HESI RN
HESI 799 RN Exit Exam Capstone
1. A client with hypertension is prescribed lisinopril. What side effect should the nurse teach the client to monitor for?
- A. Monitor for a persistent cough.
- B. Monitor for bradycardia and dizziness.
- C. Report any signs of swelling or difficulty breathing.
- D. Monitor for headache and blurred vision.
Correct answer: A
Rationale: The correct answer is A: 'Monitor for a persistent cough.' Lisinopril, an ACE inhibitor, is associated with a common side effect of a persistent dry cough. This cough can be bothersome to the client and should be reported to their healthcare provider. Choices B, C, and D are incorrect because bradycardia, dizziness, swelling, difficulty breathing, headache, and blurred vision are not typically associated with lisinopril use.
2. A client receiving chemotherapy has severe neutropenia. What snack is best for the nurse to recommend?
- A. Baked apples with raisins.
- B. Yogurt with fresh berries.
- C. Avocados and cheese.
- D. Fresh fruit salad.
Correct answer: B
Rationale: For a client with severe neutropenia, it is crucial to recommend a snack that is low in bacteria to reduce the risk of infection. Yogurt with fresh berries is an excellent choice as it is not only low in bacteria but also provides nutritional value. Baked apples with raisins (choice A) may not be ideal as the preparation process could introduce bacteria. Avocados and cheese (choice C) may not be the best option due to their potential bacterial content. Fresh fruit salad (choice D) may have a higher risk of bacterial contamination compared to yogurt with fresh berries.
3. The nurse is caring for a client with a diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which intervention is most important for the nurse to implement?
- A. Encourage oral hydration
- B. Monitor for signs of dehydration
- C. Restrict fluid intake
- D. Administer IV fluids as prescribed
Correct answer: C
Rationale: In SIADH, there is excessive ADH secretion leading to water retention and dilutional hyponatremia. The most crucial intervention is to restrict fluid intake to prevent further fluid overload and worsening of hyponatremia. Encouraging oral hydration (choice A) would exacerbate the condition by adding more fluids. Monitoring for signs of dehydration (choice B) is not appropriate as the client is at risk of fluid overload. Administering IV fluids (choice D) would worsen the hyponatremia and should be avoided.
4. A client with hypertension is prescribed a thiazide diuretic. What dietary recommendation should the nurse make?
- A. Encourage a diet low in carbohydrates and fats.
- B. Avoid foods high in vitamin K, such as spinach and kale.
- C. Increase salt intake to prevent dehydration.
- D. Eat potassium-rich foods like bananas and oranges.
Correct answer: D
Rationale: The correct answer is D: 'Eat potassium-rich foods like bananas and oranges.' Thiazide diuretics can lead to potassium loss, so it is essential for clients to consume potassium-rich foods to maintain adequate levels. Choice A is incorrect because focusing solely on low carbohydrates and fats does not address the specific issue of potassium loss. Choice B is unrelated as vitamin K content is not a concern with thiazide diuretics. Choice C is incorrect as increasing salt intake would exacerbate hypertension and not prevent dehydration.
5. A client with a history of adrenal insufficiency is admitted with acute adrenal crisis. The client complains of nausea and joint pain, vital signs show a temperature of 102°F, heart rate of 138, and blood pressure of 80/60. Which intervention should the nurse implement first?
- A. Obtain an analgesic prescription.
- B. Infuse an intravenous fluid bolus.
- C. Administer PRN oral antipyretic.
- D. Cover the client with a cooling blanket.
Correct answer: B
Rationale: In acute adrenal crisis, the priority intervention is to infuse an intravenous fluid bolus to address the hypotension (blood pressure of 80/60) and help stabilize the client's condition. Adequate fluid volume is crucial in managing adrenal insufficiency crisis. Options A, C, and D do not directly address the hypotension and fluid volume depletion that are critical in this situation. Analgesics, antipyretics, and cooling blankets may be considered later, but the immediate focus should be on fluid resuscitation.
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