HESI RN
HESI Exit Exam RN Capstone
1. A nurse is reviewing the medication list for a client with heart failure. Which medication should the nurse question?
- A. Furosemide
- B. Digoxin
- C. Ibuprofen
- D. Carvedilol
Correct answer: C
Rationale: The correct answer is C: Ibuprofen. Ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), can cause fluid retention, which may worsen heart failure symptoms. It should be used with caution or avoided in clients with heart failure. Furosemide (choice A) is a diuretic commonly used in heart failure to reduce fluid overload. Digoxin (choice B) is a medication that helps the heart beat stronger and slower, often used in heart failure. Carvedilol (choice D) is a beta-blocker that is beneficial in heart failure management. Therefore, Ibuprofen is the medication that the nurse should question in this scenario.
2. A client with heart failure is prescribed furosemide. The nurse notes that the client's potassium level is 3.1 mEq/L. What is the nurse's priority action?
- A. Administer a potassium supplement
- B. Encourage the client to eat potassium-rich foods
- C. Hold the next dose of furosemide
- D. Increase the client's fluid intake
Correct answer: A
Rationale: A potassium level of 3.1 mEq/L is considered low, indicating hypokalemia. Administering a potassium supplement is the nurse's priority action to prevent complications such as cardiac arrhythmias associated with low potassium levels. Encouraging the client to eat potassium-rich foods is beneficial in the long term but may not rapidly correct the low potassium level. Holding the next dose of furosemide may worsen the client's heart failure symptoms. Increasing the client's fluid intake is not the priority action in this situation; addressing the low potassium level takes precedence to prevent potential serious complications.
3. A client with hypothyroidism is prescribed levothyroxine. What is the most important teaching point for the nurse to provide?
- A. Take the medication with food to avoid stomach upset.
- B. Take the medication at the same time every day to maintain consistent thyroid levels.
- C. Expect increased sensitivity to cold as a side effect of the medication.
- D. Increase the dosage of levothyroxine if symptoms worsen.
Correct answer: B
Rationale: The correct answer is B. Levothyroxine should be taken at the same time every day to maintain stable thyroid hormone levels and ensure effective management of hypothyroidism. Consistent dosing is critical for preventing fluctuations in hormone levels. Choice A is incorrect because levothyroxine is usually recommended to be taken on an empty stomach for optimal absorption. Choice C is incorrect because increased sensitivity to cold is not a common side effect of levothyroxine. Choice D is incorrect because adjusting the dosage without healthcare provider guidance can be dangerous and should not be done independently.
4. Which intervention should be included in the long-term plan of care for a client with COPD?
- A. Administer high-flow oxygen during sleep.
- B. Reduce risk factors for infection.
- C. Limit fluid intake to reduce secretions.
- D. Use diaphragmatic breathing to achieve better exhalation.
Correct answer: D
Rationale: The correct answer is D: 'Use diaphragmatic breathing to achieve better exhalation.' Diaphragmatic breathing is an essential intervention for clients with COPD as it helps improve exhalation and lung function, ultimately reducing symptoms over the long term. Option A is incorrect because high-flow oxygen during sleep is more relevant for clients with conditions like sleep apnea rather than COPD. Option B, 'Reduce risk factors for infection,' is important but not as specific to the long-term management of COPD as diaphragmatic breathing. Option C, 'Limit fluid intake to reduce secretions,' is not a recommended intervention for clients with COPD, as adequate hydration is crucial for maintaining respiratory health.
5. An older adult client with gastroenteritis has been taking the antidiarrheal diphenoxylate for the past 24 hours. What finding requires the nurse to take further action?
- A. Monitor the client’s fluid intake.
- B. Obtain a stool sample for testing.
- C. Administer a laxative to clear the infection.
- D. Assess skin turgor and provide fluids.
Correct answer: D
Rationale: The correct answer is D. Assessing skin turgor is crucial as tented skin turgor indicates dehydration, which can be worsened by antidiarrheal medications like diphenoxylate. Providing fluids is essential to address dehydration in this client. Monitoring fluid intake (choice A) is important, but assessing skin turgor takes precedence in this situation. Obtaining a stool sample for testing (choice B) could be necessary for diagnostic purposes but is not the immediate priority. Administering a laxative (choice C) is contraindicated in this case as it can worsen the client's condition by further exacerbating fluid loss.
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