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 lupus erythematosus is prescribed prednisone. What teaching should the nurse include?
- A. Take the medication with food to prevent stomach upset.
- B. Avoid crowded places to reduce the risk of infection.
- C. Take the medication in the morning to prevent insomnia.
- D. Take extra calcium supplements to prevent osteoporosis.
Correct answer: B
Rationale: The correct teaching for a client with lupus erythematosus prescribed prednisone is to avoid crowded places to reduce the risk of infection. Prednisone suppresses the immune system, making individuals more susceptible to infections. Taking the medication with food may help reduce stomach upset but is not the priority teaching. Taking prednisone in the morning may help reduce insomnia, but infection prevention is more critical. While prednisone can lead to osteoporosis, advising extra calcium supplements is not the most immediate concern when starting the medication.
3. A client with heart failure has a prescription for digoxin. The nurse is aware that sufficient potassium should be included in the diet because hypokalemia in combination with this medication ____________.
- A. Can predispose to dysrhythmias
- B. May lead to oliguria
- C. May cause irritability and anxiety
- D. Sometimes alters consciousness
Correct answer: A
Rationale: The correct answer is A: Can predispose to dysrhythmias. Hypokalemia combined with digoxin increases the risk of dysrhythmias due to the potentiation of digoxin's effects on cardiac conduction. Choice B, May lead to oliguria, is incorrect because hypokalemia is not typically associated with oliguria. Choice C, May cause irritability and anxiety, is incorrect as these symptoms are more commonly associated with hypocalcemia. Choice D, Sometimes alters consciousness, is incorrect as altered consciousness is not a typical effect of hypokalemia combined with digoxin.
4. The nurse prepares a discharge plan for an older adult client following cataract extraction. What instructions should the nurse provide?
- A. Avoid straining, bending, or lifting heavy objects.
- B. Limit exposure to sunlight for the first 2 weeks.
- C. Irrigate the conjunctiva with saline before applying ointment.
- D. Read without direct lighting for 6 weeks.
Correct answer: A
Rationale: The correct instruction for the nurse to provide after cataract extraction is to advise the client to avoid straining, bending, or lifting heavy objects. These activities can increase intraocular pressure, which should be minimized post-surgery to promote healing and prevent complications. Choices B, C, and D are incorrect because limiting sunlight exposure, irrigating the conjunctiva with saline, and reading without direct lighting are not primary instructions following cataract extraction.
5. The nurse is providing discharge instructions to a client with chronic venous insufficiency. Which recommendation should the nurse include to help prevent complications?
- A. Use a heating pad on the legs
- B. Wear compression stockings
- C. Massage the legs daily
- D. Elevate legs for 10 minutes every hour
Correct answer: B
Rationale: The correct recommendation for a client with chronic venous insufficiency to prevent complications is to wear compression stockings. Compression stockings help improve venous circulation and prevent the worsening of symptoms. While elevating the legs is also beneficial, the priority intervention in preventing complications is wearing compression stockings. Using a heating pad on the legs can actually worsen the condition by dilating blood vessels, and massaging the legs daily can potentially damage fragile skin in clients with chronic venous insufficiency.
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