HESI RN
HESI RN Exit Exam Capstone
1. A client with bipolar disorder is prescribed lithium. What should the nurse teach the client about lithium toxicity?
- A. Take the medication with meals to prevent gastrointestinal upset.
- B. Report any symptoms of nausea, vomiting, or diarrhea.
- C. Monitor lithium levels regularly and maintain hydration.
- D. Avoid taking nonsteroidal anti-inflammatory drugs (NSAIDs) while on lithium.
Correct answer: D
Rationale: The correct answer is D. Clients taking lithium should avoid NSAIDs as they can increase lithium levels leading to toxicity. It is essential to monitor lithium levels regularly and maintain hydration to prevent toxicity. Reporting symptoms like nausea, vomiting, or diarrhea is important, but the key teaching point regarding lithium toxicity is to avoid NSAIDs.
2. A client with a diagnosis of hyperkalemia is receiving sodium polystyrene sulfonate (Kayexalate). Which laboratory value should the nurse monitor to evaluate the effectiveness of this medication?
- A. Serum sodium level.
- B. Serum potassium level.
- C. Serum calcium level.
- D. Serum glucose level.
Correct answer: B
Rationale: The correct answer is B: Serum potassium level. Sodium polystyrene sulfonate (Kayexalate) is used to treat hyperkalemia by exchanging sodium ions for potassium ions in the intestines, leading to potassium removal from the body. Monitoring the serum potassium level allows the nurse to assess the effectiveness of this medication in lowering the elevated potassium levels. Serum sodium (A), calcium (C), and glucose (D) levels are not directly impacted by the action of sodium polystyrene sulfonate.
3. When preparing to examine a client’s skin using a Wood light, what should the nurse do to facilitate this procedure?
- A. Darken the examining room
- B. Administer a local anesthetic
- C. Obtain a signed informed consent
- D. Shave the skin and scrub it with povidone-iodine (Betadine)
Correct answer: A
Rationale: When using a Wood light to examine the skin, the nurse should darken the examining room. This is necessary because the Wood light emits long-wavelength UV light, which is better visualized in a darkened environment. Administering a local anesthetic (Choice B) is not needed for this procedure. Obtaining a signed informed consent (Choice C) is not directly related to using a Wood light for skin examination. Shaving the skin and scrubbing it with povidone-iodine (Betadine) (Choice D) is not required and may not be appropriate for this type of skin examination.
4. A client is receiving levothyroxine for hypothyroidism. Which of the following findings would indicate that the medication is effective?
- A. Decreased heart rate
- B. Increased weight
- C. Increased energy levels
- D. Decreased appetite
Correct answer: C
Rationale: The correct answer is C: Increased energy levels. When a client with hypothyroidism is receiving levothyroxine, increased energy levels indicate that thyroid hormone levels are being normalized, which is a positive response to treatment. This improvement reflects the effectiveness of the medication in addressing the underlying hypothyroidism. Choices A, B, and D are incorrect. Decreased heart rate and decreased appetite may be symptoms of hypothyroidism and would not necessarily indicate the effectiveness of levothyroxine. Increased weight could also be a symptom of hypothyroidism and does not directly reflect the medication's effectiveness.
5. Which of the following is NOT a phase of the menstrual cycle?
- A. Follicular phase
- B. Ovulatory phase
- C. Luteal phase
- D. Secretory phase
Correct answer: D
Rationale: The secretory phase is not considered a distinct phase of the menstrual cycle; it is actually part of the luteal phase. During the luteal phase, the endometrium thickens due to progesterone secretion, preparing for implantation. The follicular phase is characterized by follicle development, leading to ovulation. The ovulatory phase is when the mature egg is released from the ovary. Therefore, the secretory phase is the correct answer as it is not a standalone phase but a part of the luteal phase.