HESI RN
HESI RN Exit Exam 2023 Capstone
1. A client with pancreatitis reports severe pain after eating fatty foods. What intervention should the nurse implement?
- A. Encourage the client to eat small, low-fat meals.
- B. Administer antispasmodic medication as prescribed.
- C. Instruct the client to avoid eating until the pain subsides.
- D. Increase the client’s intake of high-protein foods.
Correct answer: B
Rationale: In pancreatitis, pain after consuming fatty foods is common due to increased pancreatic stimulation. Administering antispasmodics is the appropriate intervention as it can help reduce the pain by decreasing pancreatic enzyme secretion. Encouraging the client to eat small, low-fat meals (Choice A) is beneficial in managing pancreatitis symptoms but does not directly address the acute pain. Instructing the client to avoid eating until the pain subsides (Choice C) may lead to nutritional deficiencies and is not the best approach. Increasing high-protein foods intake (Choice D) is not recommended as it can put additional strain on the pancreas.
2. A client with cirrhosis is receiving lactulose. What is the most important assessment for the nurse to monitor?
- A. Monitor the client's ammonia levels.
- B. Monitor the client's blood glucose level.
- C. Monitor the client's potassium levels.
- D. Monitor the client's level of consciousness.
Correct answer: D
Rationale: The correct answer is to monitor the client's level of consciousness. Lactulose is used to reduce ammonia levels in hepatic encephalopathy. Monitoring the level of consciousness helps assess the effectiveness of lactulose therapy in improving the client's condition. Monitoring ammonia levels (choice A) is important, but assessing the client's response to therapy through their level of consciousness is more crucial. Blood glucose levels (choice B) and potassium levels (choice C) are not directly related to lactulose therapy for cirrhosis and hepatic encephalopathy.
3. The nurse is teaching a client about lifestyle changes to manage hypertension. Which of the following should be emphasized?
- A. Increase daily intake of sodium.
- B. Exercise regularly and maintain a healthy weight.
- C. Reduce intake of potassium-rich foods.
- D. Drink alcohol in moderation.
Correct answer: B
Rationale: The correct answer is B. Regular exercise and maintaining a healthy weight are crucial lifestyle changes in managing hypertension. Exercise helps lower blood pressure and improves heart health, while maintaining a healthy weight reduces the risk of hypertension. Choices A, C, and D are incorrect. Increasing daily intake of sodium can elevate blood pressure, reducing intake of potassium-rich foods is not recommended as potassium helps lower blood pressure, and drinking alcohol should be limited or avoided as it can raise blood pressure.
4. A middle-aged woman talks to the nurse in the healthcare provider's office about uterine fibroids, also called leiomyomas or myomas. What statement by the woman indicates more education is needed?
- A. I am one out of every 4 women that get fibroids, and among women my age, between the 30s or 40s, fibroids occur more frequently.
- B. My fibroids are noncancerous tumors that grow slowly.
- C. The associated problems I have had are pelvic pressure and pain, urinary incontinence, frequent urination or urine retention, and constipation.
- D. Fibroids that cause no problems still need to be taken out.
Correct answer: D
Rationale: The correct answer is D because fibroids that do not cause symptoms do not necessarily need to be removed unless they pose other health risks. Choice A provides accurate information about the prevalence of fibroids among women of the woman's age group. Choice B correctly describes fibroids as noncancerous tumors. Choice C lists common symptoms associated with fibroids, which is relevant information. However, choice D is incorrect as fibroids that are asymptomatic or not causing problems usually do not require treatment, unless they lead to complications or health risks.
5. A client with multiple sclerosis is receiving intravenous methylprednisolone. What is the nurse's priority action?
- A. Monitor blood glucose levels every 6 hours.
- B. Monitor for signs of infection.
- C. Encourage increased oral fluid intake.
- D. Check the client's temperature every 4 hours.
Correct answer: B
Rationale: When a client with multiple sclerosis is receiving intravenous methylprednisolone, the nurse's priority action is to monitor for signs of infection. Corticosteroids like methylprednisolone can suppress the immune system, increasing the risk of infection. Monitoring for signs of infection allows for early detection and prompt intervention. Monitoring blood glucose levels may be important in clients receiving corticosteroids for prolonged periods, but it is not the priority in this case. Encouraging increased oral fluid intake is generally beneficial but not the priority over monitoring for infection. Checking the client's temperature is important but not the priority action compared to monitoring for signs of infection.
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