HESI RN
HESI 799 RN Exit Exam Quizlet
1. The healthcare provider should observe most closely for drug toxicity when a client receives a medication that has which characteristic?
- A. Low bioavailability
- B. Rapid onset of action
- C. Short half-life
- D. Narrow therapeutic index
Correct answer: D
Rationale: The correct answer is D, narrow therapeutic index. Narrow therapeutic index (NTI) drugs are defined as those drugs where small differences in dose or blood concentration may lead to serious therapeutic failures or adverse drug reactions. Choices A, B, and C are not directly related to the risk of drug toxicity. Low bioavailability (Choice A) refers to the amount of drug that enters the bloodstream unchanged after administration. Rapid onset of action (Choice B) and short half-life (Choice C) are characteristics related to drug effectiveness and metabolism but do not necessarily indicate a higher risk of drug toxicity.
2. The healthcare provider prescribes carboprost tromethamine (Hemabate) 250 mcg IM for a multigravida postpartum client who is experiencing heavy, bright red vaginal bleeding. Prior to administering this medication, which intervention should the RN implement?
- A. Give the prescribed antiemetic.
- B. Administer IV fluids.
- C. Prepare for possible blood transfusion.
- D. Monitor vital signs every 5 minutes.
Correct answer: A
Rationale: The correct answer is A. Hemabate can cause severe nausea, vomiting, or diarrhea, so administering the prescribed antiemetic can help manage these side effects. Choice B is incorrect as there is no indication in the scenario to administer IV fluids. Choice C is not the priority at this stage as the client's condition does not necessitate an immediate blood transfusion. Choice D is unnecessary every 5 minutes; monitoring vital signs should be done but not at such a high frequency.
3. When obtaining a rectal temperature with an electronic thermometer, which action is most important for the nurse to perform?
- A. Hold the thermometer in place.
- B. Place the disposable pad under the buttocks.
- C. Instruct the client to breathe deeply.
- D. Return the probe to the charger.
Correct answer: A
Rationale: When obtaining a rectal temperature with an electronic thermometer, holding the thermometer in place is crucial. This action ensures accurate temperature measurement and prevents injury to the client. Option B, placing a disposable pad under the buttocks, is not the most important action; it may enhance comfort but does not impact the accuracy of the temperature reading. Option C, instructing the client to breathe deeply, is irrelevant to obtaining a rectal temperature. Option D, returning the probe to the charger, is an incorrect action after temperature measurement.
4. The nurse is caring for a client with diabetic ketoacidosis (DKA). Which laboratory value requires immediate intervention?
- A. Serum glucose of 300 mg/dL
- B. Serum potassium of 4.5 mEq/L
- C. Serum bicarbonate of 15 mEq/L
- D. Serum pH of 7.28
Correct answer: D
Rationale: A serum pH of 7.28 indicates metabolic acidosis in a client with diabetic ketoacidosis (DKA), requiring immediate intervention. In DKA, the body produces excess ketones, leading to acidosis. Monitoring and correcting the pH level is crucial in managing DKA. Serum glucose levels may be high in DKA, but the immediate concern is correcting the acidosis to prevent complications. Serum potassium and bicarbonate levels are also important but not as immediately critical as correcting the acidosis in DKA.
5. A client with a history of atrial fibrillation is prescribed warfarin (Coumadin). Which laboratory value is most concerning?
- A. INR of 3.0
- B. Prothrombin time (PT) of 15 seconds
- C. Hemoglobin of 10 g/dl
- D. White blood cell count
Correct answer: A
Rationale: An INR of 3.0 is most concerning in a client prescribed warfarin (Coumadin) as it indicates a high risk of bleeding, requiring immediate intervention. A high INR value suggests that the blood is taking longer to clot, putting the patient at an increased risk of hemorrhage. Prothrombin time (PT) measures how long it takes for blood to clot, but the specific value of 15 seconds is within the normal range. Hemoglobin of 10 g/dl indicates mild anemia and does not directly relate to the risk of bleeding associated with warfarin therapy. White blood cell count assesses immune function and infection risk, but it is not directly related to the anticoagulant effects of warfarin.
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