HESI RN
HESI Exit Exam RN Capstone
1. A client with gastroesophageal reflux disease (GERD) reports frequent heartburn. What dietary modification should the nurse recommend?
- A. Avoid eating large meals late at night.
- B. Eat a high-fat diet to buffer stomach acid.
- C. Reduce fluid intake to prevent acid reflux.
- D. Consume spicy foods to neutralize stomach acid.
Correct answer: A
Rationale: The correct answer is to recommend avoiding eating large meals late at night. This dietary modification can help reduce the risk of acid reflux, which can exacerbate GERD symptoms. Consuming smaller, more frequent meals is generally recommended to minimize pressure on the lower esophageal sphincter. Choice B is incorrect because a high-fat diet can worsen GERD symptoms by delaying stomach emptying. Choice C is incorrect because reducing fluid intake can lead to dehydration and will not prevent acid reflux. Choice D is incorrect because spicy foods can actually trigger or worsen acid reflux symptoms in individuals with GERD.
2. An older male client, who is a retired chef, is hospitalized with a diabetic ulcer on his foot. His daughter tells the nurse that her father has become increasingly obsessed with the way his food is prepared in the hospital. The nurse's response should be based on what information?
- A. His daughter's observations suggest the client is depressed
- B. His compulsiveness about food may indicate new cognitive decline
- C. Obsessiveness with food is common in diabetic clients
- D. If the client was compulsive about food when he was younger, the aging process can magnify this
Correct answer: D
Rationale: Age can magnify pre-existing compulsive tendencies. If the client was detail-oriented about food earlier in life, this behavior may intensify with aging. It's important to acknowledge and address the client's concerns respectfully. Choices A, B, and C are incorrect because the daughter's observations do not necessarily point to depression, the compulsiveness about food does not indicate new cognitive decline without further assessment, and obsessiveness with food is not specifically common in diabetic clients.
3. A client with chronic liver disease is prescribed lactulose. Which laboratory value should the nurse monitor to evaluate the effectiveness of this medication?
- A. Bilirubin level
- B. Serum ammonia level
- C. Serum potassium level
- D. Albumin level
Correct answer: B
Rationale: The correct answer is B: Serum ammonia level. Lactulose is used to lower serum ammonia levels in clients with chronic liver disease, particularly in cases of hepatic encephalopathy. Monitoring serum ammonia levels is crucial to evaluate the effectiveness of lactulose in managing hepatic encephalopathy. Choices A, C, and D are incorrect because they are not directly related to the action or evaluation of lactulose in chronic liver disease.
4. The nurse is caring for a client post-surgery with an order to ambulate the client every 2 hours. Which of the following tasks could be safely delegated to an unlicensed assistive personnel (UAP)?
- A. Assessing the client's ability to ambulate safely
- B. Documenting the client's tolerance of ambulation
- C. Assisting the client with ambulation
- D. Evaluating the client's pain level after ambulation
Correct answer: C
Rationale: Assisting with ambulation is a task that can be safely delegated to a UAP as it is a supportive activity that does not require clinical judgment. Choices A, B, and D involve assessments, documentation, and evaluation, which require nursing knowledge and clinical judgment, making them tasks that should be performed by a licensed nurse.
5. A client with a urinary tract infection is prescribed ciprofloxacin. What is the nurse's priority teaching?
- A. Take the medication with a full glass of water.
- B. Avoid direct sunlight while taking the medication.
- C. Take the medication with meals to prevent nausea.
- D. Discontinue the medication if you experience dizziness.
Correct answer: A
Rationale: The correct answer is A: 'Take the medication with a full glass of water.' It is crucial for the nurse to teach the client to take ciprofloxacin with a full glass of water to prevent crystalluria, a potential side effect of the medication. Choice B is incorrect because ciprofloxacin does not require avoiding direct sunlight. Choice C is incorrect as taking the medication with meals is not necessary to prevent nausea. Choice D is incorrect as dizziness is not a common reason to discontinue ciprofloxacin.
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