HESI RN
HESI Fundamentals Practice Exam
1. A client with a diagnosis of hyperkalemia is receiving sodium polystyrene sulfonate (Kayexalate). Which laboratory value should the nurse monitor to evaluate the effectiveness of this medication?
- A. Serum sodium level.
- B. Serum potassium level.
- C. Serum calcium level.
- D. Serum glucose level.
Correct answer: B
Rationale: The correct answer is B: Serum potassium level. Sodium polystyrene sulfonate (Kayexalate) is used to treat hyperkalemia by exchanging sodium ions for potassium ions in the intestines, leading to potassium removal from the body. Monitoring the serum potassium level allows the nurse to assess the effectiveness of this medication in lowering the elevated potassium levels. Serum sodium (A), calcium (C), and glucose (D) levels are not directly impacted by the action of sodium polystyrene sulfonate.
2. What information should the nurse offer a client who uses herbal therapies to supplement their diet and manage common ailments about the general use of herbal supplements?
- A. Most herbs are toxic or carcinogenic and should only be used when proven effective.
- B. There is no evidence that herbs are safe or effective compared to conventional supplements in maintaining health.
- C. Herbs should be obtained from manufacturers with a history of quality control for their supplements.
- D. Herbal therapies may mask the symptoms of serious diseases, requiring frequent medical evaluations during use.
Correct answer: C
Rationale: It is essential for clients using herbal therapies to obtain herbs from manufacturers with a history of quality control for their supplements. This recommendation is crucial because quality control processes help in maintaining the purity and effectiveness of the herbal supplements. Option A is incorrect as it provides a negative and inaccurate generalization about herbs. Option B is also incorrect as there is existing evidence on the safety and efficacy of certain herbal supplements. Option D is not the most relevant information to offer initially to a client seeking advice on the general use of herbal supplements.
3. One week after being told that she has terminal cancer with a life expectancy of 3 weeks, a female client tells the nurse, 'I think I will plan a big party for all my friends.' How should the nurse respond?
- A. You may not have enough energy before long to hold a big party.
- B. Do you mean to say that you want to plan your funeral and wake?
- C. Planning a party and thinking about all your friends sounds like fun.
- D. You should be thinking about spending your last days with your family.
Correct answer: C
Rationale: Setting goals that bring pleasure is appropriate and should be encouraged by the nurse. Choice A is discouraging and focuses on limitations. Choice B jumps to a conclusion and is not in line with the client's statement. Choice D dictates what the client should be doing, which is not respectful of the client's autonomy. Therefore, the most appropriate response is C, as it acknowledges the client's wishes and provides positive reinforcement without perpetuating denial.
4. In completing a client's preoperative routine, the nurse finds that the operative permit is not signed. The client begins to ask more questions about the surgical procedure. Which action should the nurse take next?
- A. Witness the client's signature on the permit.
- B. Answer the client's questions about the surgery.
- C. Inform the surgeon that the operative permit is not signed and the client has questions about the surgery.
- D. Reassure the client that the surgeon will answer any questions before the anesthesia is administered.
Correct answer: C
Rationale: The nurse should inform the surgeon promptly that the operative permit is not signed and the client has questions about the surgery. It is crucial for the surgeon to be aware of these issues as it is their responsibility to explain the procedure to the client and ensure that the necessary consent is obtained before proceeding with the surgery. Answering the client's questions directly (choice B) may not be appropriate as the surgeon is the one responsible for providing detailed information about the procedure. Witnessing the client's signature (choice A) is premature since the permit is not signed. Reassuring the client (choice D) is not the most appropriate action at this point; the priority is to involve the surgeon in addressing the unsigned permit and the client's questions.
5. Which assessment data would provide the most accurate determination of proper placement of a nasogastric tube?
- A. Aspirating gastric contents to assure a pH value of 4 or less.
- B. Hearing air pass in the stomach after injecting air into the tubing.
- C. Examining a chest x-ray obtained after the tubing was inserted.
- D. Checking the remaining length of tubing to ensure that the correct length was inserted.
Correct answer: C
Rationale: The most accurate method to confirm the proper placement of a nasogastric tube is by examining a chest x-ray obtained after the tubing was inserted. This visual assessment allows healthcare providers to directly visualize the position of the tube in relation to anatomical landmarks, ensuring it is correctly placed in the stomach. Aspirating gastric contents or hearing air pass may provide some information but are not as definitive as a chest x-ray for confirming placement. Checking the remaining length of tubing is not a reliable method for determining proper placement as it does not indicate where the tip of the tube lies within the body.
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