HESI RN
HESI Exit Exam RN Capstone
1. A client with hypertension is prescribed a beta-blocker. What teaching should the nurse provide about this medication?
- A. Instruct the client to avoid high-potassium foods.
- B. Monitor the client’s heart rate and report any bradycardia.
- C. Advise the client to rise slowly from a sitting or lying position.
- D. Instruct the client to avoid sudden position changes.
Correct answer: C
Rationale: The correct answer is to advise the client to rise slowly from a sitting or lying position. Beta-blockers can cause bradycardia and hypotension, so clients should be advised to rise slowly to prevent dizziness and falls. Monitoring the client's heart rate and blood pressure regularly is essential. Instructing the client to avoid high-potassium foods (Choice A) is not directly related to beta-blockers. While monitoring the client's heart rate (Choice B) is important, advising the client to rise slowly (Choice C) is more directly related to potential side effects of beta-blockers. Instructing the client to avoid sudden position changes (Choice D) is not as specific or essential as advising them to rise slowly to prevent adverse effects.
2. A client with atrial fibrillation is prescribed warfarin. Which instruction should the nurse include in the teaching?
- A. Maintain a consistent intake of leafy green vegetables
- B. Use an electric razor when shaving
- C. Monitor blood pressure daily
- D. Avoid eating bananas and oranges
Correct answer: B
Rationale: Clients on warfarin are at increased risk of bleeding due to its anticoagulant effects. Using an electric razor reduces the risk of cuts and bleeding, which is an important safety precaution. While leafy greens should not be avoided, their intake should be consistent to maintain a stable level of vitamin K in the body. Monitoring blood pressure daily is important for other conditions but not directly related to warfarin therapy. Avoiding bananas and oranges is not a standard instruction for clients on warfarin.
3. A client with chronic kidney disease is prescribed a low-sodium diet. What is the nurse's priority teaching?
- A. Choose fresh fruits and vegetables.
- B. Restrict fluid intake to 1500 mL per day.
- C. Limit sodium intake to 2 grams per day.
- D. Increase potassium intake to prevent hypokalemia.
Correct answer: C
Rationale: The correct answer is C: 'Limit sodium intake to 2 grams per day.' For a client with chronic kidney disease, limiting sodium intake is crucial because it helps prevent fluid retention and reduces the workload on the kidneys. Choice A, 'Choose fresh fruits and vegetables,' is generally a healthy dietary recommendation but not the priority when focusing on a low-sodium diet. Choice B, 'Restrict fluid intake to 1500 mL per day,' is important but secondary to limiting sodium intake. Choice D, 'Increase potassium intake to prevent hypokalemia,' is not the priority teaching for a client with chronic kidney disease on a low-sodium diet.
4. A client with a history of asthma reports using an albuterol inhaler more frequently than prescribed. Which action should the nurse take first?
- A. Notify the healthcare provider immediately
- B. Schedule a pulmonary function test
- C. Assess the client's respiratory status
- D. Instruct the client to decrease inhaler use
Correct answer: C
Rationale: Increased use of a rescue inhaler like albuterol may indicate worsening asthma symptoms. The nurse should first assess the client's respiratory status to determine the severity of the issue and the next steps in care. Option A is not the first action because assessing the client's condition should precede notifying the healthcare provider. Option B, scheduling a pulmonary function test, is not the priority as immediate assessment of the client's respiratory status is crucial. Instructing the client to decrease inhaler use should come after assessing the client's condition to ensure the appropriate intervention.
5. A client receiving lactulose for hepatic encephalopathy needs evaluation. Which assessment should the nurse prioritize?
- A. Percussion of the abdomen.
- B. Blood glucose level.
- C. Serum electrolytes.
- D. Level of consciousness.
Correct answer: D
Rationale: The correct answer is D: Level of consciousness. When managing hepatic encephalopathy with lactulose, monitoring the client's level of consciousness is crucial as it is a key indicator of the therapeutic response to lactulose in reducing ammonia levels. Changes in consciousness can reflect the effectiveness of treatment and the progression of hepatic encephalopathy. Option A, percussion of the abdomen, is not directly related to evaluating the response to lactulose. Option B, blood glucose level, is important but not the priority in this context. Option C, serum electrolytes, while significant in liver disease, do not directly assess the impact of lactulose therapy on hepatic encephalopathy.
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