HESI RN
Community Health HESI
1. A client with hyperthyroidism is receiving radioactive iodine therapy. Which statement by the client indicates a need for further teaching?
- A. I should avoid close contact with pregnant women and children for a few days.
- B. I may experience dry mouth and taste changes for a few days.
- C. I may experience some neck swelling.
- D. I should expect to have no side effects.
Correct answer: D
Rationale: The correct answer is 'D.' The client stating 'I should expect to have no side effects' indicates a need for further teaching as it is incorrect. With radioactive iodine therapy, side effects like dry mouth, taste changes, and neck swelling are common. Choices A and B are correct statements; the client should avoid close contact with pregnant women and children due to radiation exposure, and dry mouth and taste changes are common side effects. Choice C is also correct, making D the correct answer.
2. The nurse is caring for a patient who has had severe vomiting. The patient’s serum sodium level is 130 mEq/L. The nurse will expect the patient’s provider to order which treatment?
- A. Diuretic therapy
- B. Intravenous hypertonic 5% saline
- C. Intravenous normal saline 0.9%
- D. Oral sodium supplements
Correct answer: C
Rationale: In this scenario, the patient has hyponatremia with a serum sodium level of 130 mEq/L. For a serum sodium level between 125 and 135 mEq/L, the appropriate treatment is intravenous normal saline 0.9%. Normal saline helps to increase the sodium content in the vascular fluid. Diuretic therapy would exacerbate sodium and fluid depletion, which is not suitable for a patient already dehydrated from severe vomiting. Intravenous hypertonic 5% saline is typically reserved for severe hyponatremia with a serum sodium level below 120 mEq/L. Oral sodium supplements are not feasible in this case as the patient is vomiting and may not be able to tolerate oral intake easily.
3. A client receiving continuous ambulatory peritoneal dialysis (CAPD) has lost weight and exhibits increasing edema. What should the nurse prioritize?
- A. Evaluate the patency of the arteriovenous (AV) graft.
- B. Instruct the client to continue a fluid-restricted diet.
- C. Recommend support stockings for venous return.
- D. Monitor the client's serum albumin levels.
Correct answer: A
Rationale: In a client receiving continuous ambulatory peritoneal dialysis (CAPD) who has lost weight and exhibits increasing edema, the nurse should prioritize evaluating the patency of the arteriovenous (AV) graft. This assessment is crucial to determine if hemodialysis can be resumed, addressing the client's presenting issues effectively. Instructing the client to continue a fluid-restricted diet (choice B) may not address the underlying issue related to the CAPD. Recommending support stockings for venous return (choice C) is not directly relevant to the situation described. Monitoring the client's serum albumin levels (choice D) may be important but does not directly address the immediate concern of weight loss and increasing edema in a CAPD client.
4. A client is taking cetirizine hydrochloride (Zyrtec). The nurse checks for which of the following side effects of this medication?
- A. Diarrhea
- B. Excitability
- C. Drowsiness
- D. Excess salivation
Correct answer: C
Rationale: Cetirizine hydrochloride (Zyrtec) is known to commonly cause drowsiness or sedation as a side effect. Therefore, the nurse should monitor the client for signs of drowsiness when administering this medication. Choice A, Diarrhea, is not a common side effect of cetirizine. Choice B, Excitability, is not a typical side effect of this antihistamine; instead, it tends to cause drowsiness. Choice D, Excess salivation, is not associated with cetirizine use.
5. A client with DM is preparing for a foot care exam. The nurse should advise the client to:
- A. Wear loose-fitting shoes to protect the feet.
- B. Apply lotion to the tops and bottoms of the feet to keep the skin moist.
- C. Avoid using a heating pad to prevent burns on the feet.
- D. Avoid using sharp instruments to trim the toenails.
Correct answer: D
Rationale: The correct answer is to advise the client to avoid using sharp instruments to trim the toenails. This is crucial because using sharp instruments can lead to injuries such as cuts or wounds, increasing the risk of infections, especially in clients with diabetes who have decreased sensation in their feet. Choice A is incorrect because tight shoes can restrict circulation and increase the risk of pressure sores. Choice B is incorrect because applying lotion between the toes can create a moist environment, leading to fungal infections. Choice C is incorrect because using a heating pad can lead to burns, which can go unnoticed due to decreased sensation in diabetic feet.