HESI RN
HESI RN Exit Exam 2023 Capstone
1. The nurse is preparing a female client for discharge after being treated for a urinary tract infection (UTI). Which statement by the client indicates a need for further teaching?
- A. I will use douches regularly to prevent future infections.
- B. I should drink at least 8 glasses of water a day.
- C. I should avoid tight-fitting clothing.
- D. I will wipe from front to back after using the toilet.
Correct answer: A
Rationale: The correct answer is A. Using douches is not recommended as it can disrupt the natural flora and increase the risk of infections. Choices B, C, and D are all correct statements that can help prevent UTIs. Drinking an adequate amount of water helps flush out bacteria, avoiding tight-fitting clothing promotes ventilation and reduces moisture, and wiping from front to back prevents the spread of bacteria from the anal region to the urethra.
2. What might be suggested to a client with fibrocystic breasts in an attempt to help relieve symptoms?
- A. Increase intake of high-calcium foods in your diet
- B. Wear a supportive bra during the day and at night
- C. Take over-the-counter pain relievers
- D. Perform regular breast massage
Correct answer: B
Rationale: The correct answer is B: 'Wear a supportive bra during the day and at night.' Wearing a supportive bra is essential for individuals with fibrocystic breasts as it helps relieve discomfort by providing necessary support to reduce strain on breast tissue. Option A is incorrect as high-calcium foods are not directly related to symptom relief in fibrocystic breasts. Option C is not the first-line recommendation and may not address the underlying issue. Option D, performing regular breast massage, is not typically recommended and may not provide significant relief for fibrocystic breast symptoms.
3. A client with peripheral vascular disease reports leg pain while walking. What intervention is most effective for the nurse to recommend?
- A. Recommend elevating the legs above the heart.
- B. Encourage the client to increase walking distance gradually.
- C. Encourage the client to avoid sitting or standing for long periods.
- D. Instruct the client to use warm compresses for pain relief.
Correct answer: B
Rationale: The correct answer is to encourage the client to increase walking distance gradually. This intervention is effective because gradual increases in walking distance promote circulation, improve oxygen delivery to tissues, and help reduce leg pain caused by peripheral vascular disease. Elevating the legs above the heart (Choice A) may be beneficial in other conditions like venous insufficiency but not specifically for peripheral vascular disease. Encouraging the client to avoid sitting or standing for long periods (Choice C) can help prevent blood pooling but does not directly address the walking-induced leg pain. Instructing the client to use warm compresses for pain relief (Choice D) may provide temporary relief but does not address the underlying circulation issues associated with peripheral vascular disease.
4. A client with a history of atrial fibrillation is prescribed warfarin. What is the nurse's priority teaching?
- A. Avoid eating foods high in potassium.
- B. Avoid foods high in vitamin K.
- C. Take the medication on an empty stomach.
- D. Take the medication at bedtime for best results.
Correct answer: B
Rationale: The correct answer is B: 'Avoid foods high in vitamin K.' Warfarin is an anticoagulant medication that works by interfering with vitamin K-dependent clotting factors. Therefore, consuming foods high in vitamin K can affect the medication's effectiveness. Choices A, C, and D are incorrect because: A) Warfarin is not affected by foods high in potassium; C) Warfarin should be taken with food to minimize gastrointestinal side effects; D) There is no specific requirement for taking warfarin at bedtime for best results.
5. A client presents to the clinic with concerns about her left breast. Which assessment finding is most important for the nurse to report?
- A. Multiple firm, round, freely movable masses.
- B. A slight asymmetry of the breasts.
- C. A fixed nodular mass with dimpling of the skin.
- D. Bloody discharge from the nipple.
Correct answer: C
Rationale: The correct answer is C. A fixed nodular mass with dimpling of the skin is concerning for malignancy, such as breast cancer, and should be reported immediately for further evaluation. This finding is more suspicious compared to multiple firm, round, freely movable masses (choice A), which could be benign breast lumps. A slight asymmetry of the breasts (choice B) is a common finding and not as alarming as a fixed nodular mass with dimpling of the skin. Bloody discharge from the nipple (choice D) can be suggestive of other conditions like intraductal papilloma but is not as urgent as the finding described in choice C.
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