HESI RN
HESI 799 RN Exit Exam Capstone
1. What breakfast selection indicates appropriate dietary management for osteoporosis?
- A. Pancakes with syrup and orange juice
- B. Bagel with jelly and skim milk
- C. Eggs with sausage and whole milk
- D. French toast with butter and syrup
Correct answer: B
Rationale: The correct answer is B. A bagel with jelly and skim milk is a calcium-rich and low-fat option that aligns with the dietary recommendations for managing osteoporosis. Osteoporosis is a condition characterized by weak and brittle bones, so it is essential to consume an adequate amount of calcium while avoiding excess fat intake. Choices A, C, and D are not ideal for osteoporosis management as they either lack sufficient calcium, contain high fat content, or both.
2. A 60-year-old male client had a hernia repair in an outpatient surgery clinic. He is awake and alert but has not been able to void since he returned from surgery 6 hours ago. He received 1000 mL of IV fluid. Which action would be most likely to help him void?
- A. Have him drink several glasses of water
- B. Crede the bladder from the bottom to the top
- C. Assist him to stand by the side of the bed to void
- D. Wait 2 hours and have him try to void again
Correct answer: C
Rationale: Assisting the client to stand by the side of the bed to void is the most appropriate action in this situation. Standing to void often helps relieve the bladder, especially after surgery. Option A, having him drink several glasses of water, may not be as effective as the client might already be adequately hydrated. Option B, Crede maneuver, is a technique for emptying the bladder by applying manual pressure and is not the first-line intervention for a client who cannot void post-surgery. Option D, waiting 2 hours before trying to void again, may delay necessary intervention if the client is experiencing urinary retention.
3. A client receiving full-strength continuous enteral tube feeding develops diarrhea. What intervention should the nurse take?
- A. Stop the feeding and provide IV fluids.
- B. Dilute the feeding to half strength and continue at the same rate.
- C. Reduce the feeding rate and monitor for improvement.
- D. Add fiber to the client's diet to resolve diarrhea.
Correct answer: B
Rationale: When a client develops diarrhea from continuous enteral tube feeding, diluting the feeding to half strength and continuing at the same rate is the appropriate intervention. This helps reduce the strength of the feeding, minimizing gastrointestinal upset while still providing necessary nutrition. Stopping the feeding abruptly (Choice A) may lead to nutritional deficits. Simply reducing the feeding rate (Choice C) may not effectively address the issue of diarrhea. Adding fiber (Choice D) could potentially worsen the diarrhea in this scenario instead of resolving it.
4. A client recovering from a stroke is demonstrating slurred speech. What action should the nurse take?
- A. Consult the healthcare provider to order speech therapy.
- B. Administer a dose of aspirin to prevent further neurological damage.
- C. Encourage the client to use communication aids, such as writing.
- D. Encourage the client to eat soft foods to avoid choking.
Correct answer: C
Rationale: The correct action for a client recovering from a stroke demonstrating slurred speech is to encourage the client to use communication aids, such as writing. This intervention can help the client effectively communicate while working on regaining speech abilities. Consulting the healthcare provider to order speech therapy (choice A) is a valid option, but immediate encouragement of using communication aids is beneficial. Administering aspirin (choice B) without healthcare provider orders is not recommended. Encouraging the client to eat soft foods (choice D) is important for preventing aspiration but doesn't directly address the communication issue.
5. A pregnant client complains of heartburn. What instruction should the nurse provide?
- A. Eat spicy food to help digestion.
- B. Eat small meals throughout the day to avoid a full stomach.
- C. Drink carbonated beverages to ease digestion.
- D. Avoid drinking fluids after meals.
Correct answer: B
Rationale: The correct instruction for a pregnant client experiencing heartburn is to eat small meals throughout the day to avoid a full stomach. This helps prevent the stomach from becoming overly full, reducing the likelihood of heartburn during pregnancy. Choices A, C, and D are incorrect. Eating spicy food can exacerbate heartburn, carbonated beverages may trigger heartburn due to gas, and avoiding fluids after meals does not directly address the issue of heartburn.
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