HESI RN
HESI 799 RN Exit Exam Quizlet
1. The nurse observes an adolescent client preparing to administer a prescribed corticosteroid medication using a metered dose inhaler. What action should the nurse take?
- A. Remind the client to hold their breath after inhaling the medication
- B. Confirm that the client has correctly shaken the inhaler
- C. Affirm that the client has correctly positioned the inhaler
- D. Ask the client if they have a spacer to use for this medication
Correct answer: A
Rationale: Corrected Rationale: Reminding the client to hold their breath after inhaling the medication is crucial as it helps ensure the medication is absorbed into the lungs. Option B is incorrect because shaking the inhaler is not directly related to the client's inhalation technique. Option C is incorrect as correct positioning of the inhaler is important but not the immediate action needed in this situation. Option D is incorrect as asking about the spacer is not the most relevant action to take at this moment.
2. A client with type 1 diabetes is admitted with diabetic ketoacidosis (DKA). Which laboratory value is most concerning?
- A. Serum glucose of 300 mg/dl
- B. Serum bicarbonate of 18 mEq/L
- C. Serum potassium of 5.5 mEq/L
- D. Serum sodium of 135 mEq/L
Correct answer: C
Rationale: A serum potassium level of 5.5 mEq/L is concerning in a client with DKA as it may indicate worsening hyperkalemia, requiring immediate intervention. Elevated serum potassium levels can lead to life-threatening cardiac arrhythmias. While elevated glucose and low bicarbonate are characteristic of DKA, hyperkalemia poses a higher immediate risk. Serum sodium within the normal range is not typically a primary concern in DKA.
3. While performing a skin inspection for a female adult client, the nurse observes a rash that is well circumscribed, has silvery scales and plaques, and is located on the elbows and knees. These assessment findings are likely to indicate which condition?
- A. Tinea corporis
- B. Herpes zoster
- C. Psoriasis
- D. Drug reaction
Correct answer: C
Rationale: The correct answer is C, Psoriasis. Psoriasis commonly presents with well-circumscribed, silvery scales and plaques, typically found on extensor surfaces like elbows and knees. Tinea corporis (A) presents as a circular rash, herpes zoster (B) presents as a painful rash following a dermatomal pattern, and drug reactions (D) have variable presentations not specific to elbows and knees with silvery scales and plaques.
4. After checking the fingerstick glucose at 1630, what action should be implemented?
- A. Notify the healthcare provider.
- B. Administer 8 units of insulin aspart SubQ.
- C. Give an IV bolus of Dextrose 50% 50 ml.
- D. Perform quality control on the glucometer.
Correct answer: B
Rationale: Administering insulin aspart (rapid-acting insulin) is the appropriate action to manage the elevated glucose level of 1630. Choice A, notifying the healthcare provider, is not the immediate action needed for this glucose level. Choice C, giving an IV bolus of Dextrose 50%, would exacerbate hyperglycemia instead of treating it. Choice D, performing quality control on the glucometer, is not relevant to the management of the patient's glucose level at this time.
5. A client with type 2 diabetes is admitted with hyperglycemic hyperosmolar syndrome (HHS). Which laboratory value is most concerning?
- A. Serum glucose of 300 mg/dL
- B. Blood pressure of 140/90 mmHg
- C. Serum osmolarity of 320 mOsm/kg
- D. Serum pH of 7.30
Correct answer: C
Rationale: In a client with hyperglycemic hyperosmolar syndrome (HHS), a serum osmolarity of 320 mOsm/kg is the most concerning laboratory value. This high osmolarity indicates severe dehydration, which can lead to serious complications. Elevated serum glucose levels (choice A) are expected in HHS but do not directly reflect dehydration. Blood pressure (choice B) and serum pH (choice D) are important parameters to monitor but are not the most concerning values in HHS compared to serum osmolarity.
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