HESI RN
HESI Exit Exam RN Capstone
1. A client with chronic kidney disease has a potassium level of 6.2 mEq/L. Which intervention should the nurse implement?
- A. Encourage the client to eat foods rich in potassium
- B. Administer a potassium-sparing diuretic
- C. Administer a potassium-binding medication
- D. Hold all medications containing potassium
Correct answer: C
Rationale: A potassium level of 6.2 mEq/L indicates hyperkalemia, which is dangerous and requires immediate treatment. Administering a potassium-binding medication will help lower potassium levels and prevent life-threatening complications.
2. What pathophysiological events occur sequentially in the development of atherosclerosis?
- A. Foam cells release growth factors.
- B. Smooth muscle grows over fatty streaks creating fibrous plaques.
- C. Macrophages consume low-density lipoprotein (LDL) and create foam cells.
- D. Arterial endothelium injury causes inflammation.
Correct answer: D
Rationale: The correct sequence of pathophysiological events in the development of atherosclerosis starts with arterial endothelium injury causing inflammation. This inflammation triggers the formation of foam cells by macrophages consuming low-density lipoprotein (LDL). Subsequently, smooth muscle grows over fatty streaks, creating fibrous plaques. Therefore, option D is the correct answer. Choices A, B, and C are incorrect because they do not reflect the accurate chronological order of events in the pathogenesis of atherosclerosis.
3. Which meal option should the nurse recommend for a client with renal disease who is following a low-protein diet?
- A. Grilled chicken with steamed vegetables
- B. Tofu stir-fry with rice
- C. Pasta with marinara sauce
- D. Baked salmon with quinoa
Correct answer: C
Rationale: The correct answer is C: Pasta with marinara sauce. Clients with renal disease following a low-protein diet should opt for lower-protein options. Pasta with marinara sauce is a suitable choice as it is lower in protein compared to grilled chicken, tofu, or salmon. Grilled chicken, tofu, and salmon are higher in protein content and are not ideal for individuals following a low-protein diet for renal disease as they may strain the kidneys.
4. A client is newly prescribed lithium for bipolar disorder. Which finding is most important to report to the healthcare provider?
- A. A serum lithium level of 1.2 mEq/L.
- B. Fine hand tremors noted after starting the medication.
- C. A blood pressure of 110/60 mmHg.
- D. A serum sodium level of 140 mEq/L.
Correct answer: B
Rationale: The correct answer is B. Fine hand tremors noted after starting lithium are an early sign of lithium toxicity. It is crucial to report this finding to the healthcare provider promptly. Adjusting the dose or monitoring serum levels more closely may be necessary to prevent further toxicity. Choice A, a serum lithium level of 1.2 mEq/L, is within the therapeutic range (0.6-1.2 mEq/L) for treating bipolar disorder. Choice C, a blood pressure of 110/60 mmHg, and Choice D, a serum sodium level of 140 mEq/L, are within normal limits and not directly related to lithium therapy or toxicity.
5. A client's chest tube insertion site has crepitus (crackling sensation) upon palpation. What is the nurse's next step?
- A. Apply a pressure dressing to the chest tube site.
- B. Administer an oral antihistamine.
- C. Assess the client for allergies to cleaning agents.
- D. Measure the area of swelling and crackling.
Correct answer: D
Rationale: The correct next step for the nurse is to measure the area of crepitus. Crepitus indicates subcutaneous emphysema, which is a serious condition requiring monitoring. Applying a pressure dressing (Choice A) could worsen the condition by trapping air under the skin. Administering an oral antihistamine (Choice B) is not indicated for crepitus. Assessing for allergies to cleaning agents (Choice C) is not the priority when dealing with crepitus and subcutaneous emphysema.
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