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 Cushing's syndrome presents with excessive bruising and elevated blood glucose. What action should the nurse take first?
- A. Check the client's blood glucose level.
- B. Administer insulin per sliding scale protocol.
- C. Administer intravenous fluids.
- D. Check the client's skin for signs of bruising.
Correct answer: A
Rationale: Excessive bruising and elevated blood glucose are common symptoms of Cushing's syndrome. The nurse should first check the client's blood glucose level to assess and address the hyperglycemia promptly. Administering insulin or IV fluids would be premature without knowing the current blood glucose level. Checking the skin for bruising, although important for overall assessment, does not address the immediate concern of elevated blood glucose.
3. The nurse is developing a teaching plan for a client receiving chemotherapy. Which of the following should be the nurse's first priority?
- A. The client will maintain adequate nutrition.
- B. The client will manage side effects of treatment.
- C. The client will recognize signs and symptoms of infection.
- D. The client will experience a reduction in pain.
Correct answer: C
Rationale: The correct answer is C. Recognizing signs and symptoms of infection should be the nurse's first priority when developing a teaching plan for a client receiving chemotherapy. Chemotherapy often compromises the immune system, making patients more susceptible to infections. Early identification and prompt treatment of infections are crucial to prevent complications. Options A, B, and D are important aspects of care but recognizing signs of infection takes precedence due to the potential life-threatening consequences in clients undergoing chemotherapy treatment.
4. The nurse is providing discharge teaching to a client with newly diagnosed hypertension. Which lifestyle modification should the nurse emphasize to the client?
- A. Increase sodium intake to improve fluid balance
- B. Engage in regular physical activity
- C. Increase caffeine intake to improve energy
- D. Reduce potassium intake to lower blood pressure
Correct answer: B
Rationale: Engaging in regular physical activity is a crucial lifestyle modification for managing hypertension. Regular exercise helps improve cardiovascular health, lower blood pressure, and contribute to overall well-being. Choices A, C, and D are incorrect. Increasing sodium intake is not recommended for hypertension as it can worsen fluid retention and elevate blood pressure. Increasing caffeine intake is also not advised as it may lead to increased heart rate and blood pressure. Reducing potassium intake is not beneficial as potassium is essential for maintaining healthy blood pressure levels.
5. A client with hypothyroidism is prescribed levothyroxine. What is the most important teaching point for the nurse to provide?
- A. Take the medication with food to avoid stomach upset.
- B. Take the medication at the same time every day to maintain consistent thyroid levels.
- C. Expect increased sensitivity to cold as a side effect of the medication.
- D. Increase the dosage of levothyroxine if symptoms worsen.
Correct answer: B
Rationale: The correct answer is B. Levothyroxine should be taken at the same time every day to maintain stable thyroid hormone levels and ensure effective management of hypothyroidism. Consistent dosing is critical for preventing fluctuations in hormone levels. Choice A is incorrect because levothyroxine is usually recommended to be taken on an empty stomach for optimal absorption. Choice C is incorrect because increased sensitivity to cold is not a common side effect of levothyroxine. Choice D is incorrect because adjusting the dosage without healthcare provider guidance can be dangerous and should not be done independently.
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