APV1 : HESI Medical Health Adult Health
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Free APV1 : HESI Medical Health Adult Health Questions
An older adult client is admitted to the hospital after 24 hours of acute diarrhea. To determine fluid status, which initial data is most important for the nurse to obtain?
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Number and frequency of stools.
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Intake and output 24 hours prior to admission.
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Color and amount of urine.
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Usual and current weight.
Explanation
Correct Answer:
D
Why the other options are incorrect:
Option A is incorrect because while the number and frequency of stools provides context about the diarrhea, it does not directly quantify the client's current fluid status. Option B is incorrect because intake and output data, while useful, is less reliable than weight change for determining overall fluid status, especially in the acute setting. Option C is incorrect because color and amount of urine provides supportive information but is not as precise or objective an indicator as a weight comparison.
A client diagnosed with chronic obstructive pulmonary disease (COPD) is given a new prescription for tiotropium via an inhalation device. Which statement indicates that the client understands the instructions for using this medication?
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I will use my other inhaler in between uses.
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If I have sudden shortness of breath, I will use this inhaler.
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When I cough up sputum, the secretions should be less thick.
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I should use this medication in its handihaler every day.
Explanation
Correct Answer:
D
Why the other options are incorrect:
Option A is incorrect because this statement does not specifically address the correct understanding of tiotropium's administration and could suggest confusion about combining medications inappropriately. Option B is incorrect because tiotropium is a long-acting maintenance medication, not a rescue inhaler for acute shortness of breath, so using it for sudden symptoms would be an incorrect understanding. Option C is incorrect because tiotropium works by bronchodilation and does not have a specific mucolytic effect on thinning secretions.
A client is being cared for in the emergency department (ED) with acute abdominal pain and a provisional diagnosis of pancreatitis. The nurse assesses the client and obtains the results from laboratory studies. Which information is most valuable in reporting the client's status to the healthcare provider (HCP)?
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Severity of nausea and vomiting and serum amylase results
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Reports of chronic constipation and serum gastrin levels
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Presence of bowel sounds and degree of abdominal pain
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Serum Helicobacter pylori (H. pylori) antibody results and urine output amounts
Explanation
Elevated serum amylase is a key diagnostic marker for pancreatitis, and the severity of associated nausea and vomiting provides important clinical information about the client's symptom burden and status, making this the most valuable and relevant information to report for a provisional diagnosis of pancreatitis.
Why the other options are incorrect:
B. Reports of chronic constipation and serum gastrin levels — Chronic constipation and gastrin levels are not the primary or most relevant findings associated with pancreatitis; gastrin is more closely associated with conditions like Zollinger-Ellison syndrome or peptic ulcer disease.
C. Presence of bowel sounds and degree of abdominal pain — While abdominal pain is relevant, bowel sounds and pain alone are less specific and valuable for confirming a pancreatitis diagnosis compared to lab markers like amylase.
D. Serum Helicobacter pylori (H. pylori) antibody results and urine output amounts — H. pylori antibody testing is associated with peptic ulcer disease, not pancreatitis, making this information not directly relevant to the client's provisional diagnosis.
A client is recovering from the surgical removal of glass in the right eye. Which intervention should the nurse implement immediately following the procedure?
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Obtain vital signs every 2 hours during hospitalization.
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Encourage deep breathing and coughing exercises.
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Provide an eye shield to be worn while sleeping.
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Teach a family member to administer eye drops.
Explanation
Correct Answer:
C
Why the other options are incorrect:
Option A is incorrect because routine vital sign monitoring is not the immediate priority specific to eye protection following this procedure. Option B is incorrect because deep breathing and coughing exercises can increase intraocular pressure and should generally be avoided or minimized after eye surgery. Option D is incorrect because client and family teaching on eye drop administration is important but is not the immediate priority right after the procedure compared to protecting the eye from injury.
A client presents to the emergency department (ED) with muscle aches, headache, fever, and describes a recent loss of taste and smell. The nurse obtains a nasal swab for COVID-19 testing. Which action is most important for the nurse to take?
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Report the COVID-19 result to the local health department according to Centers for Disease Control and Prevention (CDC) guidelines.
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Isolate the client from other clients, family, and healthcare workers not wearing proper personal protective equipment (PPE).
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Teach the client to wear a mask, hand wash, and social distance to prevent spreading the virus.
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Counsel family members to monitor for illness symptoms for 2 weeks after last contact with patient.
Explanation
Correct Answer:
B
Why the other options are incorrect:
Option A is incorrect because reporting to the health department is an important follow-up action but is not the immediate priority compared to preventing transmission through isolation. Option C is incorrect because while client education is valuable, it does not take priority over immediately implementing isolation precautions to protect others. Option D is incorrect because counseling family members is a later step and does not address the immediate need to isolate the client and prevent transmission within the healthcare facility.
The nurse is caring for a client who is taking diclofenac for rheumatoid arthritis. During a clinic visit, the client appears pale and reports increasing fatigue. Which of the client's serum laboratory values is most important for the nurse to review?
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Total protein.
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Glucose.
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Sodium.
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Hemoglobin.
Explanation
Correct Answer:
D
Why the other options are incorrect:
Option A is incorrect because total protein is not directly associated with the client's presenting symptoms of pallor and fatigue related to diclofenac use. Option B is incorrect because glucose levels are not relevant to the symptoms described or to diclofenac's known adverse effects. Option C is incorrect because sodium levels are not associated with the client's presenting symptoms or with the primary adverse effects of diclofenac.
