HESI RN
HESI 799 RN Exit Exam Capstone
1. A client with a urinary tract infection (UTI) is prescribed ciprofloxacin. What client teaching is essential?
- A. Increase fluid intake to prevent crystalluria.
- B. Take the medication with meals to prevent GI upset.
- C. Avoid sunlight exposure while taking the medication.
- D. Report any changes in the color of urine.
Correct answer: A
Rationale: The correct answer is to increase fluid intake to prevent crystalluria, a potential side effect of ciprofloxacin. Crystalluria is the formation of crystals in the urine, which can be reduced by maintaining adequate hydration. Choice B is incorrect because ciprofloxacin can be taken with or without food. Choice C is incorrect as avoiding sunlight exposure is more relevant for medications that cause photosensitivity, not typically a concern with ciprofloxacin. Choice D is less essential than choice A because while reporting changes in urine color is important, preventing crystalluria through adequate fluid intake is a higher priority.
2. A client with a urinary tract infection is prescribed ciprofloxacin. What is the most important teaching the nurse should provide?
- A. Take the medication with milk to prevent stomach upset.
- B. Increase fluid intake to 2-3 liters per day.
- C. Avoid taking the medication with dairy products.
- D. Continue taking the medication even if symptoms improve.
Correct answer: B
Rationale: Ciprofloxacin can cause crystalluria, so increasing fluid intake to 2-3 liters per day helps flush out the medication and prevent crystal formation in the kidneys. This also ensures adequate hydration, which supports the body's ability to fight the infection. Choice A is incorrect because ciprofloxacin should not be taken with dairy products as they can interfere with the absorption of the medication. Choice D is incorrect because although it's important to complete the full course of antibiotics, it's equally crucial to report any improvement in symptoms to the healthcare provider.
3. The nurse reviews the diagnostic tests prescribed for a client with a positive skin test. Which subjective findings reported by the client support the diagnosis of tuberculosis?
- A. Mucopurulent cough and night sweats
- B. Fatigue and headache
- C. Persistent cough and weight gain
- D. Weight loss and fever
Correct answer: A
Rationale: A mucopurulent cough and night sweats are hallmark signs of active tuberculosis. These symptoms are key indicators of TB as the combination of a productive cough with night sweats is highly suggestive of the disease. Fatigue and headache (choice B) are nonspecific symptoms that can occur in many conditions and are not specific to TB. Persistent cough and weight gain (choice C) are not typical findings in tuberculosis. Weight loss and fever (choice D) can be present in TB, but the specific combination of mucopurulent cough and night sweats is more specific to the diagnosis.
4. A client with a history of hypertension and hyperlipidemia is admitted with chest pain. What is the nurse's priority action?
- A. Administer prescribed nitroglycerin.
- B. Obtain a 12-lead electrocardiogram (ECG).
- C. Check the client's vital signs.
- D. Place the client on continuous telemetry.
Correct answer: B
Rationale: The correct answer is to obtain a 12-lead electrocardiogram (ECG). This action is crucial in assessing the heart's electrical activity and helps in the evaluation of chest pain. Administering nitroglycerin (Choice A) may be necessary but should come after obtaining the ECG to confirm the diagnosis. Checking vital signs (Choice C) is important but does not provide direct information about the heart's electrical status. Placing the client on continuous telemetry (Choice D) may be appropriate later but does not provide immediate information on the heart's electrical activity as an ECG does.
5. An older client is admitted to the intensive care unit unconscious after several days of vomiting and diarrhea. The nurse inserts a urinary catheter and observes dark amber urine output. Which intervention should the nurse implement first?
- A. Begin dopamine infusion at 2 mcg/kg/minute.
- B. Begin potassium chloride 10 mEq over 1 hour.
- C. Give a bolus of 0.9% sodium chloride 1000 mL over 30 minutes.
- D. Administer promethazine 25 mg IV push.
Correct answer: C
Rationale: In this scenario, the priority intervention is to give a bolus of 0.9% sodium chloride 1000 mL over 30 minutes. The client's dark amber urine output indicates dehydration and hypovolemia, requiring rapid fluid resuscitation. Dopamine infusion, potassium chloride, and promethazine are not the initial interventions needed for a client with hypovolemic symptoms.
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