action should the nurse take?

Correct Answer: B

Rationale: An increase in a large amount of dark red blood in the chest tube collection chamber may indicate active bleeding. The nurse should notify the healthcare provider immediately to address the situation promptly and prevent further complications. Documenting the findings without taking immediate action could delay necessary interventions. Checking the tube for kinks or dependent loops is a good practice but not the priority when dealing with a potentially life-threatening situation like active bleeding. Increasing the suction without healthcare provider's orders can lead to complications and is not appropriate in this scenario.

Question 3 of 5

A male client reports the onset of numbness and tingling in his fingers and around his mouth. Which lab test is important for the nurse to review before contacting the healthcare provider?

Correct Answer: C

Rationale: The correct answer is C: Serum calcium. Numbness and tingling in the fingers and around the mouth are indicative of hypocalcemia. Serum calcium levels should be reviewed as they play a crucial role in diagnosing and managing hypocalcemia. Option A, capillary glucose, is not relevant to the symptoms described. Option B, urine specific gravity, is not typically used to assess numbness and tingling. Option D, white blood cell count, is unrelated to the symptoms presented by the client.

Question 4 of 5

A woman with an anxiety disorder calls her obstetrician's office and tells the nurse of increased anxiety since the normal vaginal delivery of her son three weeks ago. Since she is breastfeeding, she stopped taking her antianxiety medications, but thinks she may need to start taking them again because of her increased anxiety. What response is best for the nurse to provide this woman?

Correct Answer: C

Rationale: The correct response, option C, is the most appropriate in this scenario because it provides the woman with accurate and helpful information. When a breastfeeding mother is considering restarting her antianxiety medication, it is crucial to inform her that there are medications that are safe to take while breastfeeding. This response promotes the well-being of both the mother and the infant by addressing the woman's mental health needs without compromising the safety of her breastfeeding child. Option A is incorrect because solely discussing the transmission of drugs to the infant does not address the woman's immediate concern of managing her anxiety effectively. Option B, while promoting stress-relieving techniques, may not be sufficient for managing clinical anxiety in this situation. Option D is incorrect as it dismisses the woman's legitimate concerns and fails to offer any practical solutions to address her anxiety. In an educational context, this question highlights the importance of understanding pharmacological considerations in special populations, such as breastfeeding mothers. It emphasizes the need for healthcare providers to be knowledgeable about safe medication use during breastfeeding to support maternal mental health while ensuring infant safety. Encouraging open communication and providing evidence-based information are essential in guiding women through such complex decisions.

Question 5 of 5

The healthcare provider prescribes ceftazidime (Fortaz) 35 mg every 8 hours IM for an infant. The 500 mg vial is labeled with the instruction to add 5.3 ml diluent to provide a concentration of 100 mg/ml. How many ml should the nurse administer for each dose?

Correct Answer: B

Rationale: To calculate the volume to be administered for 35 mg of ceftazidime, divide the prescribed dose by the concentration: 35 mg / 100 mg/ml = 0.35 ml. Rounding off, the nurse should administer 0.4 ml for each dose. Choice A is incorrect as it doesn't consider rounding off. Choice C is incorrect because it's not the correct calculation. Choice D is incorrect as it doesn't reflect the accurate volume needed.

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