HESI RN
HESI RN Exit Exam Capstone
1. 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.
2. What is the primary purpose of the logrolling technique for turning?
- A. To decrease the risk of back injury by working together.
- B. To maintain straight spinal alignment.
- C. To increase client safety by using two or three people.
- D. To reduce the likelihood of skin damage by turning instead of pulling.
Correct answer: B
Rationale: The correct answer is B: To maintain straight spinal alignment. Logrolling is a technique used to carefully turn a client while keeping the spine in a straight line, especially important for those with spinal injuries or after back surgery. Choice A is incorrect because the primary purpose is not specifically to decrease the risk of back injury but to ensure safe turning. Choice C is incorrect as the main aim is not to increase client safety by using multiple people but to protect the spine. Choice D is incorrect because the primary purpose of logrolling is not to prevent skin damage but to safeguard the spine during turning.
3. A client is scheduled for a spiral CT scan with contrast to evaluate for pulmonary embolism. Which information in the client's history requires follow-up by the nurse?
- A. Is allergic to shellfish
- B. Has a history of smoking
- C. Takes metformin for type 2 diabetes mellitus
- D. Has hypertension controlled with medication
Correct answer: A
Rationale: An allergy to shellfish often indicates an allergy to iodine, which is used in contrast dyes for CT scans. This poses a significant risk of an allergic reaction during the procedure. The nurse must ensure appropriate precautions or alternative imaging are considered. Choices B, C, and D are not directly contraindicated for a CT scan with contrast. Smoking history, metformin use, and controlled hypertension do not typically impact the safety or feasibility of the procedure.
4. Which medication should the nurse withhold if the client's serum potassium level is 6.2 mEq/L?
- A. Losartan
- B. Spironolactone
- C. Metoprolol
- D. Furosemide
Correct answer: B
Rationale: The correct answer is B: Spironolactone. Spironolactone is a potassium-sparing diuretic that can lead to hyperkalemia. With potassium levels already elevated at 6.2 mEq/L, withholding Spironolactone is essential to prevent further increase in potassium levels, which could result in dangerous cardiac arrhythmias. Losartan (Choice A) is an angiotensin receptor blocker and does not directly affect potassium levels. Metoprolol (Choice C) is a beta-blocker and also does not impact potassium levels significantly. Furosemide (Choice D) is a loop diuretic that can actually lower potassium levels, so it would not be the medication to withhold in this case.
5. A client with cirrhosis is at risk for bleeding due to impaired liver function. Which laboratory result is the most important to monitor?
- A. Blood urea nitrogen (BUN)
- B. Prothrombin time (PT)
- C. Aspartate aminotransferase (AST)
- D. Serum albumin
Correct answer: B
Rationale: Prothrombin time (PT) measures the time it takes for blood to clot and is a critical indicator of bleeding risk in clients with liver dysfunction. Impaired liver function reduces clotting factor production, leading to an increased PT, which requires close monitoring. Monitoring BUN (Choice A) is more indicative of kidney function, not clotting ability. Aspartate aminotransferase (AST) (Choice C) and serum albumin (Choice D) are important indicators of liver function, but they do not directly assess the client's bleeding risk.
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