HESI RN
HESI RN Exit Exam 2023
1. A client with chronic obstructive pulmonary disease (COPD) is admitted with an exacerbation. Which assessment finding is most concerning?
- A. Oxygen saturation of 90%
- B. Respiratory rate of 24 breaths per minute
- C. Use of accessory muscles
- D. Inspiratory crackles
Correct answer: C
Rationale: The correct answer is C. Use of accessory muscles is the most concerning finding in a client with COPD experiencing an exacerbation. This indicates increased work of breathing and can be a sign of respiratory failure, requiring immediate intervention. Oxygen saturation of 90% is low but not as concerning as the increased work of breathing. A respiratory rate of 24 breaths per minute can be within normal limits. Inspiratory crackles may be present in COPD due to airway inflammation but are not as concerning as the use of accessory muscles.
2. A woman with an anxiety disorder calls her obstetrician's office and tells the nurse of increased anxiety since the normal vaginal delivery of her son three weeks ago. Since she is breastfeeding, she stopped taking her antianxiety medications, but thinks she may need to start taking them again because of her increased anxiety. What response is best for the nurse to provide this woman?
- A. Describe the transmission of drugs to the infant through breast milk
- B. Encourage her to use stress-relieving alternatives, such as deep breathing exercises
- C. Inform her that some antianxiety medications are safe to take while breastfeeding
- D. Explain that anxiety is a normal response for the mother of a 3-week-old.
Correct answer: C
Rationale: There are several antianxiety medications that are not contraindicated for breastfeeding mothers, so it is important to inform her of this option.
3. A client with a history of coronary artery disease (CAD) is admitted with chest pain. Which diagnostic test should the nurse anticipate preparing the client for first?
- A. Electrocardiogram (ECG)
- B. Chest X-ray
- C. Arterial blood gases (ABGs)
- D. Echocardiogram
Correct answer: A
Rationale: The correct answer is A: Electrocardiogram (ECG). An electrocardiogram should be performed first to assess for cardiac ischemia in a client with a history of CAD and chest pain. An ECG provides immediate information about the heart's electrical activity, helping to identify signs of ischemia or a heart attack. While other diagnostic tests like chest X-ray, arterial blood gases, and echocardiogram may also be necessary in the evaluation of chest pain, they do not provide the initial direct assessment of cardiac ischemia that an ECG does.
4. The nurse is reinforcing home care instructions with a client who is being discharged following a transurethral resection of the prostate (TURP). Which intervention is most important for the nurse to include in the client's instructions?
- A. Avoid strenuous activity for 6 weeks.
- B. Report fresh blood in the urine.
- C. Take acetaminophen for fever of 101°F.
- D. Consume 6 to 8 glasses of water daily.
Correct answer: B
Rationale: Reporting fresh blood in the urine is crucial following a TURP procedure as it may indicate a complication such as bleeding or clot formation. This symptom requires immediate attention to prevent further complications. Choices A, C, and D are important aspects of post-TURP care, but identifying and reporting fresh blood in the urine take precedence due to its association with potential serious complications.
5. The nurse is assessing a primigravida at 39-weeks gestation during a weekly prenatal visit. Which finding is most important for the nurse to report to the healthcare provider?
- A. Fetal heart rate of 200 beats/minute.
- B. Mild ankle edema.
- C. Complaints of back pain.
- D. Decreased fetal movements.
Correct answer: A
Rationale: A fetal heart rate of 200 beats per minute is significantly elevated and requires immediate medical attention. This finding could indicate fetal distress, tachycardia, or other serious issues that need prompt evaluation. Mild ankle edema, complaints of back pain, and decreased fetal movements are common in pregnancy but are not as urgent or concerning as a high fetal heart rate.
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