HESI RN
HESI 799 RN Exit Exam Capstone
1. A client with hypothyroidism is prescribed levothyroxine. What symptom indicates that the dosage may need adjustment?
- A. Increased appetite and weight gain.
- B. Increased sensitivity to cold and dry skin.
- C. Increased heart palpitations and sweating.
- D. Increased shortness of breath and rapid heart rate.
Correct answer: B
Rationale: Increased sensitivity to cold and dry skin may indicate that the dosage of levothyroxine is too low, requiring adjustment. This symptom is typical of hypothyroidism when the body's metabolism slows down, leading to feeling cold and having dry skin. Choices A, C, and D present symptoms more commonly associated with hyperthyroidism, where the body is in a state of overactivity, leading to weight loss, increased heart rate, and sweating. Therefore, these symptoms would not indicate the need for dosage adjustment in a client with hypothyroidism.
2. The nurse administers an antibiotic for a respiratory tract infection. To evaluate the medication's effectiveness, which laboratory values should the nurse monitor?
- A. Platelet count and red blood cell count.
- B. White blood cell count and sputum culture.
- C. Hemoglobin A1c and glucose tolerance test.
- D. Arterial blood gases and serum electrolytes.
Correct answer: B
Rationale: The correct answer is B: White blood cell count and sputum culture. Monitoring white blood cell count and sputum cultures is essential to assess the effectiveness of the antibiotic in treating the respiratory tract infection. Changes in white blood cell count can indicate the body's response to infection, while sputum cultures help determine if the antibiotic is targeting the specific pathogens causing the infection. Choices A, C, and D are incorrect because platelet count, red blood cell count, hemoglobin A1c, glucose tolerance test, arterial blood gases, and serum electrolytes are not directly related to evaluating the effectiveness of an antibiotic in treating a respiratory tract infection.
3. A client with Alzheimer’s disease is becoming increasingly confused. What action should the nurse take first?
- A. Reorient the client to time and place.
- B. Monitor the client’s vital signs.
- C. Provide the client with calming activities to reduce confusion.
- D. Consult with the healthcare provider about adjusting the client’s medication.
Correct answer: B
Rationale: The correct action for the nurse to take first when a client with Alzheimer’s disease is becoming increasingly confused is to monitor the client’s vital signs (Choice B). Increased confusion in Alzheimer’s disease patients may indicate underlying issues like infection, dehydration, or medication side effects. Monitoring vital signs is crucial in identifying any potential causes of the confusion. Choices A, C, and D are not the priority in this situation. Reorienting the client to time and place (Choice A) can be helpful but is not the first priority. Providing calming activities (Choice C) and consulting with the healthcare provider about medication adjustments (Choice D) may be necessary but should come after assessing the client's vital signs to rule out immediate physical causes of confusion.
4. A client is admitted for first and second-degree burns on the face, neck, anterior chest, and hands. The nurse's priority should be
- A. Cover the areas with dry sterile dressings
- B. Assess for dyspnea or stridor
- C. Initiate intravenous therapy
- D. Administer pain medication
Correct answer: B
Rationale: Assessing for dyspnea or stridor is crucial as these are signs of airway compromise, which is a priority concern in burns involving the face. Burns on the face can lead to airway swelling or compromise due to airway proximity, making respiratory assessment the top priority. Covering the areas with dry sterile dressings, initiating intravenous therapy, and administering pain medication are important interventions but assessing for airway issues takes precedence in this situation.
5. A client with chronic kidney disease is prescribed erythropoietin. What is the nurse's priority action?
- A. Monitor the client's hemoglobin and hematocrit.
- B. Monitor the client's blood pressure.
- C. Assess the client for signs of infection.
- D. Monitor the client for signs of bleeding.
Correct answer: A
Rationale: The correct answer is A: 'Monitor the client's hemoglobin and hematocrit.' When a client with chronic kidney disease is prescribed erythropoietin, the nurse's priority action is to monitor the client's hemoglobin and hematocrit. Erythropoietin stimulates red blood cell production, so monitoring these lab values helps evaluate the effectiveness of erythropoietin in treating anemia. Monitoring the client's blood pressure (choice B) is important but not the priority in this scenario. Assessing the client for signs of infection (choice C) is important but not the priority related to the prescription of erythropoietin. Monitoring the client for signs of bleeding (choice D) is relevant but not the priority action when erythropoietin is prescribed.
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