HESI RN
RN HESI Exit Exam
1. A client with chronic kidney disease (CKD) is scheduled for a renal biopsy. Which laboratory value is most concerning?
- A. Serum potassium of 5.5 mEq/L
- B. Serum creatinine of 1.5 mg/dl
- C. Serum creatinine of 2.5 mg/dl
- D. White blood cell count of 8,000/mm3
Correct answer: C
Rationale: A serum creatinine level of 2.5 mg/dl is the most concerning laboratory value in a client with chronic kidney disease scheduled for a renal biopsy. An elevated serum creatinine level indicates impaired kidney function, which is critical information before performing a renal biopsy. Option A (Serum potassium of 5.5 mEq/L) may be concerning for hyperkalemia but is not directly related to the renal biopsy procedure. Option B (Serum creatinine of 1.5 mg/dl) is within normal limits, suggesting relatively normal kidney function. Option D (White blood cell count of 8,000/mm3) is within the normal range and not directly related to the renal biopsy procedure or CKD management.
2. A client with urticaria due to environmental allergies is taking diphenhydramine (Benadryl). Which complaint should the nurse identify as a side effect of this OTC medication?
- A. Nausea and indigestion.
- B. Hypersalivation.
- C. Eyelid and facial twitching.
- D. Increased appetite.
Correct answer: A
Rationale: The correct answer is A: Nausea and indigestion. Diphenhydramine, an antihistamine, commonly causes gastrointestinal side effects such as nausea and indigestion. These symptoms are often reported by individuals taking this medication. Choices B, C, and D are incorrect because hypersalivation, eyelid and facial twitching, and increased appetite are not typically associated with diphenhydramine use.
3. A client who is post-op day 1 after abdominal surgery reports pain at the incision site. The nurse notes the presence of a small amount of serosanguineous drainage. What is the most appropriate nursing action?
- A. Apply a sterile dressing to the incision.
- B. Reinforce the dressing and document the findings.
- C. Remove the dressing and assess the incision site.
- D. Notify the healthcare provider.
Correct answer: B
Rationale: The correct answer is to reinforce the dressing and document the findings. It is important to monitor the incision site closely after surgery, especially when there is a small amount of serosanguineous drainage. Reinforcing the dressing helps maintain cleanliness and pressure on the wound. Documenting the findings is crucial for tracking the client's progress and alerting healthcare providers if necessary. Applying a sterile dressing (Choice A) may not be needed if the current dressing is intact. Removing the dressing (Choice C) can increase the risk of contamination. Notifying the healthcare provider (Choice D) is not the first step for minor drainage on post-op day 1.
4. A client with a history of chronic heart failure is admitted with shortness of breath and crackles in the lungs. Which laboratory value should be closely monitored?
- A. Serum creatinine of 2.0 mg/dL
- B. Serum sodium of 135 mEq/L
- C. Serum potassium of 5.5 mEq/L
- D. Blood glucose of 150 mg/dL
Correct answer: C
Rationale: A serum potassium level of 5.5 mEq/L should be closely monitored in a client with chronic heart failure as it may indicate hyperkalemia, requiring intervention. Hyperkalemia can lead to life-threatening cardiac arrhythmias in patients with heart failure. Serum creatinine (Choice A) is important to monitor for kidney function but is not the priority in this case. Serum sodium (Choice B) and blood glucose (Choice D) levels are not typically the primary focus when assessing a client with heart failure presenting with respiratory symptoms and crackles in the lungs.
5. A client with a tracheostomy has thick, tenacious secretions. Which intervention should the nurse include in the plan of care?
- A. Encourage the client to drink plenty of fluids.
- B. Perform deep suctioning every 2 to 4 hours.
- C. Increase humidity in the client's room.
- D. Administer a mucolytic agent.
Correct answer: C
Rationale: Increasing humidity in the client's room can help liquefy thick secretions and facilitate easier airway clearance in a client with a tracheostomy. Encouraging the client to drink plenty of fluids can be beneficial for overall hydration but may not directly address thick secretions. Deep suctioning every 2 to 4 hours can be harmful and cause trauma to the airway lining. Administering a mucolytic agent should be done under the healthcare provider's order and may not be the initial intervention for thick secretions.
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