HESI RN
HESI RN Exit Exam 2023 Capstone
1. A client is scheduled for surgery in the morning and is NPO. Which statement indicates that the client understands the reason for being NPO?
- A. Being NPO helps reduce the risk of nausea.
- B. I should not eat or drink anything to prevent complications during surgery.
- C. NPO reduces the risk of aspiration during surgery.
- D. NPO helps ensure the stomach is empty during surgery.
Correct answer: C
Rationale: The correct answer is C: 'NPO reduces the risk of aspiration during surgery.' When a client is NPO (nothing by mouth) before surgery, it is to prevent aspiration, which can lead to serious complications such as pneumonia. Choice A is incorrect because being NPO is more about preventing aspiration than nausea. Choice B is a general statement without specifying the reason for being NPO. Choice D is partially correct but does not emphasize the crucial aspect of preventing aspiration, which is the primary reason for fasting before surgery.
2. A pregnant client complains of heartburn. What instruction should the nurse provide?
- A. Eat spicy food to help digestion.
- B. Eat small meals throughout the day to avoid a full stomach.
- C. Drink carbonated beverages to ease digestion.
- D. Avoid drinking fluids after meals.
Correct answer: B
Rationale: The correct instruction for a pregnant client experiencing heartburn is to eat small meals throughout the day to avoid a full stomach. This helps prevent the stomach from becoming overly full, reducing the likelihood of heartburn during pregnancy. Choices A, C, and D are incorrect. Eating spicy food can exacerbate heartburn, carbonated beverages may trigger heartburn due to gas, and avoiding fluids after meals does not directly address the issue of heartburn.
3. An unlicensed assistive personnel (UAP), who usually works on a surgical unit, is assigned to float to a pediatric unit. Which question by the charge nurse would be most appropriate when making delegation decisions?
- A. How long have you been a UAP and what units have you worked on?
- B. What type of care do you provide on the surgical unit, and what are the ages of the clients?
- C. What is your comfort level in caring for children and at what ages?
- D. Have you reviewed the list of expected skills you might need on this unit?
Correct answer: D
Rationale: The most appropriate question by the charge nurse would be to ask the UAP if they have reviewed the list of expected skills needed on the pediatric unit. This ensures that the UAP is aware of the specific skills required for safe and appropriate care in that particular unit. Choices A, B, and C do not directly address the need for the UAP to review the expected skills, which is crucial for delegation decisions during floating assignments.
4. The nurse is caring for a 24-month-old toddler who has sensory sensitivity, difficulty engaging in social interactions, and has not yet spoken two-word phrases. Which assessment should the nurse administer?
- A. Peabody Picture Vocabulary Test
- B. The Modified Checklist for Autism in Toddlers (M-CHAT)
- C. Wechsler Preschool and Primary Scale of Intelligence
- D. Denver Developmental Screening Test
Correct answer: B
Rationale: The Modified Checklist for Autism in Toddlers (M-CHAT) is specifically designed to screen for autism spectrum disorders in young children. It is appropriate for this child, given the signs of social and communication delays. The Peabody Picture Vocabulary Test (Choice A) assesses receptive vocabulary and may not capture the social and communication aspects seen in autism. The Wechsler Preschool and Primary Scale of Intelligence (Choice C) measures cognitive ability and may not address the social and communication delays. The Denver Developmental Screening Test (Choice D) is a broad developmental assessment tool, but the M-CHAT is more specific to screening for autism in this case.
5. A client with hyperthyroidism is experiencing palpitations. What intervention should the nurse implement?
- A. Encourage the client to rest and limit activity.
- B. Administer a beta-blocker to reduce heart rate.
- C. Encourage the client to drink cool fluids.
- D. Provide the client with a cool environment.
Correct answer: B
Rationale: In clients with hyperthyroidism experiencing palpitations, administering a beta-blocker is the appropriate intervention. Beta-blockers help reduce heart rate and control symptoms in hyperthyroidism. Encouraging rest (Choice A) may be helpful but does not directly address the palpitations. Drinking cool fluids (Choice C) and providing a cool environment (Choice D) are more focused on temperature regulation and comfort, which are not the primary interventions for palpitations in hyperthyroidism.
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