one week after being told that she has terminal cancer with a life expectancy of 3 weeks a female client tells the nurse i think i will plan a big par
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Nursing Elites

HESI RN

HESI Fundamentals Practice Exam

1. One week after being told that she has terminal cancer with a life expectancy of 3 weeks, a female client tells the nurse, 'I think I will plan a big party for all my friends.' How should the nurse respond?

Correct answer: C

Rationale: Setting goals that bring pleasure is appropriate and should be encouraged by the nurse. Choice A is discouraging and focuses on limitations. Choice B jumps to a conclusion and is not in line with the client's statement. Choice D dictates what the client should be doing, which is not respectful of the client's autonomy. Therefore, the most appropriate response is C, as it acknowledges the client's wishes and provides positive reinforcement without perpetuating denial.

2. A client has a nursing diagnosis of 'spiritual distress.' What intervention is best for the nurse to implement when caring for this client?

Correct answer: D

Rationale: When a client is going through spiritual distress, employing reflective listening techniques is crucial. This method allows the client to voice their concerns and emotions, providing them with a supportive environment to explore their feelings. Options A and B do not directly address the client's spiritual distress and may undermine the client's feelings. While option C involves a chaplain, using reflective listening directly involves the nurse in addressing and supporting the client's spiritual concerns.

3. A client with cirrhosis and ascites is receiving furosemide 40 mg BID. The pharmacy provides 20 mg tablets. How many tablets should the client receive each day? [Enter numeric value only]

Correct answer: A

Rationale: To calculate the total daily dose of furosemide needed, 40 mg BID (twice a day) is 80 mg/day. Since each tablet is 20 mg, the client should receive a total of 4 tablets per day (80 mg ÷ 20 mg per tablet = 4 tablets). Therefore, the correct answer is 4 tablets. Choice B (3 tablets) is incorrect because it does not provide the correct total daily dose. Choice C (2 tablets) is incorrect as it would not meet the required dose of 80 mg/day. Choice D (1 tablet) is incorrect as it would be insufficient to achieve the prescribed daily dose.

4. A client with a history of heart failure is admitted with a diagnosis of pulmonary edema. Which intervention should the nurse implement first?

Correct answer: A

Rationale: Administering oxygen via a non-rebreather mask is the priority intervention for a client with pulmonary edema to improve oxygenation and address respiratory distress. Adequate oxygenation is essential to support vital organ function. Administering furosemide intravenously, inserting a Foley catheter to monitor urine output, and positioning the client in a high Fowler's position are important interventions but are secondary to ensuring optimal oxygenation in this client with pulmonary edema.

5. The nurse is providing discharge teaching to a client with a new prescription for warfarin (Coumadin). Which dietary instruction should the nurse include?

Correct answer: A

Rationale: The correct dietary instruction for a client taking warfarin is to avoid foods high in vitamin K. Warfarin is an anticoagulant that works by inhibiting vitamin K-dependent clotting factors. Consuming foods high in vitamin K, such as leafy green vegetables, can antagonize the effects of warfarin, potentially leading to treatment inefficacy or fluctuations in anticoagulation levels. Therefore, clients on warfarin therapy should be advised to avoid foods high in vitamin K to maintain the effectiveness of the medication. Choices B, C, and D are incorrect because increasing leafy green vegetables (choice B) would introduce more vitamin K, consuming a consistent amount of foods high in potassium (choice C) is not directly related to warfarin therapy, and limiting high-protein foods (choice D) is not a specific concern for clients on warfarin therapy.

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