HESI RN
HESI RN Exit Exam Capstone
1. A client with adrenal insufficiency is admitted to the ICU with acute adrenal crisis. The client's vital signs include heart rate 138 bpm and BP 80/60. What is the nurse's first intervention?
- A. Obtain an analgesic prescription.
- B. Administer an IV fluid bolus.
- C. Administer PRN antipyretic.
- D. Cover the client with a cooling blanket.
Correct answer: B
Rationale: The correct first intervention for a client with adrenal crisis and hypotension is to administer an IV fluid bolus. In adrenal crisis, the body is deficient in cortisol, leading to hypotension. Fluid resuscitation helps stabilize the blood pressure. Obtaining an analgesic prescription (Choice A) is not the priority in this situation. Administering a PRN antipyretic (Choice C) is not indicated as the client's vital signs do not suggest fever. Covering the client with a cooling blanket (Choice D) is not appropriate for addressing hypotension in adrenal crisis.
2. A child with cystic fibrosis is admitted to the hospital with respiratory distress. Which intervention should the practical nurse (PN) implement?
- A. Administer bronchodilators as prescribed.
- B. Limit fluid intake.
- C. Provide a high-fat diet.
- D. Encourage bed rest only.
Correct answer: A
Rationale: Administering bronchodilators as prescribed is crucial for managing respiratory distress in children with cystic fibrosis. Bronchodilators help to open the airways, facilitating easier breathing for the child. Limiting fluid intake, providing a high-fat diet, or encouraging bed rest only are not appropriate interventions for respiratory distress associated with cystic fibrosis. Limiting fluid intake could worsen dehydration, a high-fat diet is not recommended due to pancreatic insufficiency in cystic fibrosis, and bed rest alone does not address the respiratory distress.
3. Protein synthesis begins with a process known as transcription. What is produced during this process?
- A. A codon
- B. A DNA helix
- C. A DNA strand
- D. An RNA strand
Correct answer: D
Rationale: The correct answer is D: An RNA strand. During transcription, the DNA template is used to produce an RNA strand, not a codon, DNA helix, or another DNA strand. A codon is a sequence of nucleotides that specifies a particular amino acid during translation, not produced during transcription. A DNA helix refers to the double-stranded structure of DNA, which is not produced during transcription. Another DNA strand is not produced during transcription since the process involves creating an RNA copy of a specific gene.
4. A client who is admitted to the mental health unit reports shortness of breath and dizziness. The client tells the nurse, “I feel like I’m going to die.” Which nursing problem should the nurse include in this client’s plan of care?
- A. Mood disturbance
- B. Moderate anxiety
- C. Altered thoughts
- D. Social isolation
Correct answer: B
Rationale: The correct answer is B: Moderate anxiety. When a client presents with symptoms such as shortness of breath, dizziness, and a fear of dying, it indicates moderate anxiety. Anxiety can manifest physically with symptoms like these. Mood disturbance (choice A) refers to a change in mood, while altered thoughts (choice C) relate to cognitive changes. Social isolation (choice D) involves a lack of social interaction, which is not the primary concern in this scenario where the client is experiencing acute anxiety symptoms.
5. A client with liver cirrhosis and ascites is admitted with jaundice. Which laboratory value is most concerning to the nurse?
- A. Serum albumin of 3.0 g/dl
- B. Bilirubin of 3.0 mg/dl
- C. Ammonia level of 80 mcg/dl
- D. Prothrombin time of 18 seconds
Correct answer: C
Rationale: An ammonia level of 80 mcg/dl is elevated and concerning in a client with liver cirrhosis, as it may indicate hepatic encephalopathy. Elevated ammonia levels can lead to neurological symptoms such as confusion, altered mental status, and even coma. Serum albumin, bilirubin, and prothrombin time are important in liver cirrhosis but are not the most concerning for acute neurological deterioration associated with hepatic encephalopathy.