HESI RN

1. A client is admitted with a possible myocardial infarction. Which laboratory test result is most indicative of a myocardial infarction?

• A. Serum creatinine kinase (CK)
• B. Serum troponin
• C. Serum myoglobin
• D. C-reactive protein (CRP)

Correct Answer: B

Rationale: Serum troponin is the most specific and sensitive indicator of myocardial infarction and should be monitored closely.

2. The nurse is preparing to administer an enema to a client with severe constipation. Which position is most appropriate for the client?

• A. Supine with the head elevated 30 degrees
• B. Left lateral with the right leg flexed
• C. Sims’ position with the right leg flexed
• D. Prone position with the head turned to the side

Correct Answer: C

Rationale: Sims’ position with the right leg flexed is the most appropriate for administering an enema as it facilitates the flow of the enema solution.

3. Which nursing intervention is most important when caring for a client with myasthenia gravis?

• A. Encourage the client to rest frequently.
• B. Administer medication 30 minutes before meals.
• C. Maintain a patent airway.
• D. Monitor for signs of respiratory infection.

Correct Answer: C

Rationale: Maintaining a patent airway is the most critical intervention for a client with myasthenia gravis to ensure adequate breathing and oxygenation.

4. The nurse is preparing to administer an intramuscular injection to a client with muscle wasting in the gluteal region. What is the most appropriate site for the injection?

• A. Dorsogluteal site
• B. Ventrogluteal site
• C. Deltoid site
• D. Vastus lateralis site

Correct Answer: D

Rationale: The vastus lateralis site is the most appropriate for an IM injection in a client with muscle wasting in the gluteal region, ensuring effective medication administration.

5. A nurse is teaching a client with type 2 diabetes about the importance of foot care. Which statement by the client indicates a need for further teaching?

• A. I should check my feet every day for cuts or blisters.'
• B. I need to moisturize my feet daily, especially between my toes.'
• C. I should wear comfortable shoes that fit well.'
• D. I should avoid walking barefoot, even indoors.'

Correct Answer: B

Rationale: Moisturizing between the toes can create a moist environment that fosters fungal infections, so this statement indicates a need for further teaching.