This is the same case set as before (78-year-old female, stage 3 pressure injury at the coccyx).
Nurses' Notes 0800: Head-to-toe assessment complete. Vital signs stable. Pressure injury at the coccyx has an antimicrobial gel in the wound base covered with foam. Dressing clean, dry, and intact. 1200: Client returned from physical therapy for hip pain. Vital signs stable. Wound dressing clean, dry, and intact. 1500: Client called out on the call light. Reported an incontinent episode. Perineal cleaning and linen change completed by unlicensed assistive personnel (UAP). During follow up assessment, the wound dressing is noted to be soiled with a broken seal. Contacted wound care nurse for dressing change.
Laboratory Results Wound culture: Pending (Reference range: Negative)
Orders — 0830 Wound dressing change every Monday, Wednesday, Friday, and PRN Cleanse with normal saline and pat dry Apply antimicrobial gel to wound base Cover with foam dressing
Flow Sheet 0800 Vital signs: Temperature 98°F (36.7°C) orally, Heart rate 82 beats/minute, Respirations 14 breaths/minute, Blood pressure 136/62 mm Hg, Oxygen saturation 99% on room air, Pain 1 on 0 to 10 scale, located at coccyx. 1200 Vital signs: Temperature 98.4°F (36.9°C) orally, Heart rate 82 beats/minute, Respirations 14 breaths/minute, Blood pressure 136/62 mm Hg, Oxygen saturation 99% on room air, Pain 2 on 0 to 10 scale, located at coccyx.
The wound care nurse is preparing to change the client's dressing. For each technique item, indicate whether the technique is indicated or not indicated.
Techniques | Indicated | Not Indicated
- Gather materials to change soiled items only — Not Indicated
- Place sterile gauze directly on wound bed — Not Indicated
- Apply sterile gloves prior to changing — Indicated
- Apply sterile foam dressing over wound bed — Indicated
- Thoroughly clean wound using normal saline prior to redressing — Indicated
- Maintain clean medical asepsis — Not Indicated
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Gather materials to change soiled items only — Not Indicated
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Place sterile gauze directly on wound bed — Not Indicated
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Apply sterile gloves prior to changing — Indicated
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Apply sterile foam dressing over wound bed — Indicated
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Thoroughly clean wound using normal saline prior to redressing — Indicated
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Maintain clean medical asepsis — Not Indicated
Explanation
A stage 3 pressure injury involves full-thickness skin loss and requires sterile technique, not clean medical asepsis, to prevent introducing infection into the wound. The current dressing was soiled with a broken seal, meaning the entire dressing system has been compromised and must be fully replaced rather than only the soiled portions. Per the order, the wound bed should receive normal saline cleansing followed by antimicrobial gel and a foam dressing, not gauze placed directly on the wound. Sterile gloves are required throughout the procedure to maintain a sterile field and reduce infection risk, especially given the recent contamination from the incontinent episode.
A woman with a long history of taking oral contraceptives develops shortness of breath and a severe headache. She is admitted to the intensive care unit (ICU) with a suspected pulmonary embolus (PE). Her admission laboratory test results include a platelet count of 20,000/mm³ (20 × 10⁹/L). Which action should the nurse implement?
Reference Range: Platelets [150,000 to 400,000/mm³ (150 to 400 × 10⁹/L)]
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Administer a PRN analgesic for the headache.
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Monitor for evidence of spontaneous bleeding.
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Limit visitors to two family members at a time.
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Implement protective environment precautions.
Explanation
Correct Answer:
B
Why the other options are incorrect:
Option A is incorrect because while pain management is important, it is not the priority when the client has a critically low platelet count that poses a life-threatening bleeding risk. Option C is incorrect because limiting visitors does not address the client's immediate physiological risk related to thrombocytopenia. Option D is incorrect because protective environment precautions are used for clients who are severely immunocompromised or neutropenic, not for thrombocytopenia.
A client has been administered lactulose for several days. Which therapeutic response should the nurse expect for a client with hepatic encephalopathy?
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Improved mental status.
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Reduction in number of liquid stools.
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Ability to ambulate independently.
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Increase in urine output.
Explanation
Correct Answer:
A
Why the other options are incorrect:
Option B is incorrect because lactulose is expected to increase, not reduce, the number of liquid stools as part of its mechanism to eliminate ammonia from the body. Option C is incorrect because improved ambulation is not a direct therapeutic response to lactulose, as this medication specifically targets ammonia reduction rather than motor function. Option D is incorrect because lactulose does not have a therapeutic effect on urine output, as its primary action is through the gastrointestinal system.
A client with cholelithiasis has a gallstone lodged in the common bile duct and is unable to eat or drink without episodes of nausea and vomiting manifesting. Which finding should the nurse report to the healthcare provider (HCP)?
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Belching.
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Yellow sclera.
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Amber urine.
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Flatulence.
Explanation
Correct Answer:
B
Why the other options are incorrect:
Option A is incorrect because belching is a common, nonspecific symptom associated with gallbladder disease and does not indicate a worsening or urgent complication. Option C is incorrect because while amber urine can occur with bile duct obstruction, yellow sclera is a more direct and visible indicator of rising bilirubin levels that warrants prompt reporting. Option D is incorrect because flatulence is a common, benign symptom often associated with gallbladder disease and does not indicate a serious complication requiring immediate reporting.
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