HESI RN
HESI 799 RN Exit Exam Capstone
1. A client with dysphagia is having difficulty swallowing medications. What is the nurse's best intervention?
- A. Crush the medications and mix them with applesauce.
- B. Encourage the client to drink water with each dose.
- C. Consult with the healthcare provider about switching to liquid medications.
- D. Offer the client soft foods to reduce difficulty swallowing.
Correct answer: C
Rationale: The best intervention for a client with dysphagia experiencing difficulty swallowing medications is to consult with the healthcare provider about switching to liquid medications. Liquid medications are often easier to swallow and can reduce the risk of choking and aspiration in clients with dysphagia. Crushing medications can alter their effectiveness, encouraging the client to drink water may not be sufficient, and offering soft foods is not directly related to improving medication swallowing.
2. A nurse is reinforcing teaching about food choice with the mother of an 8-month-old infant. Which of the following statements by the mother indicates a need for further teaching?
- A. I will give my child peanut butter and mashed egg whites.
- B. I will give my child rice cereal and crackers.
- C. I will give my child pureed liver and strained pears.
- D. I will give my child applesauce and green peas.
Correct answer: A
Rationale: The correct answer is A because peanut butter and egg whites are not recommended for infants under 12 months due to the risk of choking and allergies. Choices B, C, and D are appropriate food choices for an 8-month-old infant. Rice cereal, crackers, pureed liver, strained pears, applesauce, and green peas are all suitable options for introducing solid foods to infants.
3. A client with a diagnosis of chronic obstructive pulmonary disease (COPD) is receiving oxygen via nasal cannula at 4 liters per minute. Which assessment finding indicates a need for immediate action?
- A. The client's respiratory rate is 14 breaths per minute.
- B. The client's oxygen saturation is 92%.
- C. The client reports shortness of breath.
- D. The client's respiratory rate is 24 breaths per minute.
Correct answer: C
Rationale: A report of shortness of breath (C) indicates that the client is not tolerating the oxygen therapy well and may need an adjustment. Shortness of breath is a critical symptom in a client with COPD, as it signifies potential respiratory distress. A respiratory rate of 14 (A) is within an acceptable range for a client with COPD and does not require immediate action. An oxygen saturation of 92% (B) is slightly lower but still acceptable in COPD patients. Although a respiratory rate of 24 (D) is higher, it is not as immediately concerning as shortness of breath in this context.
4. What is the primary purpose of using pethidine?
- A. Relieve constriction ring.
- B. Relieve pain.
- C. Affect milk production.
- D. Induce labor.
Correct answer: B
Rationale: Pethidine is primarily used to relieve pain. It is an opioid analgesic commonly used for pain relief in various medical settings. Choices A, C, and D are incorrect as pethidine is not indicated for relieving constriction ring, affecting milk production, or inducing labor.
5. Why is prostaglandin E1 prescribed for a child with transposition of the great arteries?
- A. Prevents hypercyanotic (blue or tet) spells
- B. Maintains an adequate hormone level
- C. Maintains the position of the great arteries
- D. Provides adequate oxygen saturation and maintains cardiac output
Correct answer: D
Rationale: Prostaglandin E1 is prescribed for a child with transposition of the great arteries to increase blood mixing, which helps maintain adequate oxygen saturation and cardiac output. This medication does not prevent hypercyanotic spells, maintain hormone levels, or influence the position of the great arteries.