HESI RN
RN HESI Exit Exam Capstone
1. A child newly diagnosed with sickle cell anemia (SCA) is being discharged from the hospital. Which information is most important for the nurse to provide the parents prior to discharge?
- A. Nutritional guidelines to support blood health
- B. Signs of infection to monitor for
- C. When to give pain medication
- D. Instructions about how much fluid the child should drink daily
Correct answer: D
Rationale: Proper hydration is crucial in managing sickle cell anemia (SCA) as it helps prevent sickling of red blood cells and reduces blood viscosity, which can lead to painful crises. Ensuring the child drinks enough fluids is essential to maintain adequate hydration levels and reduce the risk of complications. While nutritional guidelines and recognizing signs of infection are important aspects of care, maintaining proper hydration is the most immediate and critical factor in managing SCA and preventing crises.
2. 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.
3. A client with hypocalcemia is receiving calcium gluconate. What assessment finding requires immediate intervention?
- A. Decreased deep tendon reflexes.
- B. Wheezing and stridor.
- C. Decreased bowel sounds.
- D. Positive Chvostek's sign.
Correct answer: B
Rationale: Wheezing and stridor may indicate a severe allergic reaction to calcium gluconate, such as anaphylaxis, which requires immediate intervention. While hypocalcemia can present with decreased deep tendon reflexes and positive Chvostek's sign, these findings do not indicate an immediate life-threatening situation. Decreased bowel sounds are not directly related to a severe reaction to calcium gluconate and do not require immediate intervention.
4. A middle-aged woman talks to the nurse in the healthcare provider's office about uterine fibroids, also called leiomyomas or myomas. What statement by the woman indicates more education is needed?
- A. I am one out of every 4 women that get fibroids, and among women my age, between the 30s or 40s, fibroids occur more frequently.
- B. My fibroids are noncancerous tumors that grow slowly.
- C. The associated problems I have had are pelvic pressure and pain, urinary incontinence, frequent urination or urine retention, and constipation.
- D. Fibroids that cause no problems still need to be taken out.
Correct answer: D
Rationale: The correct answer is D because fibroids that do not cause symptoms do not necessarily need to be removed unless they pose other health risks. Choice A provides accurate information about the prevalence of fibroids among women of the woman's age group. Choice B correctly describes fibroids as noncancerous tumors. Choice C lists common symptoms associated with fibroids, which is relevant information. However, choice D is incorrect as fibroids that are asymptomatic or not causing problems usually do not require treatment, unless they lead to complications or health risks.
5. During an acute exacerbation of asthma, what is the nurse's first action for a client experiencing this condition?
- A. Administer a bronchodilator as prescribed.
- B. Check the client's oxygen saturation.
- C. Reassure the client and encourage deep breathing.
- D. Provide emotional support to reduce anxiety.
Correct answer: A
Rationale: The correct first action when managing an acute exacerbation of asthma is to administer a bronchodilator as prescribed. Bronchodilators help open the airways and improve breathing in individuals experiencing an asthma exacerbation. Checking oxygen saturation (Choice B) is important but not the first action. Reassuring the client and encouraging deep breathing (Choice C) can be beneficial but should come after administering the bronchodilator. Providing emotional support to reduce anxiety (Choice D) is important but is not the initial priority in managing an acute exacerbation of asthma.
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