HESI RN
HESI 799 RN Exit Exam Capstone
1. A client with dyspnea is being admitted to the medical unit. To best prepare for the client's arrival, the nurse should ensure that the client's bed is in which position?
- A. Trendelenburg
- B. Supine
- C. Prone
- D. Fowler's
Correct answer: D
Rationale: Fowler's position (head elevated at 45-60 degrees) improves oxygenation by expanding the lungs, making it the best position for clients with dyspnea. Supine or prone positions restrict lung expansion, and Trendelenburg position (head down) can exacerbate breathing difficulties by increasing pressure on the lungs and diaphragm.
2. A client is experiencing chest pain and is prescribed nitroglycerin. What should the nurse assess before administering the medication?
- A. Monitor the client’s oxygen saturation level.
- B. Check the client’s heart rate and blood pressure.
- C. Evaluate the client’s level of consciousness.
- D. Assess the client's chest pain severity using a pain scale.
Correct answer: B
Rationale: Before administering nitroglycerin, it is crucial to check the client’s heart rate and blood pressure. Nitroglycerin can lower blood pressure and heart rate, so assessing these parameters is essential to prevent exacerbating hypotension or bradycardia. While monitoring the client’s oxygen saturation level is important in some situations, it is not the primary assessment needed before administering nitroglycerin. Evaluating the client’s level of consciousness is relevant for other conditions but not specifically necessary before giving nitroglycerin. Assessing chest pain severity using a pain scale is valuable for pain management but is not the priority assessment before administering nitroglycerin.
3. The nurse is reviewing the laboratory results of a client with chronic kidney disease. The client's serum calcium level is 7.5 mg/dL. Which condition should the nurse suspect?
- A. Hypercalcemia
- B. Hyperkalemia
- C. Hyponatremia
- D. Hypocalcemia
Correct answer: D
Rationale: A serum calcium level of 7.5 mg/dL is indicative of hypocalcemia, a common complication in clients with chronic kidney disease due to impaired calcium absorption and metabolism. Hypercalcemia (Choice A) is the opposite of the condition presented in the question and is characterized by elevated serum calcium levels. Hyperkalemia (Choice B) is an increased potassium level, not related to the client's serum calcium level. Hyponatremia (Choice C) is a decreased sodium level and is also not related to the client's serum calcium level.
4. The client with a below-the-knee amputation is being taught about proper care of the residual limb. The most important point to emphasize would be
- A. Wrap the stump with an elastic bandage to prevent swelling
- B. Keep the skin on the stump clean and dry
- C. Use alcohol to cleanse the stump daily
- D. Apply moisturizing lotion to the stump daily
Correct answer: B
Rationale: The correct answer is B: Keep the skin on the stump clean and dry. This is crucial for preventing infection and promoting healing of the residual limb. Wrapping the stump with an elastic bandage can constrict blood flow and cause issues. Using alcohol to cleanse the stump daily can be too harsh and drying for the skin, leading to irritation. Applying moisturizing lotion daily is not as essential as keeping the skin clean and dry to prevent complications.
5. What is the expected outcome of prescribing a proton pump inhibitor to a client with a peptic ulcer?
- A. Promote healing of the gastric mucosa.
- B. Neutralize the effects of stomach acid.
- C. Inhibit the growth of Helicobacter pylori.
- D. Reduce gastric acid secretion.
Correct answer: D
Rationale: The correct answer is D: Reduce gastric acid secretion. Proton pump inhibitors (PPIs) work by reducing gastric acid secretion, which helps prevent further irritation of the gastric mucosa and allows ulcers to heal. While promoting healing of the gastric mucosa (Choice A) is an indirect outcome of reducing gastric acid secretion, the primary mechanism of PPIs is to lower acid levels. Choice B, neutralizing the effects of stomach acid, is typically associated with antacids, not PPIs. Inhibiting the growth of Helicobacter pylori (Choice C) is usually achieved with antibiotics, not PPIs.
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