HESI RN
RN HESI Exit Exam
1. A client presents at the clinic with blepharitis. What instructions should the nurse provide for home care?
- A. Use bilateral eye patches while sleeping to prevent injury to the eyes.
- B. Wear sunglasses when outdoors to prevent photophobia.
- C. Apply cold compresses to reduce inflammation.
- D. Apply warm moist compresses then gently scrub eyelids with diluted baby shampoo.
Correct answer: D
Rationale: The correct answer is D. Blepharitis is managed with warm moist compresses to help loosen debris and oils on the eyelids, followed by gentle scrubbing with a mild solution like diluted baby shampoo. This helps in controlling the condition. Choice A is incorrect as using eye patches while sleeping is not a standard recommendation for blepharitis. Choice B is incorrect as wearing sunglasses does not directly treat blepharitis but may help with light sensitivity. Choice C is incorrect as cold compresses are not typically used for blepharitis, as warm compresses are more effective in managing the condition.
2. A client with a history of chronic kidney disease (CKD) is receiving erythropoietin therapy. Which laboratory value should the nurse monitor closely?
- A. Serum potassium level
- B. White blood cell count
- C. Hemoglobin level
- D. Serum calcium level
Correct answer: A
Rationale: The correct answer is A: Serum potassium level. In a client receiving erythropoietin therapy for chronic kidney disease, monitoring serum potassium levels is crucial due to the risk of hyperkalemia. Erythropoietin can stimulate red blood cell production, leading to an increased demand for potassium. Monitoring potassium levels helps prevent complications associated with hyperkalemia. Choices B, C, and D are incorrect because erythropoietin therapy specifically impacts potassium levels, not white blood cell count, hemoglobin level, or serum calcium level.
3. A client with chronic kidney disease (CKD) is admitted with hyperkalemia. Which laboratory value requires immediate intervention?
- A. Serum potassium of 6.5 mEq/L
- B. Serum sodium of 135 mEq/L
- C. Serum creatinine of 2.0 mg/dL
- D. Blood glucose of 150 mg/dL
Correct answer: A
Rationale: A serum potassium level of 6.5 mEq/L is most concerning in a client with CKD as it indicates severe hyperkalemia, requiring immediate intervention. Hyperkalemia can lead to life-threatening cardiac arrhythmias. Serum sodium levels within the normal range (135 mEq/L) are not immediately concerning. Serum creatinine of 2.0 mg/dL may indicate impaired kidney function but does not require immediate intervention for hyperkalemia. Blood glucose of 150 mg/dL is within normal limits and does not directly correlate with hyperkalemia in this scenario.
4. A client with a history of myocardial infarction is admitted with chest pain. Which laboratory value should the nurse monitor closely?
- A. White blood cell count
- B. Serum creatinine
- C. Troponin level
- D. Hemoglobin level
Correct answer: C
Rationale: The correct answer is C: Troponin level. Troponin levels should be closely monitored in a client with chest pain and a history of myocardial infarction to assess for ongoing myocardial injury. Troponin is a specific marker for myocardial damage. Monitoring white blood cell count (choice A) is not directly related to myocardial infarction. Serum creatinine (choice B) is more indicative of renal function rather than cardiac status. Hemoglobin level (choice D) is important but does not directly reflect ongoing myocardial injury.
5. The nurse is assessing a client with chronic kidney disease (CKD) who is receiving erythropoietin therapy. Which assessment finding is most concerning?
- A. Increased fatigue
- B. Elevated blood pressure
- C. Low urine output
- D. Elevated hemoglobin
Correct answer: B
Rationale: In a client with chronic kidney disease (CKD) receiving erythropoietin therapy, an elevated blood pressure is the most concerning assessment finding. Elevated blood pressure can indicate worsening hypertension, which requires immediate intervention. Increased fatigue may be expected due to anemia associated with CKD and erythropoietin therapy. Low urine output may indicate impaired kidney function but is not as immediately concerning as elevated blood pressure. Elevated hemoglobin levels are the desired outcome of erythropoietin therapy, indicating an appropriate response to treatment.
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