HESI RN
HESI RN Exit Exam 2023 Capstone
1. A 66-year-old woman is retiring and needs health insurance. To which agency should the employee health nurse refer her?
- A. Medicaid
- B. Medicare
- C. COBRA
- D. Private insurance
Correct answer: B
Rationale: The correct answer is B: Medicare. Medicare is the federal health insurance program for individuals aged 65 and older, so it is the most suitable option for the 66-year-old woman retiring. Medicaid (choice A) is a state and federally funded program for low-income individuals and families, not specifically for retirees. COBRA (choice C) allows employees to continue their employer-sponsored health insurance for a limited time after leaving employment. Private insurance (choice D) refers to health insurance plans purchased directly from private insurance companies.
2. Which intervention should be prioritized by the nurse when assessing tissue perfusion post-above knee amputation (AKA)?
- A. Evaluate the closest proximal pulse.
- B. Observe color and amount of wound drainage.
- C. Observe for swelling around the stump.
- D. Assess the skin elasticity of the stump.
Correct answer: A
Rationale: The correct answer is to evaluate the closest proximal pulse when assessing tissue perfusion post-above knee amputation (AKA). Checking the closest proximal pulse provides the best indication of tissue perfusion in the extremities after an AKA procedure. Observing the color and amount of wound drainage (Choice B) is important for wound care but does not directly assess tissue perfusion. Observing for swelling around the stump (Choice C) may indicate inflammation or fluid accumulation but is not the most direct way to assess tissue perfusion. Assessing the skin elasticity of the stump (Choice D) is more related to skin integrity and wound healing rather than tissue perfusion.
3. Which of the following is a group of three RNA nucleotides?
- A. A stop codon
- B. A codon
- C. An anticodon
- D. tRNA
Correct answer: B
Rationale: The correct answer is B - A codon. A codon is a sequence of three RNA nucleotides that specifies a particular amino acid or a stop signal during protein synthesis. Choice A, a stop codon, is a sequence of three nucleotides that signals the termination of protein synthesis. Choice C, an anticodon, is a group of three nucleotides found in tRNA that pairs with the complementary codon in mRNA. Choice D, tRNA, stands for transfer RNA, which is a type of RNA that carries amino acids to the ribosome during protein synthesis.
4. A patient has begun taking spironolactone (Aldactone) in addition to a thiazide diuretic. With the addition of the spironolactone, the nurse will counsel this patient to
- A. not take a potassium supplement daily.
- B. recognize that abdominal cramping is a common side effect.
- C. report decreased urine output to the provider.
- D. take these medications in the morning.
Correct answer: C
Rationale: When combining a potassium-sparing diuretic like spironolactone with a thiazide diuretic, there is an increased risk of hyperkalemia, especially in patients with poor renal function. Therefore, the patient should be educated to report any decrease in urine output, which could indicate a potential issue with kidney function. Choice A is incorrect because taking additional potassium supplements can further increase the risk of hyperkalemia. Choice B is incorrect as abdominal cramping is not a common side effect of spironolactone. Choice D is incorrect because the timing of medication administration is not directly related to the addition of spironolactone and thiazide diuretic; there is no specific recommendation to take these medications only at bedtime.
5. A client is experiencing angina at rest. Which statement indicates a good understanding of the care required?
- A. I will notify the nurse if my chest pain is not relieved in 30 minutes.
- B. I will use nitroglycerin as needed, every 5 minutes, up to 3 doses.
- C. I will avoid physical activity until the pain subsides completely.
- D. I will take nitroglycerin 30 minutes before any physical activity.
Correct answer: B
Rationale: The correct answer is B. Using nitroglycerin as needed, every 5 minutes, up to 3 doses, is the appropriate management for angina at rest. This helps dilate blood vessels, improving blood flow to the heart. Choice A is incorrect because chest pain that persists at rest should be addressed immediately, not waiting for 30 minutes. Choice C is incorrect as avoiding physical activity is not a recommended approach during an angina episode. Choice D is incorrect because nitroglycerin should be used during chest pain episodes, not as a preventive measure before physical activity.