HESI RN
HESI RN Exit Exam 2023 Capstone
1. A client with a history of coronary artery disease is experiencing chest pain. What is the nurse's first action?
- A. Administer sublingual nitroglycerin
- B. Obtain a 12-lead electrocardiogram
- C. Call the healthcare provider
- D. Check the client's oxygen saturation
Correct answer: A
Rationale: The correct answer is A: Administer sublingual nitroglycerin. Sublingual nitroglycerin is the first-line treatment for chest pain related to coronary artery disease. It helps dilate the coronary arteries and improve blood flow to the heart, providing immediate relief from ischemia. Administering nitroglycerin promptly can help alleviate the chest pain and prevent further complications. Obtaining a 12-lead electrocardiogram (Choice B) is important but should not delay the administration of nitroglycerin. Calling the healthcare provider (Choice C) can be done after initiating immediate treatment. Checking the client's oxygen saturation (Choice D) is relevant but not the first action to take in this scenario.
2. Which lab result would be most indicative of renal failure?
- A. Elevated creatinine levels.
- B. Low potassium levels.
- C. Low calcium levels.
- D. High sodium levels.
Correct answer: A
Rationale: The correct answer is A: Elevated creatinine levels. Creatinine is a waste product that is normally filtered by the kidneys. Elevated creatinine levels indicate impaired kidney function, which is commonly seen in renal failure. Choice B, low potassium levels, is not typically associated with renal failure. In fact, renal failure is more likely to cause high potassium levels due to the kidneys' inability to excrete potassium effectively. Choice C, low calcium levels, are not directly indicative of renal failure. Renal failure can lead to disturbances in calcium levels, but low calcium levels alone are not a specific marker for renal failure. Choice D, high sodium levels, are also not typically associated with renal failure. In renal failure, there may be disturbances in sodium levels, but high sodium levels alone are not a direct indicator of renal failure.
3. Which of the following organelles is the site of cellular respiration?
- A. Nucleus
- B. Mitochondria
- C. Lysosomes
- D. Ribosomes
Correct answer: B
Rationale: The correct answer is B: Mitochondria. Mitochondria are known as the powerhouse of the cell because they generate most of the cell's supply of ATP through cellular respiration. The other organelles listed, such as the nucleus (choice A), lysosomes (choice C), and ribosomes (choice D), do not play a direct role in cellular respiration. The nucleus contains genetic material, lysosomes are involved in digestion and waste removal, and ribosomes are responsible for protein synthesis.
4. Appropriate Technologies and Skills:
- A. Must be selected according to universal standards
- B. Involves ensuring the woman delivers at the hospital
- C. Requires specific qualifications such as being a nurse
- D. Necessitates the presence of a doctor at the service providing facility
Correct answer: A
Rationale: The correct answer is A because appropriate technologies must adhere to universal standards to ensure their effectiveness. Choice B is incorrect because the question is not specifically referring to childbirth. Choice C is incorrect as it limits the scope to only nurses. Choice D is incorrect as it implies the necessity of a doctor, which may not always be the case.
5. A client admitted with left-sided heart failure presents with shortness of breath and pink frothy sputum. Which assessment finding requires immediate intervention?
- A. Decreased breath sounds bilaterally.
- B. Heart rate of 110 bpm and irregular rhythm.
- C. Pink frothy sputum and increased respiratory rate.
- D. Elevated blood pressure and shortness of breath.
Correct answer: C
Rationale: Correct Answer: Pink frothy sputum and increased respiratory rate. Pink frothy sputum is a sign of pulmonary edema, indicating fluid in the lungs, a life-threatening condition that requires immediate intervention to prevent respiratory failure. Increased respiratory rate is also concerning as it indicates the body's effort to compensate for the decreased oxygenation. Options A, B, and D are not the most critical findings in this situation. Decreased breath sounds bilaterally may indicate a pneumothorax or atelectasis, heart rate of 110 bpm and irregular rhythm can be managed with medications and further assessment, and elevated blood pressure with shortness of breath is not as urgent as pink frothy sputum and increased respiratory rate.