HESI RN
HESI RN Exit Exam 2023
1. A client's subjective data includes dysuria, urgency, and urinary frequency. What action should the nurse implement next?
- A. Collect a clean-catch specimen
- B. Administer prescribed antibiotics
- C. Perform a bladder scan
- D. Increase the client's fluid intake
Correct answer: A
Rationale: The correct action for the nurse to implement next is to collect a clean-catch specimen. This is essential to diagnose the cause of the client's symptoms accurately before initiating any treatment. Administering antibiotics (Choice B) without confirming the diagnosis through a specimen collection can be inappropriate and potentially harmful. Performing a bladder scan (Choice C) may not provide the necessary information to identify the specific cause of the symptoms. Increasing the client's fluid intake (Choice D) is a general recommendation and may not address the underlying issue causing the symptoms.
2. The nurse is assisting the mother of a child with phenylketonuria (PKU) to select foods that are in keeping with the child's dietary restrictions. Which foods are contraindicated for this child?
- A. Wheat products
- B. Foods sweetened with aspartame
- C. High-fat foods
- D. High-calorie foods
Correct answer: B
Rationale: The correct answer is B: Foods sweetened with aspartame. Aspartame should not be consumed by a child with PKU because it is converted to phenylalanine in the body, which can be harmful to individuals with PKU. Choice A (Wheat products) is not specifically contraindicated for PKU. Choice C (High-fat foods) and Choice D (High-calorie foods) are not typically restricted in PKU diets unless they contain high levels of phenylalanine.
3. A client with a history of chronic kidney disease (CKD) is scheduled for a CT scan with contrast. Which laboratory value should the nurse review before the procedure?
- A. Serum creatinine
- B. Blood urea nitrogen (BUN)
- C. Serum potassium
- D. Serum glucose
Correct answer: A
Rationale: The correct answer is A: Serum creatinine. Before a CT scan with contrast, the nurse should review the serum creatinine level. This is crucial in patients with CKD because contrast agents can potentially worsen kidney function and lead to contrast-induced nephropathy. Monitoring serum creatinine helps assess kidney function and determine the risk of complications. Choices B, C, and D are less relevant in this scenario. Blood urea nitrogen (BUN) is another marker of kidney function, but serum creatinine is a more specific indicator. Serum potassium levels are important in assessing electrolyte balance but are not directly related to the risk of contrast-induced nephropathy. Serum glucose levels are not typically a primary concern before a CT scan with contrast in a patient with CKD.
4. The nurse is assessing a 1-year-old child with bronchiolitis caused by respiratory syncytial virus (RSV). Which assessment finding requires immediate intervention?
- A. Wheezing heard on expiration
- B. Oxygen saturation of 90%
- C. Respiratory rate of 40 breaths per minute
- D. Nasal flaring with sternal retractions
Correct answer: D
Rationale: Nasal flaring with sternal retractions indicates severe respiratory distress in a 1-year-old with bronchiolitis, requiring immediate intervention. Nasal flaring and sternal retractions are signs of increased work of breathing and decreased air movement, indicating the child is struggling to breathe. Wheezing on expiration (Choice A) is common in bronchiolitis but may not require immediate intervention. An oxygen saturation of 90% (Choice B) is low but may not be the most critical finding in this case. A respiratory rate of 40 breaths per minute (Choice C) is elevated but alone may not indicate the need for immediate intervention as much as nasal flaring and sternal retractions.
5. The nurse enters a client's room and observes the unlicensed assistive personnel (UAP) making an occupied bed. What action should the nurse take first?
- A. Place the side rails in an up position.
- B. Assist the UAP in turning the client.
- C. Provide instructions on proper bed-making techniques.
- D. Ask the client if they are comfortable.
Correct answer: A
Rationale: The correct answer is to place the side rails in an up position first. This action is essential to prevent the client from falling while the bed is being made. Assisting the UAP in turning the client (Choice B) is not the immediate priority. Providing instructions on bed-making techniques (Choice C) can wait until the safety of the client is ensured. Asking the client if they are comfortable (Choice D) is important but should come after ensuring the client's safety by raising the side rails.
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