HESI RN
HESI RN Exit Exam Capstone
1. A client with hyperparathyroidism is preparing for surgery. Which preoperative lab finding is most important to report?
- A. Elevated serum calcium.
- B. Decreased serum albumin.
- C. Elevated serum potassium.
- D. Elevated serum magnesium.
Correct answer: A
Rationale: The correct answer is A: Elevated serum calcium. In hyperparathyroidism, elevated calcium levels can lead to complications such as kidney stones, bone pain, and fractures. During surgery, high calcium levels can affect neuromuscular function, cardiac function, and blood clotting. Therefore, it is crucial to report elevated serum calcium levels preoperatively to prevent potential surgical complications. Choices B, C, and D are not directly associated with hyperparathyroidism and are less likely to impact the surgical outcome in this scenario.
2. A client has altered renal function and is being treated at home. The nurse recognizes that the most accurate indicator of fluid balance during the weekly visits is?
- A. Difference in the intake and output
- B. Changes in the mucous membranes
- C. Skin turgor
- D. Weekly weight
Correct answer: D
Rationale: In clients with altered renal function being treated at home, weekly weight is the most accurate indicator of fluid balance. Fluid retention or loss can significantly affect weight, making it a reliable measure. Choices A, B, and C are not as accurate indicators of fluid balance as weekly weight. Intake and output differences can vary in accuracy and may not capture all aspects of fluid balance. Changes in mucous membranes and skin turgor can be influenced by factors other than fluid balance, making them less precise indicators.
3. Prior to administering warfarin to a client with a history of atrial fibrillation, what lab result should the nurse review?
- A. White blood cell count.
- B. Prothrombin time (PT) and International Normalized Ratio (INR).
- C. Hemoglobin and hematocrit.
- D. Blood urea nitrogen (BUN) and creatinine.
Correct answer: B
Rationale: The correct answer is B: Prothrombin time (PT) and International Normalized Ratio (INR). These lab values are crucial for monitoring the effectiveness of warfarin, an anticoagulant medication. PT measures the time it takes for blood to clot, while INR standardizes these results. Ensuring the client's PT/INR levels are within the therapeutic range is essential to prevent clotting or excessive bleeding. Choices A, C, and D are incorrect as they are not directly related to monitoring warfarin therapy in a client with atrial fibrillation.
4. When taking a health history, which information collected by the nurse correlates most directly to a diagnosis of chronic peripheral arterial insufficiency?
- A. Reports of leg cramping at rest
- B. Family history of heart disease
- C. Current use of beta-blockers
- D. History of intermittent claudication
Correct answer: D
Rationale: Corrected Rationale: Intermittent claudication, or pain in the legs while walking that is relieved by rest, is a classic symptom of peripheral arterial insufficiency. Other factors such as a family history or medication use may contribute to cardiovascular health, but claudication is the most specific indicator. Leg cramping at rest is more indicative of conditions like peripheral neuropathy or deep vein thrombosis. Family history of heart disease and current use of beta-blockers are relevant to overall cardiovascular health, but they are not as directly related to chronic peripheral arterial insufficiency as intermittent claudication.
5. A client with Alzheimer's disease is prescribed donepezil. What is the most important teaching point?
- A. Take the medication as directed for best results.
- B. Report any unusual changes in behavior.
- C. This medication helps improve cognitive function.
- D. This medication is not a cure for Alzheimer's disease.
Correct answer: C
Rationale: The most important teaching point for a client prescribed donepezil is that it helps improve cognitive function. While it is important to take the medication as directed for best results (choice A) and report any unusual changes in behavior (choice B), the key point is that donepezil is not a cure for Alzheimer's disease (choice D). Therefore, the correct answer is C.
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