HESI RN
HESI RN Exit Exam 2024 Quizlet
1. A client with a history of chronic kidney disease is scheduled for a renal biopsy. Which laboratory value should the nurse report to the healthcare provider before the procedure?
- A. Serum creatinine of 1.8 mg/dl
- B. Prothrombin time of 18 seconds
- C. Hemoglobin of 9 g/dl
- D. Platelet count of 90,000/mm3
Correct answer: D
Rationale: A platelet count of 90,000/mm3 is low and concerning for a client scheduled for a renal biopsy, as it increases the risk of bleeding. Thrombocytopenia, indicated by a low platelet count, can lead to impaired blood clotting, posing a significant risk of bleeding during or after the biopsy procedure. Elevated serum creatinine levels may be expected in chronic kidney disease but are not directly related to bleeding risk during a renal biopsy. Prothrombin time and hemoglobin levels are not as directly relevant to the bleeding risk associated with a renal biopsy as platelet count.
2. A nurse is assessing a newly admitted patient with chronic heart failure who forgot to take prescribed medications and seems confused. The patient complains of "just blowing up" and has peripheral edema and shortness of breath. Which assessment should the nurse complete first?
- A. Skin turgor
- B. Heart sounds
- C. Mental status
- D. Capillary refill
Correct answer: C
Rationale: Increases in extracellular fluid (ECF) can lead to swelling of cells in the central nervous system, initially causing confusion, which may progress to coma or seizures. Although skin turgor, capillary refill, and heart sounds also may be affected by increases in ECF, these are signs that do not have as immediate impact on patient outcomes as cerebral edema.
3. The nurse finds a 6-month-old infant unresponsive and calls for help. After opening the airway and finding the XXXX, the infant is still not breathing. What action should the nurse take next?
- A. Palpate the femoral pulse and check for regularity.
- B. Deliver cycles of 30 chest compressions and 2 breaths.
- C. Give two breaths that make the chest rise.
- D. Feel the carotid pulse and check for adequate breathing.
Correct answer: C
Rationale: In a scenario where a 6-month-old infant is unresponsive and not breathing after the airway is open, giving two breaths that make the chest rise is the appropriate action. This helps deliver oxygen to the infant's lungs and can help initiate breathing. Chest compressions are not recommended for infants as the first step in resuscitation. Checking pulses like the femoral or carotid pulse is not the priority when an infant is not breathing, as providing oxygen through breaths is essential.
4. The healthcare provider prescribes an IV infusion of isoproterenol in D5W at 300 mcg/hour. How many ml/hour should the nurse set the pump to?
- A. 100 ml/hour
- B. 75 ml/hour
- C. 60 ml/hour
- D. 125 ml/hour
Correct answer: B
Rationale: To calculate the correct infusion rate, convert 300 mcg/hour to mg/hour (300 mcg = 0.3 mg). Since the IV solution is 1 mg in 250 ml, the rate is calculated as 0.3 mg/hour = 75 ml/hour. Therefore, the nurse should set the pump to 75 ml/hour. Choice A (100 ml/hour) is incorrect as it does not reflect the accurate calculation. Choice C (60 ml/hour) is incorrect as it is lower than the correct rate. Choice D (125 ml/hour) is incorrect as it is higher than the correct rate.
5. A client with a history of chronic heart failure is prescribed spironolactone (Aldactone). Which of the following statements indicates that the client understands the medication teaching?
- A. I will avoid potassium-rich foods.
- B. I will not use a salt substitute.
- C. I will monitor my weight daily.
- D. I will increase my fluid intake as prescribed.
Correct answer: A
Rationale: The correct statement is 'I will avoid potassium-rich foods.' Spironolactone (Aldactone) is a potassium-sparing diuretic, which can lead to hyperkalemia if potassium intake is not regulated. Therefore, avoiding potassium-rich foods is crucial to prevent this complication. Using a salt substitute can also increase potassium levels. Monitoring weight daily is essential in heart failure management, but it is not specific to spironolactone. Increasing fluid intake as prescribed is generally recommended for heart failure management but is not directly related to spironolactone use.