HESI RN
HESI RN Exit Exam 2023 Capstone
1. When assessing a client with a diagnosis of bipolar disorder who reports taking a handful of medications, what information is most important to obtain?
- A. What drugs the client used in the suicide attempt.
- B. When the client last took medications for bipolar disorder.
- C. Whether the client has attempted suicide before.
- D. Which family member has the suicide note.
Correct answer: A
Rationale: The correct answer is to obtain information on what drugs the client used in the suicide attempt. This information is crucial for assessing the severity of the overdose, potential drug interactions, and determining the appropriate treatment plan. Choice B is not as urgent as identifying the drugs taken during the suicide attempt. Choice C, while important, is not as immediately critical as knowing the specific medications involved. Choice D is unrelated to the immediate medical needs of the client.
2. A client with rheumatoid arthritis is prescribed methotrexate. Which assessment finding requires immediate intervention?
- A. Fever of 100.4°F
- B. Positive Chvostek's sign
- C. Increased joint pain
- D. Swelling in the joints
Correct answer: B
Rationale: A positive Chvostek's sign indicates hypocalcemia, which requires immediate intervention as it can lead to life-threatening complications. Fever, increased joint pain, and swelling in the joints are common symptoms in clients with rheumatoid arthritis but do not require immediate intervention like addressing hypocalcemia.
3. A client has pyelonephritis and expresses embarrassment about discussing symptoms. How should the nurse respond?
- A. Assure the client that their symptoms will be kept confidential.
- B. Acknowledge the client's discomfort and avoid discussing elimination topics.
- C. Encourage the use of familiar language and assure the client they can take their time.
- D. Offer the client a nurse of the same gender to provide care.
Correct answer: C
Rationale: When a client expresses embarrassment or discomfort in discussing symptoms related to sensitive topics like elimination and the genitourinary area, the nurse should respond by encouraging the client to use words they are comfortable with. This helps the client feel more at ease and opens up communication. Offering a nurse of the same gender may not address the client's discomfort with discussing symptoms. Assuring confidentiality is important, but it should not be promised in a way that may not be fulfilled. Avoiding the topic of elimination entirely does not address the client's feelings or promote effective communication.
4. Which of the following options is the term used to represent alternative versions of a gene?
- A. Alleles
- B. Binary fission
- C. Heterozygous
- D. Homozygous
Correct answer: A
Rationale: The correct answer is A: Alleles. Alleles are different forms of a gene that can exist at a specific locus on a chromosome. They represent variations in a gene's DNA sequence. Choices B, C, and D are incorrect. Binary fission is a form of asexual reproduction in single-celled organisms, while heterozygous and homozygous refer to different combinations of alleles in an individual, not the alternative versions of a gene.
5. A client with diabetes mellitus reports feeling dizzy and has a blood glucose level of 50 mg/dl. What action should the nurse take first?
- A. Administer 1 mg of glucagon intramuscularly
- B. Provide 15 grams of carbohydrate
- C. Check the client's blood pressure
- D. Notify the healthcare provider
Correct answer: B
Rationale: Providing 15 grams of carbohydrate is the initial action to treat hypoglycemia. When a client with diabetes mellitus experiences symptoms of hypoglycemia, such as dizziness and with a blood glucose level of 50 mg/dl, the immediate priority is to raise their blood sugar levels quickly. Administering carbohydrates, such as fruit juice or glucose tablets, is the recommended first step to reverse hypoglycemia. Administering glucagon intramuscularly is usually reserved for severe hypoglycemia when the client is unconscious or unable to swallow. Checking the client's blood pressure is important but not the primary intervention for hypoglycemia. Notifying the healthcare provider can be done after the immediate management of hypoglycemia.