HESI RN
HESI RN Exit Exam 2023
1. A client with a history of coronary artery disease (CAD) is admitted with chest pain. Which diagnostic test should the nurse anticipate preparing the client for first?
- A. Electrocardiogram (ECG)
- B. Chest X-ray
- C. Arterial blood gases (ABGs)
- D. Echocardiogram
Correct answer: A
Rationale: The correct answer is A: Electrocardiogram (ECG). An electrocardiogram should be performed first to assess for cardiac ischemia in a client with a history of CAD and chest pain. An ECG provides immediate information about the heart's electrical activity, helping to identify signs of ischemia or a heart attack. While other diagnostic tests like chest X-ray, arterial blood gases, and echocardiogram may also be necessary in the evaluation of chest pain, they do not provide the initial direct assessment of cardiac ischemia that an ECG does.
2. The nurse is caring for a client with Addison's disease. The client exhibits signs of hypotension, dehydration, and confusion. The nurse should anticipate administering which of the following medications?
- A. Insulin
- B. Hydrocortisone
- C. Levothyroxine
- D. Methimazole
Correct answer: B
Rationale: In Addison's disease, the adrenal glands do not produce enough cortisol. Hydrocortisone is a glucocorticoid medication that is used to replace deficient cortisol levels in patients with Addison's disease. It helps stabilize blood pressure and fluid balance. Insulin (Choice A) is used to manage diabetes, not Addison's disease. Levothyroxine (Choice C) is a thyroid hormone replacement used to treat hypothyroidism, not Addison's disease. Methimazole (Choice D) is used in the treatment of hyperthyroidism, not Addison's disease.
3. What action does the copper used in Copper T have?
- A. Blastocidal
- B. Bacteriostatic
- C. Bacteriocidal
- D. Spermicidal
Correct answer: D
Rationale: The correct answer is D, Spermicidal. The copper in Copper T exerts its action by affecting sperm viability and motility, thus preventing fertilization. Choices A, B, and C are incorrect because Copper T primarily works by preventing sperm from reaching and fertilizing the egg, rather than acting on blastocysts, bacteria, or bacteriocins.
4. Which information is a priority for the RN to reinforce to an older client after intravenous pyelography?
- A. Eat a light diet for the remainder of the day
- B. Rest for the next 24 hours as the preparation and the test are tiring
- C. Drink at least 1 8-ounce glass of fluid every waking hour for the next 2 days
- D. Measure the urine output for the next day and promptly notify the healthcare provider if it decreases
Correct answer: D
Rationale: After intravenous pyelography, it is crucial for the client to measure urine output in the next day to monitor for any potential complications, such as kidney issues. Promptly notifying the healthcare provider in case of decreased urine output is essential for timely intervention. While rest and hydration are important post-procedure, monitoring urine output takes precedence due to its direct correlation with potential complications.
5. Which of the following data should not be included in the identification data of gynecological history?
- A. Parity
- B. Lost normal menstrual period
- C. EDD (Expected date of delivery)
- D. Last delivery
Correct answer: C
Rationale: The correct answer is C: EDD (Expected date of delivery). In a gynecological history, EDD is not typically included as it pertains more to obstetric history. Parity, lost normal menstrual period, and last delivery are important components of gynecological history. Parity refers to the number of times a woman has given birth to a fetus past 20 weeks' gestation. Lost normal menstrual period can provide insight into potential gynecological issues, while last delivery details the most recent childbirth experience. Therefore, EDD is the outlier in this context.