HESI RN
HESI RN Exit Exam 2024 Capstone
1. The nurse is managing the care of a client with Cushing's syndrome. Which interventions should the nurse delegate to the UAP?
- A. Report any client complaint of pain or discomfort
- B. Weigh the client and report any weight gain
- C. Note and report the client's food and liquid intake during meals and snacks
- D. All of the above
Correct answer: D
Rationale: The UAP can be tasked with reporting complaints, monitoring weight gain, and tracking food and fluid intake, all of which are important in managing a client with Cushing's syndrome. These tasks fall within the UAP's scope of practice. Reporting client complaints helps in early identification of complications, monitoring weight is crucial due to fluid retention in Cushing's syndrome, and tracking food and fluid intake assists in dietary management. Choices A, B, and C are all necessary components of care for a client with Cushing's syndrome, making option D the correct answer.
2. A client is prescribed an inhaled corticosteroid for asthma management. Which instruction should the nurse provide to the client regarding the use of this medication?
- A. Rinse your mouth after using the inhaler
- B. Hold your breath for 5 seconds after inhaling the medication
- C. Use the inhaler during an acute asthma attack
- D. Take the medication only when symptoms occur
Correct answer: A
Rationale: The correct instruction for a client using an inhaled corticosteroid for asthma management is to rinse the mouth after using the inhaler. This helps prevent oral thrush, a common side effect of corticosteroid inhalers. Holding the breath for 5 seconds after inhaling the medication (Choice B) is not necessary for corticosteroid inhalers. Using the inhaler during an acute asthma attack (Choice C) is not the purpose of corticosteroids, which are used for long-term asthma management. Taking the medication only when symptoms occur (Choice D) is not correct as corticosteroids are typically used regularly to control asthma symptoms.
3. When assessing a recently delivered multigravida client, the nurse finds that her vaginal bleeding is more than expected. Which factor in this client's history is related to this finding?
- A. The client delivered a large baby
- B. She is a gravida 6, para 5
- C. The client had a cesarean delivery
- D. The client had a prolonged labor
Correct answer: B
Rationale: A client with a higher gravida and para count is at greater risk for uterine atony, which can lead to postpartum hemorrhage. The uterus may be less effective at contracting after multiple pregnancies, causing increased vaginal bleeding. Choices A, C, and D are incorrect because delivering a large baby, having a cesarean delivery, or experiencing prolonged labor do not directly correlate with an increased risk of postpartum hemorrhage in a multigravida client as compared to the gravida and para count.
4. A client with lupus erythematosus is prescribed prednisone. What teaching should the nurse include?
- A. Take the medication with food to prevent stomach upset.
- B. Avoid crowded places to reduce the risk of infection.
- C. Take the medication in the morning to prevent insomnia.
- D. Take extra calcium supplements to prevent osteoporosis.
Correct answer: B
Rationale: The correct teaching for a client with lupus erythematosus prescribed prednisone is to avoid crowded places to reduce the risk of infection. Prednisone suppresses the immune system, making individuals more susceptible to infections. Taking the medication with food may help reduce stomach upset but is not the priority teaching. Taking prednisone in the morning may help reduce insomnia, but infection prevention is more critical. While prednisone can lead to osteoporosis, advising extra calcium supplements is not the most immediate concern when starting the medication.
5. 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.
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