HESI Comprehensive Exam A Practice Questions & Answers

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Which finding indicates a need to contact the health care provider before the nurse administers metformin (Glucophage)? a) The patient’s blood glucose level is 174 mg/dL. b) The patient is schedu... led for a chest x-ray in an hour. c) The patient has gained 2 lb (0.9 kg) in the past 24 hours. d) The patient’s blood urea nitrogen (BUN) level is 52 mg/dL. ANS: D The BUN indicates possible renal failure, and metformin should not be used in patients with renal failure. The other findings are not contraindications to the use of metformin. 12. A patient who has diabetes and reported burning foot pain at night receives a new prescription. Which information should the nurse teach the patient about amitriptyline ? a) Amitriptyline decreases the depression caused by your foot pain. b) Amitriptyline helps prevent transmission of pain impulses to the brain. c) Amitriptyline corrects some of the blood vessel changes that cause pain. d) Amitriptyline improves sleep and makes you less aware of nighttime pain. ANS: B Tricyclic antidepressants (TCAs) decrease the transmission of pain impulses to the spinal cord and brain. TCAs also improve sleep quality and are used for depression, but that is not the major purpose for their use in diabetic neuropathy. The blood vessel changes that contribute to neuropathy are not affected by TCAs. 13. A patient who has type 2 diabetes is being prepared for an elective coronary angiogram. Which information would the nurse anticipate might lead to rescheduling the test? a) The patient’s most recent A1C was 6.5%. b) The patient’s blood glucose is 128 mg/dL. c) The patient took the prescribed metformin today. d) The patient took the prescribed captopril this morning. ANS: C To avoid lactic acidosis, metformin should be discontinued a day or 2 before the coronary angiogram and should not be used for 48 hours after IV contrast media are administered. The other patient data will also be reported but do not indicate any need to reschedule the procedure. 14.Which action by a patient in [Show More]

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