HESI RN
HESI RN Exit Exam 2023 Capstone
1. The client has been diagnosed with hypertension, and the nurse is providing education on dietary changes. Which food should the client be advised to avoid?
- A. Bananas
- B. Processed meats
- C. Low-fat yogurt
- D. Whole grains
Correct answer: B
Rationale: Processed meats should be avoided by clients with hypertension as they are high in sodium, which can contribute to elevated blood pressure. It is essential to limit the intake of high-sodium foods to help manage hypertension. Bananas, low-fat yogurt, and whole grains are generally beneficial for heart health due to their nutrient content and should not be avoided in a heart-healthy diet.
2. A 66-year-old woman is retiring and needs health insurance. To which agency should the employee health nurse refer her?
- A. Medicaid
- B. Medicare
- C. COBRA
- D. Private insurance
Correct answer: B
Rationale: The correct answer is B: Medicare. Medicare is the federal health insurance program for individuals aged 65 and older, so it is the most suitable option for the 66-year-old woman retiring. Medicaid (choice A) is a state and federally funded program for low-income individuals and families, not specifically for retirees. COBRA (choice C) allows employees to continue their employer-sponsored health insurance for a limited time after leaving employment. Private insurance (choice D) refers to health insurance plans purchased directly from private insurance companies.
3. A client with heart failure is prescribed spironolactone. What is the nurse's priority intervention?
- A. Monitor the client's potassium levels closely.
- B. Assess for signs of hyperkalemia.
- C. Instruct the client to increase intake of potassium-rich foods.
- D. Increase the client’s fluid intake to prevent dehydration.
Correct answer: B
Rationale: The correct answer is B: Assess for signs of hyperkalemia. Spironolactone is a potassium-sparing diuretic, which can cause hyperkalemia (high potassium levels). Therefore, the nurse's priority intervention should be to assess the client for signs of hyperkalemia, such as muscle weakness, fatigue, and potentially dangerous cardiac arrhythmias. Monitoring potassium levels closely (choice A) is important but assessing for signs of hyperkalemia takes precedence. Instructing the client to increase intake of potassium-rich foods (choice C) can exacerbate hyperkalemia in this case. Increasing the client’s fluid intake to prevent dehydration (choice D) is not directly related to the potential side effect of spironolactone.
4. A client with a urinary tract infection is prescribed ciprofloxacin. What is the nurse's priority teaching?
- A. Take the medication with a full glass of water.
- B. Avoid direct sunlight while taking the medication.
- C. Take the medication with meals to prevent nausea.
- D. Discontinue the medication if you experience dizziness.
Correct answer: A
Rationale: The correct answer is A: 'Take the medication with a full glass of water.' It is crucial for the nurse to teach the client to take ciprofloxacin with a full glass of water to prevent crystalluria, a potential side effect of the medication. Choice B is incorrect because ciprofloxacin does not require avoiding direct sunlight. Choice C is incorrect as taking the medication with meals is not necessary to prevent nausea. Choice D is incorrect as dizziness is not a common reason to discontinue ciprofloxacin.
5. A client with hypertension is prescribed hydrochlorothiazide. What teaching should the nurse provide?
- A. Take the medication in the morning to avoid frequent urination at night.
- B. Increase fluid intake to prevent dehydration.
- C. Avoid potassium-rich foods, such as bananas and oranges.
- D. Monitor the client’s potassium levels weekly.
Correct answer: B
Rationale: The correct teaching for a client prescribed hydrochlorothiazide is to increase fluid intake to prevent dehydration. Hydrochlorothiazide is a diuretic that can lead to fluid loss and electrolyte imbalances, so adequate fluid intake is crucial. Choice A is incorrect because hydrochlorothiazide is typically taken in the morning to avoid nighttime urination. Choice C is incorrect as potassium-rich foods should not be avoided but monitored, as hydrochlorothiazide can cause potassium loss. Choice D is incorrect as potassium levels should be monitored regularly, but not necessarily weekly, unless indicated by the healthcare provider.
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