HESI RN
HESI 799 RN Exit Exam Capstone
1. A client is scheduled for a colonoscopy and has been prescribed a bowel preparation. What is the most important instruction for the nurse to provide?
- A. Eat a low-fiber diet the day before the procedure
- B. Drink clear liquids 24 hours before the procedure
- C. Take the entire bowel preparation as directed
- D. Avoid all solid foods 12 hours before the procedure
Correct answer: C
Rationale: The most important instruction for the nurse to provide to a client scheduled for a colonoscopy and prescribed a bowel preparation is to take the entire bowel preparation as directed. Completing the entire bowel preparation as prescribed is crucial to ensure the colon is properly cleansed for the colonoscopy. Incomplete bowel prep can interfere with the visualization of the colon, leading to inaccurate results. Choices A, B, and D are important but not as crucial as ensuring the complete intake of the bowel preparation for an effective procedure.
2. Oligomenorrhea is defined as a cycle longer than:
- A. 28 days
- B. 30 days
- C. 35 days
- D. 40 days
Correct answer: C
Rationale: Oligomenorrhea is defined as a menstrual cycle longer than 35 days. A cycle of 28 days (Choice A) is within the normal range, and not considered oligomenorrhea. Similarly, 30 days (Choice B) and 40 days (Choice D) are also within the normal range. The correct definition of oligomenorrhea specifically refers to cycles longer than 35 days, making Choice C the correct answer.
3. A client receiving chemotherapy reports severe nausea. What should the nurse implement first?
- A. Administer an antiemetic as prescribed.
- B. Offer the client small, frequent meals.
- C. Provide the client with crackers and water.
- D. Encourage the client to eat a bland diet.
Correct answer: A
Rationale: The correct answer is A: Administer an antiemetic as prescribed. When a client receiving chemotherapy reports severe nausea, the priority action is to administer an antiemetic medication as prescribed. Antiemetics help alleviate nausea and prevent complications associated with chemotherapy, such as dehydration and malnutrition. Options B, C, and D focus on dietary interventions which can be helpful but addressing the severe nausea with antiemetic medication takes precedence to provide immediate relief and ensure the client's comfort and well-being.
4. An 11-year-old client admitted to the mental health unit after threatening self-harm. What is the best activity to establish rapport and promote coping?
- A. Bring the client to the team meeting to discuss the treatment plan.
- B. Play a board game with the client and start discussing stressors.
- C. Explain the purpose of each medication the client is taking.
- D. Ask the client to write feelings in a journal and review together.
Correct answer: B
Rationale: Playing a board game with the client is an effective way to establish rapport in a relaxed setting, allowing the client to open up about stressors. This activity promotes coping by creating a safe and engaging environment for the client to express their feelings. Choices A, C, and D may not be suitable initially as they involve more formal or intrusive approaches that may not be suitable for building rapport with a client experiencing emotional distress.
5. A patient who had a transverse colectomy for diverticulosis 18 hours ago has nasogastric suction and is complaining of anxiety and incisional pain. The patient’s respiratory rate is 32 breaths/minute and the arterial blood gases (ABGs) indicate respiratory alkalosis. Which action should the nurse take first?
- A. Discontinue the nasogastric suction.
- B. Give the patient the PRN IV morphine sulfate 4 mg.
- C. Notify the health care provider about the ABG results.
- D. Teach the patient how to take slow, deep breaths when anxious.
Correct answer: B
Rationale: The patient’s respiratory alkalosis is caused by the increased respiratory rate associated with pain and anxiety. The nurse’s first action should be to medicate the patient for pain. Although the nasogastric suction may contribute to the alkalosis, it is not appropriate to discontinue the tube when the patient needs gastric suction. The health care provider may be notified about the ABGs but is likely to instruct the nurse to medicate for pain. The patient will not be able to take slow, deep breaths when experiencing pain.