HESI RN
HESI RN Exit Exam Capstone
1. A client with psoriasis is prescribed topical corticosteroids. What side effect should the nurse monitor for?
- A. Monitor for weight gain and skin thinning.
- B. Assess for increased sensitivity to sunlight.
- C. Monitor for hair loss and excessive bruising.
- D. Report any signs of increased redness or itching.
Correct answer: D
Rationale: The correct answer is D. When a client with psoriasis is prescribed topical corticosteroids, the nurse should monitor for signs of increased redness or itching. This is because topical corticosteroids can cause skin thinning and increased redness if overused. Choices A, B, and C are incorrect because weight gain, sensitivity to sunlight, hair loss, and excessive bruising are not typically associated with the use of topical corticosteroids.
2. A client with cirrhosis is admitted with ascites and peripheral edema. Which intervention should the nurse implement first?
- A. Elevate the legs to reduce swelling.
- B. Restrict fluids to reduce fluid overload.
- C. Administer furosemide to reduce fluid overload.
- D. Monitor the client's intake and output.
Correct answer: C
Rationale: Administering a diuretic like furosemide is the priority intervention for a client with cirrhosis, ascites, and peripheral edema. Furosemide helps reduce fluid overload by promoting diuresis. Elevating the legs may provide some symptomatic relief but does not address the underlying issue of fluid overload. Restricting fluids is not appropriate initially as the client needs proper hydration while managing fluid balance. Monitoring intake and output is important but not the first action to address the immediate fluid overload in this client.
3. A client with hypothyroidism is prescribed levothyroxine. What assessment finding suggests the medication dosage is too high?
- A. Increased sensitivity to cold.
- B. Increased heart rate and palpitations.
- C. Improved energy levels.
- D. Improved tolerance to heat.
Correct answer: B
Rationale: The correct answer is B: Increased heart rate and palpitations. When a client with hypothyroidism is prescribed levothyroxine, these symptoms may indicate that the dosage is too high, causing the client to develop hyperthyroidism. Choices A, C, and D are incorrect. Increased sensitivity to cold is a symptom of hypothyroidism, improved energy levels are an expected outcome of levothyroxine therapy for hypothyroidism, and improved tolerance to heat is not a common sign of levothyroxine overdose.
4. A client has altered renal function and is being treated at home. The nurse recognizes that the most accurate indicator of fluid balance during the weekly visits is?
- A. Difference in the intake and output
- B. Changes in the mucous membranes
- C. Skin turgor
- D. Weekly weight
Correct answer: D
Rationale: In clients with altered renal function being treated at home, weekly weight is the most accurate indicator of fluid balance. Fluid retention or loss can significantly affect weight, making it a reliable measure. Choices A, B, and C are not as accurate indicators of fluid balance as weekly weight. Intake and output differences can vary in accuracy and may not capture all aspects of fluid balance. Changes in mucous membranes and skin turgor can be influenced by factors other than fluid balance, making them less precise indicators.
5. A client with a urinary tract infection (UTI) is prescribed antibiotics. What is the most important instruction for the nurse to give the client?
- A. Take the antibiotics with food
- B. Complete the full course of antibiotics
- C. Increase fluid intake to at least 2 liters per day
- D. Take over-the-counter pain relievers for discomfort
Correct answer: B
Rationale: The most crucial instruction for the nurse to give a client with a UTI who is prescribed antibiotics is to complete the full course of antibiotics. Completing the full course of antibiotics is essential to ensure that the infection is fully treated and to prevent the development of antibiotic resistance. While taking antibiotics with food, increasing fluid intake, and managing discomfort with pain relievers are important aspects of UTI management, completing the prescribed course of antibiotics is the top priority to achieve the best treatment outcomes and prevent recurrence of the infection.
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