HESI RN CAT Exit Exam

HESI RN

1. A college student who is diagnosed with a vaginal infection and vulva irritation describes the vaginal discharge as having a 'cottage cheese' appearance. Which prescription should the nurse implement first?

A. Cleanse the perineum with warm soapy water 3 times per day
B. Instill the first dose of nystatin (Mycostatin) vaginally per applicator
C. Perform a glucose measurement using a capillary blood sample
D. Obtain a blood specimen for sexually transmitted diseases (STDs)

Correct answer: B

Rationale: The correct answer is to instill the first dose of nystatin vaginally per applicator. Nystatin is an antifungal medication used to treat yeast infections, which are characterized by 'cottage cheese' discharge. Cleansing the perineum with warm soapy water may help with hygiene but does not address the underlying infection. Performing a glucose measurement is not relevant to the diagnosis of a vaginal infection. Obtaining a blood specimen for STDs is not the priority in this scenario as the symptoms described are indicative of a yeast infection.

2. An angry client screams at the emergency department triage nurse, 'I've been waiting here for two hours! You and the staff are incompetent.' What is the best response for the nurse to make?

A. The emergency department is very busy at this time.
B. I'll let you see the doctor next because you've waited so long.
C. I'm doing the best I can for the sickest clients first.
D. I understand you are frustrated with the wait time.

Correct answer: D

Rationale: The correct response for the nurse is to choose option D, 'I understand you are frustrated with the wait time.' This response acknowledges the client's emotions, shows empathy, and validates their feelings of frustration. Option A justifies the situation but does not address the client's emotional state. Option B is unfair to other patients and may not be based on urgency. Option C focuses on the nurse's actions rather than addressing the client's emotions, making it less effective than option D.

3. The nurse is administering total parenteral nutrition (TPN) via a central line at 75 ml/hour to a client who had a bowel resection 4 days ago. Which laboratory finding requires the most immediate intervention by the nurse?

A. Blood glucose of 140 mg/dL
B. White blood cell count of 8000/mmÂ³
C. Serum potassium of 3.8 mEq/L
D. Serum calcium of 7.8 mg/dL

Correct answer: D

Rationale: The correct answer is D. A serum calcium level of 7.8 mg/dL requires immediate intervention due to the risk of hypocalcemia. Hypocalcemia can lead to serious complications such as tetany, seizures, and cardiac arrhythmias. The other laboratory findings are within normal limits or slightly elevated, which do not pose an immediate threat to the client's health in this scenario.

4. When caring for a laboring client whose contractions are occurring every 2-3 minutes, the nurse should document that the pump is infusing how many ml/hour?

A. 5
B. 10
C. 15
D. 20

Correct answer: A

Rationale: The correct calculation for infusion based on the given data is 5 ml/hr. To calculate the infusion rate per hour, you need to determine the number of contractions per hour. If contractions are occurring every 2-3 minutes, this would mean approximately 20-30 contractions per hour. Therefore, if the pump is infusing 5 ml per contraction, the total infusion rate per hour would be 5 ml x 20 contractions = 100 ml/hr. This makes choice A the correct answer. Choices B, C, and D are incorrect as they do not align with the calculation based on the given data.

5. The nurse offers diet teaching to a female college student who was diagnosed with iron-deficiency anemia following her voluntary adoption of a lacto-vegetarian diet. What nutrients should the nurse suggest this client eat to best meet her nutritional needs while allowing her to adhere to a lacto-vegetarian diet?

A. Drink whole milk instead of skim milk to enhance the body's production of amino acids
B. Take vitamin K 10mg PO daily to enhance production of red blood cells
C. Increase amounts of dark yellow vegetables such as carrots to fortify iron stores
D. Combine several legumes and grains such as beans and rice to form complete proteins

Correct answer: D

Rationale: Combining legumes and grains ensures the client receives all essential amino acids to form complete proteins, which is crucial in a vegetarian diet. Options A, B, and C are incorrect. Option A is not necessary as there are plant-based sources of essential amino acids in a lacto-vegetarian diet. Option B suggests vitamin K, which is not directly related to enhancing red blood cell production. Option C mentions increasing dark yellow vegetables, which are sources of non-heme iron, but combining legumes and grains is more effective in addressing the protein needs of a lacto-vegetarian.