HESI RN
HESI RN Exit Exam 2023 Capstone
1. A client is receiving IV antibiotic therapy for sepsis. Which assessment finding indicates that the client's condition is improving?
- A. Urine output increases to 25 mL/hour
- B. Client reports feeling less fatigued
- C. Heart rate decreases from 120 to 110 beats per minute
- D. White blood cell count decreases from 15,000 to 9,000/mm3
Correct answer: D
Rationale: The correct answer is D. A decrease in white blood cell count indicates that the infection is responding to treatment, making this the most objective indicator of improvement in a client with sepsis. Choices A, B, and C are subjective indicators and may not always directly correlate with the resolution of the underlying infection. While an increase in urine output, a client reporting feeling less fatigued, and a decrease in heart rate are positive signs, they are not as specific or directly related to the resolution of the infection as a decrease in white blood cell count.
2. Which cell structure is responsible for efficiently packaging DNA into a small volume to fit into the nucleus of a cell and protect the DNA structure and sequence?
- A. Golgi apparatus
- B. Chromatin
- C. Smooth endoplasmic reticulum
- D. Mitochondria
Correct answer: B
Rationale: The correct answer is B: Chromatin. Chromatin is responsible for packaging DNA into a more compact, dense shape to fit into the nucleus of a cell. This compact packaging helps protect the DNA structure and regulate gene expression. The Golgi apparatus is involved in modifying, sorting, and packaging proteins. The smooth endoplasmic reticulum is involved in lipid metabolism and detoxification. Mitochondria are known as the powerhouse of the cell, producing energy in the form of ATP.
3. A client with a history of type 1 diabetes is admitted with diabetic ketoacidosis (DKA). Which intervention is most important?
- A. Administer intravenous fluids as prescribed.
- B. Administer insulin as prescribed.
- C. Monitor the client's urine output.
- D. Check the client's blood glucose level.
Correct answer: B
Rationale: Administering insulin is the most important intervention in managing diabetic ketoacidosis. Insulin helps to reduce blood glucose levels and correct metabolic acidosis, which are critical in the treatment of DKA. While administering intravenous fluids is essential to manage dehydration, insulin takes precedence in treating the underlying cause of DKA. Monitoring urine output is important for assessing renal function but is not the primary intervention in managing DKA. Checking the client's blood glucose level is necessary, but administering insulin to reduce high blood glucose levels is the key priority in treating DKA.
4. A client with a history of heart failure is admitted with a diagnosis of pulmonary edema. Which intervention should the nurse implement first?
- A. Administer oxygen via non-rebreather mask.
- B. Administer furosemide (Lasix) IV push.
- C. Insert a Foley catheter to monitor urine output.
- D. Position the client in a high Fowler's position.
Correct answer: A
Rationale: Administering oxygen via a non-rebreather mask is the priority intervention for a client with pulmonary edema to improve oxygenation and address respiratory distress. Adequate oxygenation is essential to support vital organ function. Administering furosemide intravenously, inserting a Foley catheter to monitor urine output, and positioning the client in a high Fowler's position are important interventions but are secondary to ensuring optimal oxygenation in this client with pulmonary edema.
5. A clinic nurse prepares to administer an MMR (measles, mumps, rubella) vaccine to a child. How is this vaccine best administered?
- A. Intramuscularly in the deltoid muscle
- B. Subcutaneously in the gluteal muscle
- C. Subcutaneously in the outer aspect of the upper arm
- D. Intramuscularly in the anterolateral aspect of the thigh
Correct answer: C
Rationale: The MMR vaccine is best administered subcutaneously in the outer aspect of the upper arm. This route allows for proper absorption and efficacy of the vaccine while minimizing the risk of injury or discomfort to the child.