HESI RN
HESI RN Exit Exam 2023 Capstone
1. A client is admitted with diabetic ketoacidosis (DKA). Which laboratory result would the nurse expect to find in this client?
- A. pH level of 7.45
- B. Serum calcium of 15 mg/dL
- C. Blood glucose of 450 mg/dL
- D. Sodium level of 120 mEq/L
Correct answer: C
Rationale: Clients with diabetic ketoacidosis typically present with elevated blood glucose levels, often above 300 mg/dL. This high blood glucose level, along with other symptoms, helps confirm the diagnosis of DKA. A pH level of 7.45 would be indicative of alkalosis, not the acidosis seen in DKA. A serum calcium level of 15 mg/dL is significantly elevated and is not a typical finding in DKA. A sodium level of 120 mEq/L indicates hyponatremia, which is not a characteristic laboratory finding in DKA.
2. A client is admitted with a severe burn injury. What is the nurse's priority intervention?
- A. Monitor the client's urine output.
- B. Administer intravenous fluids.
- C. Apply cool, moist compresses to the burn area.
- D. Cover the burn area with a sterile dressing.
Correct answer: B
Rationale: The correct answer is B: Administer intravenous fluids. In a client with severe burn injury, the priority intervention is to administer intravenous fluids to prevent shock. Monitoring urine output (Choice A) is important but not the priority. Applying cool, moist compresses (Choice C) can be beneficial but is not the priority over fluid resuscitation. Covering the burn area with a sterile dressing (Choice D) is important for wound care but is not the immediate priority in managing severe burns.
3. A client with cirrhosis is at risk for bleeding due to impaired liver function. Which laboratory result is the most important to monitor?
- A. Blood urea nitrogen (BUN)
- B. Prothrombin time (PT)
- C. Aspartate aminotransferase (AST)
- D. Serum albumin
Correct answer: B
Rationale: Prothrombin time (PT) measures the time it takes for blood to clot and is a critical indicator of bleeding risk in clients with liver dysfunction. Impaired liver function reduces clotting factor production, leading to an increased PT, which requires close monitoring. Monitoring BUN (Choice A) is more indicative of kidney function, not clotting ability. Aspartate aminotransferase (AST) (Choice C) and serum albumin (Choice D) are important indicators of liver function, but they do not directly assess the client's bleeding risk.
4. The charge nurse is planning assignments on a medical unit. Which client should be assigned to the PN?
- A. Test a stool specimen for occult blood
- B. Assist with the ambulation of a client with a chest tube
- C. Irrigate and redress a leg wound
- D. Admit a client from the emergency room
Correct answer: C
Rationale: Irrigating and redressing a leg wound is a common task within the PN's scope of practice, making this assignment appropriate. Tasks like testing stool specimens for occult blood and assisting with ambulation of a client with a chest tube may require a higher level of training and assessment, typically performed by RNs. Admitting a client from the emergency room involves a comprehensive assessment and decision-making process, which is usually within the RN's responsibility.
5. The healthcare worker is wearing PPE while caring for a client. When exiting the room, which PPE should be removed first?
- A. Gloves
- B. Face shield
- C. Mask
- D. Gown
Correct answer: A
Rationale: Gloves should be removed first as they are most likely to be contaminated. This is followed by the gown, then face shield, and mask. Correct removal sequence helps prevent contamination. Removing gloves first reduces the risk of transferring pathogens from the gloves to other PPE or surfaces. Face shield and mask should be removed last as they protect mucous membranes from exposure to contaminants. Removing PPE in the correct sequence is crucial in preventing the spread of infections.
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