the nurse is assessing a client with chronic renal failure who is receiving hemodialysis which of the following findings would indicate that the clien
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Nursing Elites

HESI RN

HESI Medical Surgical Exam

1. The healthcare provider is assessing a client with chronic renal failure who is receiving hemodialysis. Which of the following findings would indicate that the client is experiencing a complication of the treatment?

Correct answer: B

Rationale: A blood pressure of 150/90 mm Hg during hemodialysis may indicate fluid overload or an ineffective dialysis session, which can lead to complications such as heart failure or pulmonary edema. This finding should be reported promptly for further evaluation and intervention. Clear dialysate outflow is a normal and expected finding during hemodialysis, indicating proper filtration of waste products. Increased heart rate can be a normal compensatory response to hemodialysis due to fluid shifts and should be monitored but does not necessarily indicate a complication. Fatigue is a common symptom in clients with chronic renal failure undergoing hemodialysis and is not specific to complications of the treatment.

2. A client is being prepared for a colonoscopy. Into which position does the nurse assist the client for the procedure?

Correct answer: A

Rationale: During a colonoscopy, the client is positioned in the left Sims' position. This position is chosen as it optimally utilizes the client’s anatomy to facilitate the introduction of the colonoscope. The lithotomy position (Choice B) is commonly used for gynecological exams, not colonoscopies. The knee-chest position (Choice C) is typically employed for rectal examinations or certain surgical procedures, not colonoscopies. The right Sims' position (Choice D) is a less common position for colonoscopy compared to the left Sims' position.

3. A client with functional urinary incontinence is being taught by a nurse. Which statement should the nurse include in this client’s teaching?

Correct answer: D

Rationale: Functional urinary incontinence is not related to bladder issues but rather to difficulties with ambulation or accessing the toilet. The goal is to help the client manage clothing independently. Elastic waistband slacks that are easy to pull down facilitate timely access to the toilet. Choices A and B are unrelated and not applicable to functional urinary incontinence. Choice C is incorrect as surgeries to repair the bladder are not indicated for functional urinary incontinence.

4. A client who has had two episodes of bacterial cystitis in the last 6 months is being assessed by a nurse. Which questions should the nurse ask? (Select all that apply.)

Correct answer: D

Rationale: The correct answers are all of the above (D). Asking about fluid intake (choice A) is important as it can affect the risk of cystitis. Estrogen levels (choice B) can also impact the likelihood of recurrent cystitis. Family history (choice C) is relevant as certain genetic factors can predispose individuals to cystitis. Cranberry juice, not grapefruit or orange juice, has been found to reduce the risk of bacterial cystitis by increasing the acidic pH. Therefore, choices A, B, and C are all pertinent questions to ask during the assessment of a client with recurrent bacterial cystitis.

5. A client with gouty arthritis reports tenderness and swelling of the right ankle and great toe. The nurse observes the area of inflammation extends above the ankle. The client receives prescriptions for colchicine and indomethacin. Which instruction should the nurse include in the discharge teaching?

Correct answer: B

Rationale: The correct answer is to instruct the client to drink at least 8 cups (1920mL) of water per day. Adequate hydration helps to prevent the formation of uric acid crystals, which can exacerbate gout symptoms. Choice A is incorrect because while maintaining a healthy weight is important, it doesn't directly address gout management. Choice C is incorrect because using an electric heating pad can worsen inflammation. Choice D is incorrect because active range of motion may exacerbate pain and inflammation in the affected joints.

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