HESI RN
HESI 799 RN Exit Exam
1. A client who recently underwent a tracheostomy is being prepared for discharge to home. Which instruction is most important for the nurse to include in the discharge plan?
- A. Explain how to use communication tools.
- B. Teach tracheal suctioning techniques.
- C. Encourage self-care and independence.
- D. Demonstrate how to clean the tracheostomy site.
Correct answer: B
Rationale: The most important instruction for a client who recently underwent a tracheostomy is to teach tracheal suctioning techniques. Suctioning helps clear secretions and maintain an open airway, which is critical for the client's respiratory function and overall well-being. While communication tools, self-care, and cleaning the tracheostomy site are important aspects of care, ensuring proper suctioning techniques is crucial for preventing complications and ensuring the client's safety.
2. Which of the following is not true of mitosis?
- A. Mitosis produces daughter cells
- B. Mitosis has five main stages
- C. Mitosis can only be done by haploids
- D. Following mitosis, daughter cells are identical to parent cells
Correct answer: C
Rationale: The correct answer is C. Mitosis occurs in diploid cells and involves stages that result in the production of two identical daughter cells. Haploids do not undergo mitosis, as mitosis is a process specific to diploid cells. Choice A is true as mitosis does produce daughter cells. Choice B is incorrect as mitosis typically consists of four main stages: prophase, metaphase, anaphase, and telophase. Choice D is true, as one of the main outcomes of mitosis is the production of daughter cells that are genetically identical to the parent cell.
3. Community health nurses are particularly concerned with the source of communicable diseases such as hepatitis A. Which group of individuals have a higher risk of contracting that type of hepatitis?
- A. IV drug users who share needles
- B. low-income families living in cramped quarters
- C. those who have recently received a blood transfusion
- D. sexually active persons with multiple partners
Correct answer: B
Rationale: The correct answer is B. Hepatitis A is often spread through close personal contact and poor sanitary conditions, which are more common in low-income, cramped living situations. IV drug users sharing needles are at higher risk of hepatitis B and C due to bloodborne transmission. Those who have recently received a blood transfusion are at risk of hepatitis C or other bloodborne infections. Sexually active persons with multiple partners are at risk of hepatitis B, which can be transmitted through sexual contact.
4. A client with pneumonia is receiving intravenous (IV) antibiotics. Which assessment finding indicates that the client's condition is improving?
- A. Client's respiratory rate decreases from 24 to 20 breaths per minute
- B. White blood cell count decreases to normal range
- C. Client reports increased energy levels
- D. Cough becomes productive with green sputum
Correct answer: B
Rationale: A decrease in white blood cell count indicates that the infection is responding to treatment and the client's condition is improving. Monitoring the white blood cell count is a more objective indicator of the body's response to the antibiotics. Choices A, C, and D may also be positive signs, but they are less specific and may vary among individuals. Respiratory rate alone may not be sufficient to indicate improvement, as other factors can influence it. Energy levels and cough characteristics are subjective and may not always correlate with the effectiveness of antibiotic treatment.
5. Which of the following would be the priority nursing diagnosis for a client with an ectopic pregnancy?
- A. Risk for infection
- B. Pain
- C. Knowledge Deficit
- D. Anticipatory Grieving
Correct answer: D
Rationale: Anticipatory grieving is the priority nursing diagnosis for a client with an ectopic pregnancy. An ectopic pregnancy is a life-threatening condition that requires immediate medical intervention, often resulting in emotional distress and potential loss. Anticipatory grieving addresses the emotional needs of the client and their family in anticipation of a possible loss. While pain management and infection prevention are important aspects of care, addressing the emotional well-being and coping mechanisms should take precedence in this situation. Knowledge deficit may also be relevant, but emotional support is crucial in this critical scenario.