HESI RN
HESI Exit Exam RN Capstone
1. A client with a urinary tract infection is prescribed ciprofloxacin. What is the most important teaching the nurse should provide?
- A. Take the medication with milk to prevent stomach upset.
- B. Increase fluid intake to 2-3 liters per day.
- C. Avoid taking the medication with dairy products.
- D. Continue taking the medication even if symptoms improve.
Correct answer: B
Rationale: Ciprofloxacin can cause crystalluria, so increasing fluid intake to 2-3 liters per day helps flush out the medication and prevent crystal formation in the kidneys. This also ensures adequate hydration, which supports the body's ability to fight the infection. Choice A is incorrect because ciprofloxacin should not be taken with dairy products as they can interfere with the absorption of the medication. Choice D is incorrect because although it's important to complete the full course of antibiotics, it's equally crucial to report any improvement in symptoms to the healthcare provider.
2. A nurse reviews the laboratory findings of a client with a urinary tract infection. The laboratory report notes a “shift to the left” in the client’s white blood cell count. Which action should the nurse take?
- A. Request that the laboratory perform a differential analysis on the white blood cells.
- B. Notify the provider and start an intravenous line for parenteral antibiotics.
- C. Collaborate with the unlicensed assistive personnel (UAP) to strain the client’s urine for renal calculi.
- D. Assess the client for a potential allergic reaction and anaphylactic shock.
Correct answer: B
Rationale: A “shift to the left” in a white blood cell count indicates an increase in band cells, which is typically associated with urosepsis. In this scenario, the nurse should notify the provider and initiate IV antibiotics as a left shift is often seen in severe infections like urosepsis. Requesting a differential analysis on white blood cells would not be the immediate action needed in response to a left shift. Collaborating to strain urine for renal calculi is unrelated to the situation of a left shift in white blood cells due to urosepsis. Assessing for allergic reactions and anaphylactic shock is not the priority as a left shift is not indicative of an allergic response; it is associated with an increase in band cells, not eosinophils.
3. A nurse is reinforcing teaching with a group of older adults about oil-rich foods. The nurse should include which of the following foods as the equivalent of 4 tsp of oil?
- A. 1 tbsp of soft margarine
- B. ½ oz of nuts
- C. 2 tbsp of peanut butter
- D. 1 oz of sunflower seeds
Correct answer: C
Rationale: The correct answer is C: 2 tbsp of peanut butter. Two tablespoons of peanut butter is approximately equivalent to 4 teaspoons of oil, providing healthy fats in the diet. Choice A, 1 tbsp of soft margarine, is not equivalent to 4 tsp of oil as margarine contains additional ingredients. Choice B, ½ oz of nuts, and choice D, 1 oz of sunflower seeds, do not provide an equivalent amount of oil as requested in the question.
4. A healthcare professional is preparing to administer an intramuscular dose of penicillin to a client with a history of anaphylactic reactions to penicillin. Which action should the healthcare professional take first?
- A. Check the medication order for accuracy.
- B. Have an epinephrine injection available.
- C. Administer a test dose to check for a reaction.
- D. Ask the client about any allergies.
Correct answer: B
Rationale: When dealing with a client who has a history of anaphylactic reactions to penicillin, the priority action for the healthcare professional is to have an epinephrine injection readily available in case of a severe allergic reaction. In such cases, the immediate focus is on being prepared to manage a potentially life-threatening situation. While checking the medication order for accuracy, administering a test dose, and asking the client about allergies are essential steps in medication administration, the first priority is ensuring the availability of epinephrine to address a severe allergic reaction promptly.
5. When administering etanercept (Enbrel) to a client with rheumatoid arthritis for 3 weeks, what is the most important assessment for the nurse to perform?
- A. Assessing the injection site for itching and edema
- B. Monitoring white blood cell counts and platelet counts
- C. Evaluating for fatigue and joint pain in the client
- D. Checking for a metallic taste in the mouth and loss of appetite
Correct answer: B
Rationale: The priority when administering etanercept (Enbrel) to a client with rheumatoid arthritis is to monitor white blood cell counts and platelet counts. Etanercept can lead to infections and pancytopenia, making it crucial to assess for changes in these blood parameters to detect any potential complications early on.