HESI RN
HESI 799 RN Exit Exam Quizlet
1. A client with rheumatoid arthritis is prescribed methotrexate. Which assessment finding requires immediate intervention?
- A. Fever of 100.4°F
- B. Positive Chvostek's sign
- C. Increased joint pain
- D. Swelling in the joints
Correct answer: B
Rationale: A positive Chvostek's sign indicates hypocalcemia, which requires immediate intervention as it can lead to life-threatening complications. Fever, increased joint pain, and swelling in the joints are common symptoms in clients with rheumatoid arthritis but do not require immediate intervention like addressing hypocalcemia.
2. The clinic nurse is performing an admission assessment on a client. The nurse notes that the client is taking azelaic acid (Azelex). Because of the medication prescription, the nurse would suspect that the client is being treated for:
- A. Acne
- B. Eczema
- C. Hair loss
- D. Herpes simplex
Correct answer: A
Rationale: Azelaic acid (Azelex) is a topical medication used to treat mild to moderate acne. It works by suppressing the growth of Propionibacterium acnes and decreasing the proliferation of keratinocytes in the skin. Therefore, if a client is prescribed azelaic acid, the nurse would suspect that the client is being treated for acne.
3. A mental health worker is caring for a client with escalating aggressive behavior. Which action by the mental health worker warrants immediate intervention by the RN?
- A. Attempting to physically restrain the client.
- B. Remaining at a distance of 4 feet from the client.
- C. Telling the client to go to the quiet area of the unit.
- D. Using a loud voice to communicate with the client.
Correct answer: A
Rationale: Attempting to physically restrain the client without proper protocol and preparation can escalate the situation. This can lead to increased agitation and aggression in the client, potentially putting both the client and the mental health worker at risk. Remaining at a distance, directing the client to a quiet area, or using a loud voice are all strategies that can be used to de-escalate the situation and ensure safety without resorting to physical intervention. Therefore, the immediate intervention is needed when the mental health worker attempts to physically restrain the client. Option B, remaining at a distance, is a safe practice to ensure personal safety. Option C, directing the client to a quiet area, is a de-escalation technique to create a calmer environment. Option D, using a loud voice, may be necessary to establish boundaries and ensure the client can hear instructions clearly.
4. A male client with impaired renal function who takes ibuprofen daily for chronic arthritis is showing signs of gastrointestinal (GI) bleeding. After administering IV fluids and a blood transfusion, his blood pressure is 100/70 mm Hg, and his renal output is 20 ml/hour. Which intervention should the nurse include in his care plan?
- A. Maintain the client NPO during the diuresis phase.
- B. Evaluate daily serial renal laboratory studies for progressive elevations.
- C. Observe the urine character for sedimentation and cloudy appearance.
- D. Monitor for the onset of polyuria greater than 150 ml/hour.
Correct answer: B
Rationale: In this scenario, the correct intervention for the nurse to include in the care plan is to evaluate daily serial renal laboratory studies for progressive elevations. This is crucial in monitoring renal function and detecting any worsening renal impairment. Option A is not directly related to managing renal function in this case. Option C focuses more on urinary characteristics rather than renal function monitoring. Option D addresses polyuria, which is an excessive urine output, but it does not specifically address the need for evaluating renal laboratory studies for progressive elevations.
5. What is included in the Quality of Care in reproductive health?
- A. Ensuring accessible services, privacy, confidentiality, and continuity of care.
- B. Providing reproductive health services only in urban areas.
- C. Ensuring that all women deliver in a hospital setting.
- D. Ensuring that reproductive health services are only provided by doctors.
Correct answer: A
Rationale: The correct answer is A. Quality of care in reproductive health encompasses ensuring accessible services, privacy, confidentiality, and continuity of care. These elements are crucial in providing comprehensive and effective reproductive health services. Choices B, C, and D are incorrect because they do not adequately address the holistic approach required for quality reproductive health care. Providing services only in urban areas limits accessibility, mandating hospital deliveries may not be suitable for all women, and restricting services to doctors only disregards the importance of a multi-disciplinary approach in reproductive health care.