HESI RN
HESI 799 RN Exit Exam
1. In a client with cirrhosis admitted with jaundice and ascites, which laboratory value is most concerning?
- A. Serum bilirubin of 3.0 mg/dl
- B. Serum albumin of 3.0 g/dl
- C. Serum ammonia level of 80 mcg/dl
- D. Serum sodium level of 135 mEq/L
Correct answer: C
Rationale: A serum ammonia level of 80 mcg/dl is most concerning in a client with cirrhosis as it may indicate hepatic encephalopathy, requiring immediate intervention. Elevated ammonia levels are associated with impaired liver function and can lead to mental status changes. Serum bilirubin (Choice A) is elevated in cirrhosis but not as concerning for acute intervention as high ammonia levels. Serum albumin (Choice B) and serum sodium (Choice D) levels are important in cirrhotic patients but are not as directly associated with hepatic encephalopathy as ammonia levels.
2. The healthcare professional is developing a health education program for adolescents on the dangers of smoking. Which strategy is most likely to be effective?
- A. showing graphic images of the effects of smoking
- B. inviting former smokers to share their experiences
- C. providing statistical data on smoking-related illnesses
- D. distributing pamphlets on smoking cessation resources
Correct answer: B
Rationale: Inviting former smokers to share their experiences is the most effective strategy because personal stories can have a powerful impact on adolescents and motivate them to avoid smoking. This approach makes the consequences of smoking more relatable and real, potentially influencing behavior change. Showing graphic images may be too harsh and could lead to desensitization or avoidance of the issue. Providing statistical data may not resonate as strongly with adolescents as personal stories. Distributing pamphlets, while informative, may not have the same emotional impact as hearing real-life experiences.
3. Which of the following lab values would be most concerning in a patient receiving heparin therapy?
- A. Elevated hemoglobin levels.
- B. Low platelet count.
- C. High potassium levels.
- D. Low sodium levels.
Correct answer: B
Rationale: A low platelet count is most concerning in patients receiving heparin therapy due to the risk of heparin-induced thrombocytopenia. Heparin can sometimes cause a drop in platelet count, leading to a potentially serious condition where blood does not clot as it should. This can result in excessive bleeding or clot formation in blood vessels. Elevated hemoglobin levels, high potassium levels, and low sodium levels are not typically associated with heparin therapy and are less likely to cause immediate concerns or complications in this context.
4. The client has hyperparathyroidism. Which of the following lab findings is consistent with this condition?
- A. Hypocalcemia
- B. Hypercalcemia
- C. Hypokalemia
- D. Hyperphosphatemia
Correct answer: B
Rationale: Hyperparathyroidism leads to increased secretion of parathyroid hormone, which results in elevated calcium levels in the blood (hypercalcemia). Therefore, the correct lab finding consistent with hyperparathyroidism is hypercalcemia (Choice B). Hypocalcemia (Choice A) is not indicative of hyperparathyroidism as the condition is associated with high calcium levels. Hypokalemia (Choice C) is a low potassium level, which is not typically associated with hyperparathyroidism. Hyperphosphatemia (Choice D) refers to high phosphate levels and is not a characteristic finding in hyperparathyroidism.
5. The public health nurse is evaluating resources in a rural community. Which healthcare resource is most important for the community?
- A. family planning center
- B. accessibility to trauma care
- C. annual health fair
- D. weather-related disaster plan
Correct answer: B
Rationale: In rural areas, accessibility to trauma care is the most critical healthcare resource due to the longer emergency response times. Trauma care can be life-saving in situations where immediate medical attention is required for severe injuries. The other options, such as a family planning center, annual health fair, and weather-related disaster plan, are important but not as crucial as trauma care in addressing urgent health needs in a rural community.