ATI RN
hesi health assessment test bank 2023 Questions
Question 1 of 9
Which serotonin antagonist can be used to relieve nausea and vomiting?
Correct Answer: B
Rationale: The correct answer is B: ondansetron (Zofran). Ondansetron is a selective serotonin receptor antagonist that effectively targets the serotonin receptors in the chemoreceptor trigger zone to relieve nausea and vomiting. It is commonly used in chemotherapy-induced nausea and vomiting. A: Metoclopramide is a dopamine receptor antagonist and primarily used for gastrointestinal motility disorders, not specifically for nausea relief. C: Hydroxyzine is an antihistamine with sedative properties, primarily used for anxiety and itching, not specifically for nausea relief. D: Prochlorperazine is a dopamine receptor antagonist primarily used for treating psychotic disorders, not specifically for nausea relief. In summary, ondansetron is the correct choice as it targets serotonin receptors specifically for relieving nausea and vomiting, whereas the other options focus on different mechanisms of action.
Question 2 of 9
A nurse is caring for a patient with pneumonia. Which of the following interventions should the nurse prioritize?
Correct Answer: B
Rationale: The correct answer is B: Administering oxygen as prescribed. Oxygen therapy is a critical intervention in pneumonia to improve oxygenation and prevent hypoxia. Priority is given to interventions that address the immediate physiological needs of the patient. Encouraging fluid intake (A) is important but not as urgent as oxygen therapy. Encouraging ambulation (C) can be beneficial for overall health but may not be suitable for a patient with pneumonia. Providing pain medication (D) is important for comfort but is not the priority in this case.
Question 3 of 9
Which nursing measure is most appropriate to meet the expected outcome of positive body image in a client with Kawasaki disease?
Correct Answer: C
Rationale: The correct answer is C: explaining progression of the disease to the client and family. This measure helps the client and family understand the disease, leading to better coping and acceptance, thus promoting a positive body image. Administering immune globulin (A) is not directly related to body image. Assessing extremities (B) and heart sounds (D) are important for monitoring the disease but do not directly impact body image.
Question 4 of 9
What is the most effective intervention for a client experiencing a panic attack?
Correct Answer: B
Rationale: The correct answer is B because lorazepam is a fast-acting medication that can help reduce the intensity of a panic attack quickly. It works by calming the central nervous system and reducing anxiety symptoms. Encouraging slow, deep breathing (choice A) can be helpful, but it may not be as effective as medication in stopping a severe panic attack. Lying down (choice C) can provide comfort but does not address the underlying physiological response. Breathing into a paper bag (choice D) can actually be harmful as it may lead to hyperventilation.
Question 5 of 9
Which of the following should be assessed first in a client with a high fever?
Correct Answer: C
Rationale: The correct answer is C: Check for dehydration. When a client has a high fever, assessing for dehydration is crucial because fever can lead to increased fluid loss through sweating and increased respiratory rate. Dehydration can exacerbate the client's condition and needs to be addressed promptly. Monitoring respiratory rate (choice A) and pulse (choice D) are important assessments but do not address the immediate need to identify dehydration. Obtaining a blood sample (choice B) may be necessary at some point but is not the initial priority in a client with a high fever. Thus, checking for dehydration should be assessed first to ensure proper management of the client's condition.
Question 6 of 9
What is the most important assessment for a client with diabetes and newly diagnosed hypertension?
Correct Answer: B
Rationale: The correct answer is B: Perform a comprehensive physical exam. This is important because it helps assess the overall health status of the client, including cardiovascular risk factors that can affect both diabetes and hypertension. Monitoring blood glucose (A) is important for diabetes management but not specific to newly diagnosed hypertension. Checking for protein in the urine (C) is important for assessing kidney function in diabetes, but not the most crucial assessment for newly diagnosed hypertension. Assessing for urinary retention (D) is not directly related to managing diabetes and hypertension.
Question 7 of 9
The nurse would plan to use the Nipissing District Developmental Screen with a child who is:
Correct Answer: A
Rationale: The correct answer is A (3 years old) because the Nipissing District Developmental Screen is specifically designed for children aged 1 month to 6 years to assess their developmental milestones. It focuses on various areas of development appropriate for this age group, such as motor skills, language, social interaction, and cognitive abilities. Using this tool with a 3-year-old child allows for early identification of potential developmental delays or concerns. Incorrect choices: B (16 years old) - The Nipissing District Developmental Screen is not intended for children above 6 years old. C (8 years old with a developmental delay) - The tool is primarily for early screening, not for children already identified with developmental delays. D (Having difficulty with gross motor skills) - While this child may benefit from assessment, the Nipissing Screen is a comprehensive tool for overall development, not just specific skill deficits.
Question 8 of 9
Which areas are most important to address for a client in Buck's traction?
Correct Answer: C
Rationale: Step 1: Nutrition is important for healing and energy. Step 2: Elimination is crucial for bowel and bladder function. Step 3: Comfort ensures the client's well-being. Step 4: Safety prevents complications. Step 5: ROM exercises can prevent muscle atrophy. Step 6: Transportation and isotonic exercises are not immediate priorities.
Question 9 of 9
The nurse is teaching parents of a newborn about feeding their infant. Which instruction should the nurse include?
Correct Answer: A
Rationale: Rationale for Correct Answer A: 1. Using the defrost setting on microwave ovens to warm bottles is safe because it ensures even heating without creating hot spots that could burn the baby's mouth. 2. This method helps to preserve the nutrients in the breast milk or formula. 3. It is important to warm the bottle to body temperature to mimic the natural feel of breast milk for the baby's comfort. Summary of Incorrect Choices: B: Feeding the baby partially used bottles after 24 hours can increase the risk of bacterial contamination and foodborne illness. C: Mixing two parts water and one part concentrate for formula concentrate is incorrect as it may dilute the formula, leading to inadequate nutrition for the baby. D: Adding new formula to partially used bottles can alter the balance of nutrients and increase the risk of contamination, affecting the baby's health.