HESI RN
HESI RN Exit Exam Capstone
1. A client with bipolar disorder is prescribed lithium. What should the nurse teach the client about lithium toxicity?
- A. Take the medication with meals to prevent gastrointestinal upset.
- B. Report any symptoms of nausea, vomiting, or diarrhea.
- C. Monitor lithium levels regularly and maintain hydration.
- D. Avoid taking nonsteroidal anti-inflammatory drugs (NSAIDs) while on lithium.
Correct answer: D
Rationale: The correct answer is D. Clients taking lithium should avoid NSAIDs as they can increase lithium levels leading to toxicity. It is essential to monitor lithium levels regularly and maintain hydration to prevent toxicity. Reporting symptoms like nausea, vomiting, or diarrhea is important, but the key teaching point regarding lithium toxicity is to avoid NSAIDs.
2. A client is newly prescribed lithium for bipolar disorder. Which finding is most important to report to the healthcare provider?
- A. A serum lithium level of 1.2 mEq/L.
- B. Fine hand tremors noted after starting the medication.
- C. A blood pressure of 110/60 mmHg.
- D. A serum sodium level of 140 mEq/L.
Correct answer: B
Rationale: The correct answer is B. Fine hand tremors noted after starting lithium are an early sign of lithium toxicity. It is crucial to report this finding to the healthcare provider promptly. Adjusting the dose or monitoring serum levels more closely may be necessary to prevent further toxicity. Choice A, a serum lithium level of 1.2 mEq/L, is within the therapeutic range (0.6-1.2 mEq/L) for treating bipolar disorder. Choice C, a blood pressure of 110/60 mmHg, and Choice D, a serum sodium level of 140 mEq/L, are within normal limits and not directly related to lithium therapy or toxicity.
3. A client reports unilateral leg swelling after a long flight. What complication is the nurse most concerned about?
- A. Monitor for signs of a pulmonary embolism.
- B. Assess for signs of dehydration.
- C. Monitor for signs of compartment syndrome.
- D. Check the client’s oxygen saturation levels.
Correct answer: A
Rationale: The correct answer is A. Unilateral leg swelling following a long flight may indicate a pulmonary embolism, which is a life-threatening complication requiring immediate attention. Pulmonary embolism occurs when a blood clot travels to the lungs, potentially blocking blood flow and leading to serious complications. Choices B, C, and D are incorrect because dehydration, compartment syndrome, and oxygen saturation levels are not typically associated with unilateral leg swelling after a long flight. While dehydration can cause leg cramps, compartment syndrome is more commonly associated with trauma or injury, and oxygen saturation levels are not the primary concern in this scenario.
4. A client with hypothyroidism is prescribed levothyroxine. What assessment finding suggests the medication dosage is too high?
- A. Increased sensitivity to cold.
- B. Increased heart rate and palpitations.
- C. Improved energy levels.
- D. Improved tolerance to heat.
Correct answer: B
Rationale: The correct answer is B: Increased heart rate and palpitations. When a client with hypothyroidism is prescribed levothyroxine, these symptoms may indicate that the dosage is too high, causing the client to develop hyperthyroidism. Choices A, C, and D are incorrect. Increased sensitivity to cold is a symptom of hypothyroidism, improved energy levels are an expected outcome of levothyroxine therapy for hypothyroidism, and improved tolerance to heat is not a common sign of levothyroxine overdose.
5. A male client with HIV on saquinavir and other antiretrovirals reports increased hunger and thirst but weight loss. Which action should the nurse take?
- A. Use a glucometer to assess capillary glucose.
- B. Explain to the client that an increased dose of medication is needed.
- C. Reassure the client that weight will improve as viral load decreases.
- D. Teach the client how to measure his weight accurately.
Correct answer: A
Rationale: Increased thirst and hunger while losing weight may indicate hyperglycemia, a common side effect of saquinavir and other antiretrovirals. Using a glucometer to assess capillary glucose levels is essential to evaluate for hyperglycemia. Choice B is incorrect because increasing the dose of medication without assessing blood glucose levels can be dangerous. Choice C is incorrect because weight loss may not necessarily improve with viral load reduction and doesn't address the immediate concern of hyperglycemia. Choice D is irrelevant to the presenting symptoms and should not be a priority over assessing for hyperglycemia.
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