HESI RN
RN HESI Exit Exam Capstone
1. A client with pneumonia is receiving intravenous (IV) antibiotics. Which assessment finding indicates that the client's condition is improving?
- A. Client's respiratory rate decreases from 24 to 20 breaths per minute
- B. White blood cell count decreases to normal range
- C. Client reports increased energy levels
- D. Cough becomes productive with green sputum
Correct answer: B
Rationale: A decrease in white blood cell count indicates that the infection is responding to treatment and the client's condition is improving. Monitoring the white blood cell count is a more objective indicator of the body's response to the antibiotics. Choices A, C, and D may also be positive signs, but they are less specific and may vary among individuals. Respiratory rate alone may not be sufficient to indicate improvement, as other factors can influence it. Energy levels and cough characteristics are subjective and may not always correlate with the effectiveness of antibiotic treatment.
2. An unresponsive male victim of a diving accident is brought to the emergency department where immediate surgery is required to save his life. No family members are available. What action should the nurse take first?
- A. Ask the friend to sign an informed consent.
- B. Notify the unit manager that a court order is needed.
- C. Continue providing life support until a guardian is found.
- D. Proceed with surgery preparation without consent.
Correct answer: D
Rationale: In emergency situations where immediate surgery is required to save a patient's life and no family members are available, consent can be waived to proceed with necessary interventions. The priority in this scenario is to proceed with surgery preparation without waiting for consent, as any delay could jeopardize the patient's life. Asking the friend to sign informed consent or notifying the unit manager for a court order would cause unnecessary delays, which are not advisable in this critical situation. Continuing life support until a guardian is found is not the most appropriate action when immediate surgical intervention is necessary.
3. The nurse is developing an educational program for older clients discharged with new antihypertensive medications. The nurse should ensure that the education materials include which characteristics?
- A. Uses pictures to help illustrate complex ideas
- B. Contains a list with definitions of unfamiliar terms
- C. Uses common words with few syllables
- D. All of the above
Correct answer: D
Rationale: The correct answer is D, 'All of the above.' When developing educational materials for older clients with new antihypertensive medications, it is essential to include characteristics such as using pictures to illustrate complex ideas, providing a list with definitions of unfamiliar terms, and using common words with few syllables. These features help enhance understanding and medication adherence, especially for older adults who may have challenges with health literacy. Choices A, B, and C collectively address the need for simplicity, visual support, and clarification of terms in educational materials, making them crucial for effective patient education.
4. A client with hypothyroidism is experiencing severe lethargy and cold intolerance. What action should the nurse take?
- A. Increase the dose of levothyroxine.
- B. Administer a PRN dose of antipyretic medication.
- C. Provide a warm blanket and increase the room temperature.
- D. Increase the client's fluid intake to avoid dehydration.
Correct answer: A
Rationale: The correct answer is to increase the dose of levothyroxine. In hypothyroidism, the body does not produce enough thyroid hormone, leading to symptoms like lethargy and cold intolerance. Increasing the dose of levothyroxine, which is a synthetic thyroid hormone replacement, helps correct the deficiency and alleviates the symptoms. Choice B, administering antipyretic medication, is incorrect as antipyretics are used to reduce fever, not treat hypothyroidism symptoms. Choice C, providing a warm blanket and increasing room temperature, may provide temporary comfort but does not address the underlying hormonal deficiency. Choice D, increasing fluid intake, is important for overall health but does not directly address the symptoms of hypothyroidism.
5. A client with chronic obstructive pulmonary disease (COPD) is experiencing difficulty breathing. What is the nurse's priority intervention?
- A. Administer a bronchodilator via nebulizer.
- B. Increase the client's oxygen flow rate.
- C. Elevate the head of the bed.
- D. Reposition the client to a side-lying position.
Correct answer: B
Rationale: In clients with COPD experiencing difficulty breathing, increasing the client's oxygen flow rate is the priority intervention. This action helps to improve oxygenation and relieve shortness of breath. While bronchodilators and other medications may be necessary, providing immediate oxygen support is crucial. Elevating the head of the bed and repositioning the client can assist with breathing comfort but do not address the immediate need for improved oxygenation in COPD exacerbation.
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