HESI RN
HESI RN Exit Exam 2024 Quizlet Capstone
1. A client receiving lactulose for hepatic encephalopathy needs evaluation. Which assessment should the nurse prioritize?
- A. Percussion of the abdomen.
- B. Blood glucose level.
- C. Serum electrolytes.
- D. Level of consciousness.
Correct answer: D
Rationale: The correct answer is D: Level of consciousness. When managing hepatic encephalopathy with lactulose, monitoring the client's level of consciousness is crucial as it is a key indicator of the therapeutic response to lactulose in reducing ammonia levels. Changes in consciousness can reflect the effectiveness of treatment and the progression of hepatic encephalopathy. Option A, percussion of the abdomen, is not directly related to evaluating the response to lactulose. Option B, blood glucose level, is important but not the priority in this context. Option C, serum electrolytes, while significant in liver disease, do not directly assess the impact of lactulose therapy on hepatic encephalopathy.
2. A client with a urinary tract infection is prescribed ciprofloxacin. What is the nurse's priority teaching?
- A. Take the medication with a full glass of water.
- B. Avoid direct sunlight while taking the medication.
- C. Take the medication with meals to prevent nausea.
- D. Discontinue the medication if you experience dizziness.
Correct answer: A
Rationale: The correct answer is A: 'Take the medication with a full glass of water.' It is crucial for the nurse to teach the client to take ciprofloxacin with a full glass of water to prevent crystalluria, a potential side effect of the medication. Choice B is incorrect because ciprofloxacin does not require avoiding direct sunlight. Choice C is incorrect as taking the medication with meals is not necessary to prevent nausea. Choice D is incorrect as dizziness is not a common reason to discontinue ciprofloxacin.
3. The nurse is preparing an older adult for discharge following cataract extraction. What is the most important instruction?
- A. Avoid straining, bending, or lifting heavy objects.
- B. Limit exposure to sunlight for the first 2 weeks.
- C. Use direct lighting when reading for 6 weeks.
- D. Irrigate the conjunctiva with saline before applying ointment.
Correct answer: A
Rationale: The most important instruction for a patient following cataract extraction is to avoid straining, bending, or lifting heavy objects. These activities can increase intraocular pressure and potentially lead to complications such as bleeding or dislocation of the intraocular lens. Choices B, C, and D are not as critical in the immediate post-operative period. Limiting sunlight exposure and using direct lighting when reading are important but not as crucial as avoiding activities that can increase intraocular pressure. Irrigating the conjunctiva with saline before applying ointment is not a standard post-cataract surgery instruction.
4. A client receiving heparin therapy experiences a drop in platelet count. What is the nurse's priority action?
- A. Continue to monitor the platelet count.
- B. Discontinue the heparin infusion.
- C. Administer platelet transfusion.
- D. Notify the healthcare provider immediately.
Correct answer: D
Rationale: The correct answer is D: Notify the healthcare provider immediately. A drop in platelet count during heparin therapy may indicate heparin-induced thrombocytopenia (HIT), a serious condition that increases the risk of clot formation. Immediate discontinuation of heparin is necessary to prevent further complications. Administering platelet transfusion without addressing the underlying cause can be harmful. Continuing to monitor the platelet count without taking immediate action can lead to delayed intervention. Notifying the healthcare provider promptly allows for assessment and initiation of alternative anticoagulation therapy to manage the client's condition effectively.
5. A client with chronic kidney disease is receiving erythropoietin injections. What laboratory value should the nurse monitor to evaluate the effectiveness of the treatment?
- A. Serum potassium
- B. Hemoglobin
- C. White blood cell count
- D. Platelet count
Correct answer: B
Rationale: The correct answer is B: Hemoglobin. Erythropoietin stimulates the production of red blood cells, leading to an increase in hemoglobin levels. Monitoring hemoglobin is crucial to assess the effectiveness of the treatment. Choices A, C, and D are incorrect. Serum potassium levels are often monitored in chronic kidney disease, but it is not the primary parameter to evaluate the effectiveness of erythropoietin therapy. White blood cell count and platelet count are not directly influenced by erythropoietin injections for chronic kidney disease.
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