HESI RN
HESI RN Exit Exam Capstone
1. A client with deep vein thrombosis (DVT) is prescribed warfarin. What lab value should the nurse review before administering the medication?
- A. Prothrombin time (PT)
- B. Hemoglobin and hematocrit (H&H)
- C. International Normalized Ratio (INR)
- D. Partial thromboplastin time (PTT)
Correct answer: C
Rationale: The correct answer is C: International Normalized Ratio (INR). Before administering warfarin to a client with deep vein thrombosis, the nurse should review the INR to ensure the client is within the therapeutic range. INR is specifically monitored for patients on warfarin therapy to assess the clotting ability of the blood. Choices A, B, and D are incorrect as they are not the primary lab value used to monitor warfarin therapy. Prothrombin time (PT) is used to measure how long blood takes to clot. Hemoglobin and hematocrit (H&H) assess for anemia and the blood's oxygen-carrying capacity. Partial thromboplastin time (PTT) is used to monitor heparin therapy, not warfarin.
2. What do you call a system involving other government Ministries, Non-Governmental Organizations, Politicians, Policy makers, Senior managers, the Community, Church organizations, and other concerned bodies and users of services?
- A. Community participation
- B. Peer consultation
- C. Multi-sectoral approach
- D. Appropriate technology
Correct answer: C
Rationale: A multi-sectoral approach involves collaboration among various sectors and stakeholders to address complex issues comprehensively. In this context, it ensures that different entities work together to provide inclusive and effective services. Choice A, 'Community participation,' focuses more on the involvement of the community specifically. Choice B, 'Peer consultation,' pertains to seeking advice or input from peers within the same field. Choice D, 'Appropriate technology,' refers to the use of suitable technology for a particular situation, which is not the primary focus of the described system.
3. A client diagnosed with cirrhosis of the liver and ascites is receiving Spironolactone (Aldactone). The nurse understands that this medication spares the elimination of which element?
- A. Sodium
- B. Potassium
- C. Phosphate
- D. Albumin
Correct answer: B
Rationale: The correct answer is B: Potassium. Spironolactone is a potassium-sparing diuretic, which means it helps retain potassium while eliminating sodium. This is beneficial for patients with cirrhosis and ascites as they are at risk of low potassium levels. Choice A, Sodium, is incorrect as Spironolactone does not spare the elimination of sodium but rather helps eliminate it. Choice C, Phosphate, is incorrect as Spironolactone does not directly affect phosphate levels. Choice D, Albumin, is incorrect as Spironolactone does not spare the elimination of albumin.
4. A patient asks the nurse about taking calcium supplements to avoid hypocalcemia. The nurse will suggest that the patient follow which instruction?
- A. Take a calcium and vitamin D combination supplement.
- B. Take calcium along with phosphorus to improve absorption.
- C. Take calcium with antacids to reduce stomach upset.
- D. Use aspirin instead of acetaminophen when taking calcium.
Correct answer: A
Rationale: The correct answer is to take a calcium and vitamin D combination supplement. Vitamin D enhances the absorption of calcium in the body, making it an essential component for calcium utilization. Choice B is incorrect because calcium and phosphorus have an inverse relationship, where an increased level of one mineral decreases the level of the other, so taking them together may not be beneficial. Choice C is incorrect because antacids often contain magnesium, which can promote calcium loss instead of absorption. Choice D is incorrect because aspirin can alter vitamin D levels and interfere with calcium absorption, so it is not recommended when taking calcium supplements.
5. Upon arrival in the nursery, a newborn infant is breathing satisfactorily but appears dusky. What action should the LPN/LVN take first?
- A. Notify the healthcare provider immediately.
- B. Suction the infant's nares, then the oral cavity.
- C. Check the infant's oxygen saturation rate.
- D. Position the infant on the right side.
Correct answer: C
Rationale: The priority action in this scenario is to check the infant's oxygen saturation rate. This will provide crucial information on the infant's oxygen levels and the need for immediate oxygen therapy. Assessing oxygen saturation is essential in determining the severity of hypoxia and guiding further interventions to ensure adequate oxygenation. Option A is not the priority as immediate intervention related to oxygenation is needed before notifying the healthcare provider. Suctioning (Option B) may be necessary but should come after assessing oxygen saturation. Positioning the infant (Option D) does not address the immediate need to evaluate oxygen levels.