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. The client is being taught to choose foods rich in potassium to prevent digitalis toxicity. Which choice indicates the client understands dietary needs?
- A. Three apricots
- B. Medium banana
- C. Naval orange
- D. Baked potato
Correct answer: D
Rationale: The correct answer is D: Baked potato. Baked potatoes are rich in potassium, which is essential in preventing digitalis toxicity by helping to maintain normal electrolyte levels. Apricots, bananas, and oranges are also sources of potassium, but a baked potato has a higher potassium content compared to the other options, making it a more effective choice for preventing digitalis toxicity.
3. When a client is suspected of having a stroke, what is the nurse's priority action?
- A. Administer tissue plasminogen activator (tPA).
- B. Perform a neurological assessment.
- C. Position the client in a supine position.
- D. Check the client's blood glucose level.
Correct answer: B
Rationale: The correct answer is to perform a neurological assessment. When a stroke is suspected, the priority action is to assess the client neurologically to determine the extent of brain injury and identify any immediate risks, such as impaired airway, speech deficits, or loss of motor function. This assessment helps in early recognition of signs that are essential for timely intervention and guides further treatment, such as administering tissue plasminogen activator (tPA), if appropriate. Positioning the client in a supine position or checking the blood glucose level can be important but not the priority when a stroke is suspected.
4. A client scheduled for a bronchoscopy in the morning is anxious and asking the nurse numerous questions about the procedure. Which intervention has the highest priority in preparing the client for the procedure?
- A. Provide detailed education about the procedure
- B. Administer prescribed anti-anxiety medication
- C. Instruct client to write down the questions
- D. Reassure the client about the safety of the procedure
Correct answer: C
Rationale: Encouraging the client to write down questions is the highest priority as it allows the nurse to address concerns systematically, reducing anxiety. This approach empowers the client and ensures that all concerns are covered before the procedure, reducing the risk of miscommunication or unaddressed fears. Providing detailed education about the procedure (choice A) is important but may not address the client's immediate anxiety. Administering anti-anxiety medication (choice B) should only be done if other interventions are ineffective or if prescribed by the healthcare provider. Reassuring the client about the safety of the procedure (choice D) is essential but may not address the specific questions and concerns causing anxiety.
5. After a thyroidectomy, which vital sign is the most important for the nurse to monitor closely?
- A. Monitor respiratory rate and rhythm.
- B. Assess for signs of hypocalcemia.
- C. Monitor for elevated body temperature.
- D. Check blood pressure every 30 minutes.
Correct answer: B
Rationale: The correct answer is B: Assess for signs of hypocalcemia. After a thyroidectomy, monitoring for hypocalcemia is crucial because damage to the parathyroid glands during surgery can result in low calcium levels, which may cause life-threatening complications. Monitoring respiratory rate and rhythm (choice A) is important but not the most critical in this situation. Monitoring for elevated body temperature (choice C) is less of a priority post-thyroidectomy. Checking blood pressure every 30 minutes (choice D) is not as vital as monitoring for hypocalcemia in this context.
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