HESI RN
HESI RN Exit Exam 2024 Quizlet Capstone
1. An older adult client is admitted with pneumonia and prescribed penicillin G potassium. Which factor increases the risk of an adverse reaction?
- A. Sputum culture showing Streptococcus pneumoniae.
- B. Previous treatment with penicillin.
- C. Daily use of spironolactone for hypertension.
- D. Documented allergy to sulfa drugs.
Correct answer: C
Rationale: The correct answer is C. Daily use of spironolactone for hypertension can increase the risk of hyperkalemia and interact with penicillin, leading to adverse reactions. Choice A is incorrect because the sputum culture showing Streptococcus pneumoniae is an expected finding in a patient with pneumonia and does not increase the risk of an adverse reaction to penicillin. Choice B is incorrect as previous treatment with penicillin does not necessarily increase the risk of an adverse reaction to penicillin if there was no history of allergic reactions. Choice D is also incorrect as a documented allergy to sulfa drugs does not directly increase the risk of an adverse reaction to penicillin.
2. A 60-year-old male client had a hernia repair in an outpatient surgery clinic. He is awake and alert but has not been able to void since he returned from surgery 6 hours ago. He received 1000 mL of IV fluid. Which action would be most likely to help him void?
- A. Have him drink several glasses of water
- B. Crede the bladder from the bottom to the top
- C. Assist him to stand by the side of the bed to void
- D. Wait 2 hours and have him try to void again
Correct answer: C
Rationale: Assisting the client to stand by the side of the bed to void is the most appropriate action in this situation. Standing to void often helps relieve the bladder, especially after surgery. Option A, having him drink several glasses of water, may not be as effective as the client might already be adequately hydrated. Option B, Crede maneuver, is a technique for emptying the bladder by applying manual pressure and is not the first-line intervention for a client who cannot void post-surgery. Option D, waiting 2 hours before trying to void again, may delay necessary intervention if the client is experiencing urinary retention.
3. The client provides three positive responses to the CAGE questionnaire. Which interpretation should the nurse provide?
- A. The CAGE is a tool for identifying substance abuse.
- B. Two positive responses suggest alcohol dependence.
- C. One positive response indicates potential alcohol issues.
- D. All responses must be positive for alcohol dependence.
Correct answer: B
Rationale: The CAGE questionnaire is a widely used screening tool for alcohol dependence. Two or more positive responses suggest a higher likelihood of alcohol dependence. One positive response may indicate potential alcohol issues, but two or more significantly increase the likelihood of dependence. Therefore, choice B is the most appropriate interpretation. Choice A is incorrect because the CAGE questionnaire specifically focuses on alcohol-related issues, not substance abuse in general. Choice C is incorrect as one positive response does not indicate addiction but rather raises a concern. Choice D is incorrect as not all responses need to be positive to suggest alcohol dependence.
4. The nurse is caring for a client with a diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which intervention is most important for the nurse to implement?
- A. Encourage oral hydration
- B. Monitor for signs of dehydration
- C. Restrict fluid intake
- D. Administer IV fluids as prescribed
Correct answer: C
Rationale: In SIADH, there is excessive ADH secretion leading to water retention and dilutional hyponatremia. The most crucial intervention is to restrict fluid intake to prevent further fluid overload and worsening of hyponatremia. Encouraging oral hydration (choice A) would exacerbate the condition by adding more fluids. Monitoring for signs of dehydration (choice B) is not appropriate as the client is at risk of fluid overload. Administering IV fluids (choice D) would worsen the hyponatremia and should be avoided.
5. A client is prescribed an inhaled corticosteroid for asthma management. Which instruction should the nurse provide to the client regarding the use of this medication?
- A. Rinse your mouth after using the inhaler
- B. Hold your breath for 5 seconds after inhaling the medication
- C. Use the inhaler during an acute asthma attack
- D. Take the medication only when symptoms occur
Correct answer: A
Rationale: The correct instruction for a client using an inhaled corticosteroid for asthma management is to rinse the mouth after using the inhaler. This helps prevent oral thrush, a common side effect of corticosteroid inhalers. Holding the breath for 5 seconds after inhaling the medication (Choice B) is not necessary for corticosteroid inhalers. Using the inhaler during an acute asthma attack (Choice C) is not the purpose of corticosteroids, which are used for long-term asthma management. Taking the medication only when symptoms occur (Choice D) is not correct as corticosteroids are typically used regularly to control asthma symptoms.
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