HESI RN
HESI Exit Exam RN Capstone
1. A client on long-term corticosteroid therapy for rheumatoid arthritis presents with weakness and hypotension. What is the nurse's first action?
- A. Administer a PRN dose of corticosteroids.
- B. Place the client in a supine position.
- C. Encourage oral fluid intake.
- D. Review the client's recent medication history.
Correct answer: A
Rationale: Administering a PRN dose of corticosteroids is the correct first action when a client on long-term corticosteroid therapy presents with weakness and hypotension. In this scenario, the client is likely experiencing adrenal insufficiency due to prolonged corticosteroid use. Administering corticosteroids promptly can help correct this insufficiency and improve the client's symptoms. Placing the client in a supine position may be necessary for symptomatic hypotension, but addressing the root cause with corticosteroids is more crucial initially. Encouraging oral fluid intake is important for many conditions but is not the priority in this case. Reviewing the client's recent medication history can provide valuable information but is not the first action needed to address the client's current presentation.
2. A client with chronic heart failure is admitted with worsening dyspnea. What is the nurse's priority action?
- A. Administer oxygen at 2 liters per nasal cannula.
- B. Administer a diuretic as prescribed.
- C. Assess the client's lung sounds.
- D. Reposition the client to relieve dyspnea.
Correct answer: A
Rationale: In a client with chronic heart failure experiencing worsening dyspnea, the priority action for the nurse is to administer oxygen at 2 liters per nasal cannula. This helps improve oxygenation and alleviate respiratory distress. Administering a diuretic (Choice B) may be necessary but addressing oxygenation comes first. While assessing lung sounds (Choice C) is important, it is not the immediate priority when the client is in respiratory distress. Repositioning the client (Choice D) may help with comfort but does not address the underlying issue of inadequate oxygenation.
3. A male client with cirrhosis has jaundice and pruritus. He tells the nurse that he has been soaking in hot baths at night with no relief of his discomfort. Which action should the nurse take?
- A. Instruct the client to use a moisturizer immediately after the bath
- B. Advise the client to take shorter baths with less water
- C. Suggest taking antihistamines for the pruritus
- D. Encourage the client to use cooler water and apply calamine lotion after soaking
Correct answer: D
Rationale: In this situation, the client's pruritus (itching) is likely exacerbated by hot baths, which can worsen the itching sensation. Using cooler water will help soothe the skin and reduce pruritus. Additionally, applying calamine lotion after soaking can provide further relief. Instructing the client to use a moisturizer immediately after the bath (Choice A) may not address the root cause of pruritus aggravated by hot baths. Advising the client to take shorter baths with less water (Choice B) might not be as effective in relieving the itching sensation caused by cirrhosis. Suggesting antihistamines for the pruritus (Choice C) may not directly address the impact of hot baths on the client's discomfort.
4. A client is receiving a low dose of dopamine (Intropin) IV for the treatment of hypotension. Which indicator reflects that the medication is having the desired effect?
- A. Increased heart rate
- B. Increased urinary output
- C. Increased blood pressure
- D. Increased respiratory rate
Correct answer: C
Rationale: Increased blood pressure is the desired effect of administering dopamine (Intropin) to treat hypotension. Dopamine acts by stimulating adrenergic receptors, leading to vasoconstriction and increased cardiac output. This results in an elevation of blood pressure. Choices A, B, and D are incorrect as they do not directly reflect the therapeutic action of dopamine in treating hypotension. Increased heart rate may indicate the body compensating for low blood pressure, increased urinary output is more related to kidney function, and increased respiratory rate is often seen in response to respiratory issues, not the action of dopamine on hypotension.
5. Complete abortion is characterized by:
- A. Os closed.
- B. Firm contracted uterus.
- C. Heavy bleeding.
- D. Heavy cramping.
Correct answer: A
Rationale: Complete abortion is characterized by a firm contracted uterus with a closed os. This closure of the os indicates that the products of conception have been completely expelled from the uterus. Choices B, C, and D are incorrect because a firm contracted uterus with a closed os is the hallmark sign of a complete abortion, not heavy bleeding, heavy cramping, or any other features.