HESI RN
HESI 799 RN Exit Exam Capstone
1. A client is recovering from a hip replacement surgery. What is the priority nursing intervention to prevent complications?
- A. Encourage bed rest to prevent strain on the hip
- B. Assist the client with early ambulation
- C. Provide continuous passive motion therapy
- D. Administer pain medication before activity
Correct answer: B
Rationale: The correct answer is B: Assist the client with early ambulation. Early ambulation is a key intervention to prevent complications like deep vein thrombosis (DVT) and promote circulation after hip replacement surgery. It also helps with overall recovery and reduces the risk of complications related to immobility, such as muscle atrophy and pressure ulcers. Choice A is incorrect as bed rest should be avoided to prevent complications associated with immobility. Choice C, continuous passive motion therapy, is not the priority intervention immediately post-hip replacement surgery. Choice D, administering pain medication before activity, is important but not the priority intervention to prevent complications in this case.
2. A client with pneumonia is receiving intravenous (IV) antibiotics. Which assessment finding indicates that the client's condition is improving?
- A. Client's respiratory rate decreases from 24 to 20 breaths per minute
- B. White blood cell count decreases to normal range
- C. Client reports increased energy levels
- D. Cough becomes productive with green sputum
Correct answer: B
Rationale: A decrease in white blood cell count indicates that the infection is responding to treatment and the client's condition is improving. Monitoring the white blood cell count is a more objective indicator of the body's response to the antibiotics. Choices A, C, and D may also be positive signs, but they are less specific and may vary among individuals. Respiratory rate alone may not be sufficient to indicate improvement, as other factors can influence it. Energy levels and cough characteristics are subjective and may not always correlate with the effectiveness of antibiotic treatment.
3. The nurse is teaching a group of women about osteoporosis and exercise. The nurse should emphasize the need for which type of regular activity?
- A. Weight-bearing exercise
- B. Aerobic exercise
- C. Low-impact exercises such as swimming
- D. Stretching and flexibility exercises
Correct answer: A
Rationale: The correct answer is A: Weight-bearing exercise. Weight-bearing exercise helps build and maintain bone density, which is critical in preventing osteoporosis. Activities like aerobic exercises, stretching, and low-impact exercises such as swimming are beneficial for overall fitness but do not directly contribute to improving bone strength, making them less effective in preventing osteoporosis.
4. Which information is a priority for the RN to reinforce to an older client after intravenous pyelography?
- A. Eat a light diet for the remainder of the day
- B. Rest for the next 24 hours as the preparation and the test are tiring
- C. Drink at least 1 8-ounce glass of fluid every waking hour for the next 2 days
- D. Measure the urine output for the next day and promptly notify the healthcare provider if it decreases
Correct answer: D
Rationale: After intravenous pyelography, it is crucial for the client to measure urine output in the next day to monitor for any potential complications, such as kidney issues. Promptly notifying the healthcare provider in case of decreased urine output is essential for timely intervention. While rest and hydration are important post-procedure, monitoring urine output takes precedence due to its direct correlation with potential complications.
5. The healthcare provider is caring for a client with severe anemia. Which assessment finding requires immediate intervention?
- A. Pale skin
- B. Increased heart rate
- C. Shortness of breath
- D. Fatigue
Correct answer: C
Rationale: Shortness of breath is a critical sign in severe anemia as it indicates inadequate oxygenation, which can be life-threatening. Immediate intervention is necessary to address this condition. Pale skin (choice A) is a common finding in anemia but not as urgent as shortness of breath. Increased heart rate (choice B) is a compensatory mechanism in anemia to maintain oxygen delivery and is important but not as urgent as addressing inadequate oxygenation. Fatigue (choice D) is a common symptom in anemia but does not indicate an immediate life-threatening situation like shortness of breath does.
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