HESI RN
HESI RN Exit Exam 2024 Quizlet
1. A client with chronic kidney disease (CKD) is scheduled for a hemodialysis session. Which laboratory value should the nurse monitor closely?
- A. Serum potassium
- B. Serum creatinine
- C. Serum sodium
- D. Serum chloride
Correct answer: C
Rationale: The correct answer is C: Serum sodium. In a client with chronic kidney disease (CKD) scheduled for hemodialysis, monitoring serum sodium levels closely is essential. Hemodialysis can cause rapid shifts in sodium levels, leading to electrolyte imbalances. While serum potassium (choice A) is important to monitor in CKD, it is not the most crucial before hemodialysis. Serum creatinine (choice B) is an indicator of kidney function but is not the most immediate concern before hemodialysis. Serum chloride (choice D) is not typically the primary electrolyte of concern in CKD patients before hemodialysis.
2. A client who has a new prescription for warfarin (Coumadin) asks the nurse how the medication works. What explanation should the nurse provide?
- A. It dissolves blood clots
- B. It prevents the blood from clotting
- C. It thins the blood
- D. It decreases the risk of infection
Correct answer: B
Rationale: The correct answer is B: 'It prevents the blood from clotting.' Warfarin works by inhibiting the synthesis of vitamin K-dependent clotting factors in the liver, thereby preventing the formation of blood clots. Choice A is incorrect because warfarin does not dissolve existing blood clots but prevents new ones from forming. Choice C is partially correct but not as specific as choice B in explaining how warfarin works. Choice D is unrelated to the mechanism of action of warfarin and is incorrect.
3. A water molecule contains two types of atoms that are covalently bonded. Which of the following makes up a water molecule?
- A. One hydrogen atom and one oxygen atom
- B. One hydrogen atom and two oxygen atoms
- C. Two hydrogen atoms and two oxygen atoms
- D. Two hydrogen atoms and one oxygen atom
Correct answer: D
Rationale: The correct answer is D: Two hydrogen atoms and one oxygen atom. A water molecule consists of two hydrogen atoms covalently bonded to one oxygen atom. This forms a stable structure known as H2O. Choice A is incorrect as water molecule contains two hydrogen atoms. Choices B and C are incorrect as they do not reflect the correct composition of a water molecule.
4. A patient presents with severe chest pain radiating to the left arm. Which of the following diagnostic tests is the priority?
- A. Complete blood count (CBC)
- B. Electrocardiogram (ECG)
- C. Chest X-ray
- D. Serum electrolytes
Correct answer: B
Rationale: In a patient presenting with severe chest pain radiating to the left arm, the priority diagnostic test is an Electrocardiogram (ECG) to assess for myocardial infarction. An ECG can quickly identify changes indicative of ischemia or infarction, guiding prompt management. A Complete Blood Count (CBC) may provide some information but is not the primary test for evaluating chest pain related to myocardial infarction. A Chest X-ray can be useful in assessing lung pathologies or certain cardiac conditions; however, it does not provide immediate information on myocardial infarction, making it a secondary option in this scenario. Serum electrolytes may become important in later stages but do not offer immediate insights into myocardial infarction. Therefore, they are a lower priority compared to obtaining an ECG for timely diagnosis and intervention.
5. A client who had a kidney transplant is receiving therapy with cyclosporine (Sandimmune). Which statement by the client indicates a need for further instruction?
- A. I need to obtain a yearly influenza vaccine.
- B. I need to have dental checkups every 3 months.
- C. I need to self-monitor my blood pressure at home.
- D. I need to call the health care provider (HCP) if my urine volume decreases or my urine becomes cloudy.
Correct answer: A
Rationale: The correct answer is A. Cyclosporine is an immunosuppressant that can reduce the effectiveness of vaccines. Clients should avoid vaccinations without consulting their health care provider to prevent potential complications or reduced efficacy of the vaccines.