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 hypertension is prescribed a low-sodium diet. What is the most important instruction for the nurse to provide?
- A. Limit sodium intake to 2 grams per day.
- B. Choose fresh fruits and vegetables.
- C. Drink at least 8 glasses of water daily.
- D. Avoid processed foods and canned soups.
Correct answer: D
Rationale: The correct answer is D. Avoiding processed foods and canned soups is crucial for a client with hypertension on a low-sodium diet because these foods are typically high in sodium content. Fresh fruits and vegetables are generally healthy choices but may still contain some natural sodium. While limiting sodium intake to 2 grams per day is important, specifically avoiding processed foods and canned soups is more critical in this situation. Drinking water is essential for overall health but is not the most important instruction when focusing on reducing sodium intake.
3. The nurse is reviewing the laboratory results of a client with chronic kidney disease. The client's serum calcium level is 7.5 mg/dL. Which condition should the nurse suspect?
- A. Hypercalcemia
- B. Hyperkalemia
- C. Hyponatremia
- D. Hypocalcemia
Correct answer: D
Rationale: A serum calcium level of 7.5 mg/dL is indicative of hypocalcemia, a common complication in clients with chronic kidney disease due to impaired calcium absorption and metabolism. Hypercalcemia (Choice A) is the opposite of the condition presented in the question and is characterized by elevated serum calcium levels. Hyperkalemia (Choice B) is an increased potassium level, not related to the client's serum calcium level. Hyponatremia (Choice C) is a decreased sodium level and is also not related to the client's serum calcium level.
4. At 42-weeks gestation, a client refuses induction and desires a natural delivery. What is the most important action for the nurse to take?
- A. Discuss alternative ways to support her birth plan.
- B. Explain the indications for induction in post-term pregnancy.
- C. Discuss the differences between labor with oxytocin and natural labor.
- D. Ask the healthcare provider to discuss the issue with the client.
Correct answer: A
Rationale: The correct answer is to discuss alternative ways to support her birth plan. It is crucial to respect the client's autonomy and desires while ensuring their safety and well-being. Choice B is incorrect because while educating the client about the indications for induction is important, it is not the most immediate action to take in this scenario. Choice C is incorrect as it focuses on comparing labor types rather than supporting the client's birth plan. Choice D is incorrect as the nurse should first engage with the client directly before involving the healthcare provider.
5. 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.
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