HESI RN
HESI RN Exit Exam 2023
1. A client with a history of severe rheumatoid arthritis is receiving a corticosteroid. Which assessment finding should the nurse report to the healthcare provider immediately?
- A. Blood glucose level of 180 mg/dL
- B. Weight gain of 2 pounds in 24 hours
- C. Blood pressure of 140/90 mmHg
- D. Increased joint pain
Correct answer: C
Rationale: Elevated blood pressure (140/90 mmHg) is a significant finding that the nurse should report immediately. Hypertension can be a severe side effect of corticosteroid therapy, especially in clients with preexisting conditions like rheumatoid arthritis. It requires prompt intervention to prevent complications such as cardiovascular events. The other options, while important to monitor, are not as critical as elevated blood pressure in this context. A blood glucose level of 180 mg/dL may indicate hyperglycemia, weight gain could be due to fluid retention, and increased joint pain is expected in a client with severe rheumatoid arthritis.
2. A client with deep vein thrombosis (DVT) is receiving heparin and reports tarry stools. What should the nurse do?
- A. Prepare to administer warfarin.
- B. Assess characteristics of the client's pain.
- C. Monitor stools for blood and review PTT results.
- D. Continue the heparin and prepare to administer Vitamin K.
Correct answer: C
Rationale: When a client on heparin reports tarry stools, it can be indicative of gastrointestinal bleeding. The correct action for the nurse is to monitor the stools for blood and review the Partial Thromboplastin Time (PTT) results. This is essential to detect any potential bleeding complications associated with heparin therapy. Option A is incorrect because warfarin is not the immediate intervention for tarry stools in a client on heparin. Option B is irrelevant to the situation described. Option D is incorrect as Vitamin K is the antidote for warfarin, not heparin.
3. What is the term used to describe the gestational sac surrounded by a blood clot and retained in the tube?
- A. A carneous mole.
- B. A hydatidiform mole.
- C. A vesicular mole.
- D. A chorionic mole.
Correct answer: A
Rationale: The correct answer is A: a carneous mole. A carneous mole occurs when a gestational sac is surrounded by a blood clot and retained in the tube. Choice B, a hydatidiform mole, is incorrect as it refers to an abnormal pregnancy characterized by the presence of hydropic chorionic villi. Choice C, a vesicular mole, is also incorrect as it is another term for a complete hydatidiform mole. Choice D, a chorionic mole, is not a recognized medical term and is therefore incorrect.
4. Which of the following is not found in a prokaryotic cell?
- A. Plasma membrane
- B. Cytoplasm
- C. Nucleus
- D. Ribosomes
Correct answer: C
Rationale: The correct answer is C, 'Nucleus.' Prokaryotic cells do not have a defined nucleus, unlike eukaryotic cells. The plasma membrane, cytoplasm, and ribosomes are all components found in prokaryotic cells. The plasma membrane surrounds the cell and regulates what enters and exits, the cytoplasm is the gel-like substance that fills the cell, and ribosomes are responsible for protein synthesis.
5. A client with type 2 diabetes is admitted with hyperglycemic hyperosmolar syndrome (HHS). Which laboratory value is most concerning?
- A. Serum glucose of 300 mg/dL
- B. Blood pressure of 140/90 mmHg
- C. Serum osmolarity of 320 mOsm/kg
- D. Serum pH of 7.30
Correct answer: C
Rationale: In a client with hyperglycemic hyperosmolar syndrome (HHS), a serum osmolarity of 320 mOsm/kg is the most concerning laboratory value. This high osmolarity indicates severe dehydration, which can lead to serious complications. Elevated serum glucose levels (choice A) are expected in HHS but do not directly reflect dehydration. Blood pressure (choice B) and serum pH (choice D) are important parameters to monitor but are not the most concerning values in HHS compared to serum osmolarity.