HESI RN
HESI RN Exit Exam 2024 Capstone
1. A client with chronic kidney disease is prescribed a low-potassium diet. Which food should the nurse instruct the client to avoid?
- A. Carrots
- B. White bread
- C. Bananas
- D. Apples
Correct answer: C
Rationale: The correct answer is C: Bananas. Bananas are high in potassium and should be avoided in clients who are on a low-potassium diet due to chronic kidney disease. Foods like apples and white bread are low in potassium and are safer choices. Carrots are also low in potassium and do not need to be avoided in this case.
2. During a neurologic assessment of a client with a suspected stroke, which finding is most concerning?
- A. Unilateral facial droop
- B. Slurred speech
- C. Weakness in one arm
- D. Sudden loss of consciousness
Correct answer: D
Rationale: Sudden loss of consciousness in a client with a suspected stroke is the most concerning finding as it indicates a more severe neurological event, such as brain stem involvement or hemorrhage, requiring immediate intervention. While unilateral facial droop, slurred speech, and weakness in one arm are all common signs of a stroke, sudden loss of consciousness signifies a critical condition that needs urgent attention and evaluation to prevent further complications.
3. A client was just taken off the ventilator after surgery and has a nasogastric tube draining bile-colored liquids. Which nursing measure will provide the most comfort to the client?
- A. Allow the client to melt ice chips in the mouth
- B. Provide mints to freshen the breath
- C. Perform frequent oral care with a tooth sponge
- D. Swab the mouth with glycerin swabs
Correct answer: C
Rationale: Performing frequent oral care with a tooth sponge is the most appropriate nursing measure in this scenario. This helps maintain comfort and prevent dryness in clients with nasogastric tubes. Allowing the client to melt ice chips in the mouth may not address oral care needs effectively. Providing mints to freshen the breath is not the priority when the client needs oral care. Swabbing the mouth with glycerin swabs may not be as effective as performing thorough oral care with a tooth sponge.
4. The nurse is preparing a client who had a BKA amputation for discharge to home. Which recommendations should the nurse provide this client?
- A. All of the above
- B. Inspect the skin for redness
- C. Use a residual limb shrinker
- D. Wash the stump with soap and water
Correct answer: A
Rationale: Proper care of the residual limb is essential in preventing complications like infection or poor healing. By choosing 'All of the above,' the nurse ensures that the client receives comprehensive care. Inspecting the skin for redness is crucial as it can help in early detection of infections. Using a residual limb shrinker helps reduce swelling and maintain proper shaping of the limb. Washing the stump with soap and water on a daily basis is important for hygiene and preventing infections. Therefore, all the recommendations (choices A, B, and C) are essential for the client's care, making choice A the correct answer. Choice D is incorrect as it does not encompass all the necessary recommendations for the client's care.
5. A client with hypothyroidism is prescribed levothyroxine. What should the nurse include in the teaching plan about this medication?
- A. Take the medication with a full meal
- B. Take the medication on an empty stomach
- C. Take the medication at bedtime
- D. Take the medication as needed for symptoms
Correct answer: B
Rationale: The correct answer is B: 'Take the medication on an empty stomach.' Levothyroxine should be taken on an empty stomach to enhance absorption and effectiveness. The medication is typically taken in the morning before breakfast. Choice A is incorrect because taking levothyroxine with a full meal can decrease its absorption. Choice C is incorrect because bedtime dosing may lead to insomnia. Choice D is incorrect because levothyroxine is a daily medication for hypothyroidism, not to be taken as needed for symptoms.
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