a client who had a subtotal parathyroidectomy two days ago is now preparing for discharge which assessment finding requires immediate provider notific
Logo

Nursing Elites

HESI RN

RN HESI Exit Exam Capstone

1. A client who had a subtotal parathyroidectomy two days ago is now preparing for discharge. Which assessment finding requires immediate provider notification?

Correct answer: D

Rationale: A positive Chvostek's sign suggests hypocalcemia, which is a post-parathyroidectomy complication and requires prompt treatment. The other options are less urgent: being afebrile with a normal pulse is expected, no bowel movement since surgery can be managed with interventions like early ambulation and stool softeners, and no appetite for breakfast is common postoperatively and can be addressed without immediate provider notification.

2. An elderly client reports new-onset confusion, nausea, dysuria, and urgency. What action should the nurse take first?

Correct answer: B

Rationale: The correct first action for the nurse to take in this scenario is to obtain a clean-catch midstream urine specimen. The client's symptoms of confusion, nausea, dysuria, and urgency are suggestive of a urinary tract infection (UTI). To confirm the diagnosis and identify the causative organism, a urine specimen should be collected before initiating any treatment. Initiating intravenous fluids (Choice A) may be necessary later based on the client's condition but is not the initial priority. Administering antibiotics (Choice C) should be done after confirming the diagnosis through urine culture. Starting a Foley catheter (Choice D) to obtain a sterile sample is more invasive and should not be the first step in the assessment and management of a suspected UTI.

3. A client who recently underwent a tracheostomy is being prepared for discharge to home. Which instructions are most important for the nurse to include in the discharge plan?

Correct answer: B

Rationale: The correct answer is B: Teach tracheal suctioning techniques. Tracheal suctioning is crucial for maintaining a clear airway in clients with a tracheostomy. Without proper suctioning, secretions can accumulate and cause airway obstruction or respiratory infections. Educating the client on how to perform suctioning safely is a priority for discharge planning. Choices A, C, and D are important aspects of tracheostomy care, but teaching tracheal suctioning techniques takes precedence due to its direct impact on airway patency and preventing complications.

4. A client with bipolar disorder is prescribed lithium. What should the nurse teach the client about lithium toxicity?

Correct answer: D

Rationale: The correct answer is D. Clients taking lithium should avoid NSAIDs as they can increase lithium levels leading to toxicity. It is essential to monitor lithium levels regularly and maintain hydration to prevent toxicity. Reporting symptoms like nausea, vomiting, or diarrhea is important, but the key teaching point regarding lithium toxicity is to avoid NSAIDs.

5. A client presents with a suspected infection and has a fever of 102°F. What is the nurse's immediate priority?

Correct answer: B

Rationale: The immediate priority for a client with a suspected infection and fever is to take a blood culture before administering antibiotics. This step is crucial to identify the causative organism and ensure appropriate treatment. Administering antipyretics or encouraging fluid intake are important but should come after obtaining the blood culture to avoid interfering with test results. Monitoring vital signs, although essential, is not the immediate priority compared to identifying the infectious agent.

Similar Questions

A client with anemia is prescribed iron supplements. What teaching should the nurse provide?
The nurse prepares to teach clients about blood glucose monitoring. When should clients always check glucose, regardless of age or type of diabetes?
Which foods should a healthcare provider recommend for a child with phenylketonuria (PKU) to avoid?
A client is receiving IV antibiotic therapy for sepsis. Which assessment finding indicates that the client's condition is improving?
Where should the healthcare provider consider starting a screening program for hypothyroidism?

Access More Features

HESI RN Basic
$69.99/ 30 days

  • 5,000 Questions with answers
  • All HESI courses Coverage
  • 30 days access

HESI RN Premium
$149.99/ 90 days

  • 5,000 Questions with answers
  • All HESI courses Coverage
  • 30 days access

Other Courses