HESI RN
HESI RN Exit Exam 2023 Capstone
1. The healthcare provider is assessing a client who has just received anesthesia. What is the most critical finding to report to the healthcare provider?
- A. Client reports dizziness
- B. Client has a drop in blood pressure
- C. Client experiences mild nausea
- D. Client reports dry mouth
Correct answer: B
Rationale: A significant drop in blood pressure following anesthesia could indicate a serious reaction, such as hypovolemia or anesthetic-induced hypotension. This requires immediate medical attention, while other symptoms like dizziness, mild nausea, and dry mouth are more common and less critical. Dizziness could be expected due to the effects of anesthesia, mild nausea is a common side effect, and dry mouth is a known effect of anesthesia as well.
2. A young adult visits the clinic reporting symptoms associated with gastritis. Which information in the client's history is most important for the nurse to address in the teaching plan?
- A. Experiences occasional heartburn after eating spicy food
- B. Consumes 10 or more drinks of alcohol every weekend
- C. Reports frequent use of NSAIDs
- D. Has a history of peptic ulcers
Correct answer: B
Rationale: Excessive alcohol consumption is a major risk factor for gastritis and should be prioritized in the teaching plan. While spicy foods and NSAIDs can contribute to gastritis, alcohol consumption is the most significant factor that needs immediate lifestyle changes to prevent worsening of gastritis symptoms. Peptic ulcers, although relevant, are not as directly linked to exacerbating gastritis symptoms as alcohol consumption.
3. 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.
4. A client with acute kidney injury (AKI) is experiencing hyperkalemia. What intervention should the nurse prioritize?
- A. Administer IV calcium gluconate.
- B. Administer sodium polystyrene sulfonate (Kayexalate).
- C. Administer insulin with dextrose.
- D. Restrict potassium intake in the client's diet.
Correct answer: A
Rationale: The correct intervention for a client with acute kidney injury (AKI) experiencing hyperkalemia is to administer IV calcium gluconate. Calcium gluconate helps stabilize the myocardium and prevent life-threatening arrhythmias in hyperkalemia by antagonizing the cardiac effects of high potassium levels. Choice B, administering sodium polystyrene sulfonate (Kayexalate), is used to lower potassium levels in the gastrointestinal tract but is not the priority in acute severe hyperkalemia. Choice C, administering insulin with dextrose, helps drive potassium into cells but is not the priority in a client at risk for arrhythmias due to hyperkalemia. Choice D, restricting potassium intake in the client's diet, is a long-term strategy but is not the immediate priority in managing acute hyperkalemia.
5. A client with anemia is prescribed iron supplements. What teaching should the nurse provide?
- A. Take iron supplements with meals to prevent stomach upset.
- B. Take iron supplements with milk to improve absorption.
- C. Expect black, tarry stools as a side effect of iron supplements.
- D. Take iron supplements with vitamin C to improve absorption.
Correct answer: D
Rationale: The correct answer is D: Take iron supplements with vitamin C to improve absorption. Vitamin C enhances iron uptake, making it more bioavailable for the body. It is essential to avoid taking iron supplements with milk (choice B) as calcium-rich foods can hinder iron absorption. Taking iron supplements with meals (choice A) can help reduce stomach upset, but the optimal way to enhance absorption is with vitamin C. Black, tarry stools (choice C) are not a typical side effect of iron supplements and should be reported to the healthcare provider.
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