HESI RN
RN HESI Exit Exam Capstone
1. What is the expected outcome of prescribing a proton pump inhibitor to a client with a peptic ulcer?
- A. Promote healing of the gastric mucosa.
- B. Neutralize the effects of stomach acid.
- C. Inhibit the growth of Helicobacter pylori.
- D. Reduce gastric acid secretion.
Correct answer: D
Rationale: The correct answer is D: Reduce gastric acid secretion. Proton pump inhibitors (PPIs) work by reducing gastric acid secretion, which helps prevent further irritation of the gastric mucosa and allows ulcers to heal. While promoting healing of the gastric mucosa (Choice A) is an indirect outcome of reducing gastric acid secretion, the primary mechanism of PPIs is to lower acid levels. Choice B, neutralizing the effects of stomach acid, is typically associated with antacids, not PPIs. Inhibiting the growth of Helicobacter pylori (Choice C) is usually achieved with antibiotics, not PPIs.
2. On admission to the Emergency Department, a female client who was diagnosed with bipolar disorder 3 years ago reports that this morning, she took a handful of medications and left a suicide note for her family. Which information is most important for the nurse to obtain?
- A. Client's current mood and affect
- B. When the client last took medications for bipolar disorder
- C. History of previous suicide attempts
- D. Details of the medications ingested
Correct answer: D
Rationale: Determining the specific medications ingested is the priority for guiding immediate treatment in the Emergency Department. Knowing when the client last took medications and her current mood are also important, but the ingested medications are the most urgent information needed. The client's current mood and affect are crucial for assessing her immediate state, but the priority is to identify the substances she ingested to provide appropriate interventions. While understanding the history of previous suicide attempts is relevant for assessing the client's risk, the immediate focus should be on the medications taken during this specific incident.
3. A client with heart failure is receiving furosemide. What assessment finding indicates the medication is effective?
- A. Increased urine output and weight loss.
- B. Increased heart rate and blood pressure.
- C. Decreased edema and improved peripheral pulses.
- D. Decreased shortness of breath and clear lung sounds.
Correct answer: C
Rationale: The correct answer is C: 'Decreased edema and improved peripheral pulses.' In a client with heart failure, furosemide is a diuretic that helps reduce fluid overload. Therefore, a decrease in edema (swelling due to fluid retention) and improved peripheral pulses (indicating better circulation) are signs that the medication is effective. Choices A, B, and D are incorrect. Increased urine output and weight loss (Choice A) may indicate the diuretic effect of furosemide but do not specifically reflect its effectiveness in heart failure. Increased heart rate and blood pressure (Choice B) are not desired effects of furosemide and may suggest adverse reactions. Decreased shortness of breath and clear lung sounds (Choice D) are related to improved respiratory status and may not directly reflect the effectiveness of furosemide in addressing fluid overload.
4. A teenager presents to the emergency department with palpitations after vaping at a party. The client is anxious, fearful, and hyperventilating. Which acid-base imbalance does the nurse anticipate the client developing?
- A. Metabolic alkalosis
- B. Respiratory alkalosis
- C. Respiratory acidosis
- D. Metabolic acidosis
Correct answer: B
Rationale: The correct answer is B: Respiratory alkalosis. Hyperventilation from anxiety or fear causes an excessive loss of CO2, leading to respiratory alkalosis. This shift in pH results from the rapid, shallow breathing that reduces the level of carbon dioxide in the blood. Respiratory acidosis would occur in cases of poor ventilation or CO2 retention, while metabolic acidosis/alkalosis relates to disturbances in bicarbonate, not breathing patterns. Therefore, in this case, the client's hyperventilation due to anxiety would likely result in respiratory alkalosis, making option B the correct choice.
5. The nurse is caring for a preterm newborn with nasal flaring, grunting, and sternal retractions. After administering surfactant, which assessment is most important for the nurse to monitor?
- A. Bowel sounds
- B. Heart rate
- C. Arterial blood gases
- D. Apnea episodes
Correct answer: C
Rationale: Corrected Rationale: Surfactant therapy is used to improve lung function and gas exchange in premature infants with respiratory distress. Monitoring arterial blood gases is essential to assess the effectiveness of the treatment and ensure adequate oxygenation. While monitoring heart rate is important in neonatal care, assessing arterial blood gases will provide direct information regarding the infant's oxygenation status post-surfactant administration. Bowel sounds are not directly related to the respiratory distress symptoms described, and monitoring apnea episodes, although important in preterm infants, is not the most crucial assessment immediately following surfactant administration.
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