HESI RN
HESI RN Exit Exam 2023 Capstone
1. A client with tuberculosis (TB) is being discharged on isoniazid and rifampin. What instruction should the nurse prioritize?
- A. Complete the full course of antibiotics.
- B. Notify the healthcare provider if you experience tingling in your fingers.
- C. Use a disposable mask when in contact with others.
- D. Monitor liver function tests monthly.
Correct answer: C
Rationale: The correct answer is to instruct the client to use a disposable mask when in contact with others. TB is highly contagious, and wearing a mask can help prevent the spread of the disease to others. Choice A is important but not the priority as using a mask directly impacts public health. Choice B is related to a potential side effect of isoniazid, peripheral neuropathy, but immediate healthcare provider notification is not required. Choice D is relevant due to the potential hepatotoxicity of isoniazid and rifampin, but it is not the priority instruction in this scenario.
2. A 16-year-old female student with a history of asthma controlled with both an oral antihistamine and an albuterol (Proventil) metered-dose inhaler (MDI) comes to the school nurse. The student complains that she cannot sleep at night, feels shaky, and her heart feels like it is 'beating a mile a minute.' Which information is most important for the nurse to obtain?
- A. When she last took the antihistamine.
- B. When her last asthma attack occurred.
- C. Duration of most asthma attacks.
- D. How often the MDI is used daily.
Correct answer: D
Rationale: The most important information for the nurse to obtain is how often the MDI is used daily. This is crucial to assess if the symptoms of insomnia, shakiness, and rapid heart rate are related to overuse of the inhaler, leading to potential side effects such as systemic effects of beta-2 agonists.
3. The parents of a 10-year-old child with newly diagnosed type 1 diabetes are being taught by the nurse about managing their child’s condition. Which statement by the parents indicates they need further teaching?
- A. We should rotate injection sites to prevent tissue damage
- B. Our child should avoid all sugary foods and drinks
- C. We will monitor blood glucose levels regularly
- D. Our child needs to wear a medical alert bracelet
Correct answer: B
Rationale: It is important for individuals with diabetes to manage their carbohydrate intake, including sugary foods and drinks, rather than completely avoiding them. Sugary foods should be consumed in moderation as part of a balanced diet to help maintain stable blood glucose levels.
4. A client with deep vein thrombosis (DVT) is prescribed warfarin. What teaching should the nurse provide to the client?
- A. Avoid leafy green vegetables while taking warfarin.
- B. Report any unusual bruising or bleeding.
- C. Take warfarin at the same time every day.
- D. Avoid alcohol consumption while on warfarin.
Correct answer: D
Rationale: The correct answer is D: 'Avoid alcohol consumption while on warfarin.' Alcohol can increase the risk of bleeding when taken with warfarin, so it should be avoided. Choice A is incorrect as leafy green vegetables contain vitamin K, which can interfere with the anticoagulant effects of warfarin. Choice B is important but not directly related to alcohol consumption. Choice C is a general instruction for medication adherence but not specifically related to the interaction with alcohol.
5. What is the mechanism of action of corticotropin (Acthar) when prescribed as replacement therapy for a male client who has undergone surgical removal of a pituitary tumor?
- A. It decreases cyclic adenosine monophosphate (cAMP) production and affects the metabolic rate of target organs.
- B. It interacts with plasma membrane receptors to inhibit enzymatic actions.
- C. It interacts with plasma membrane receptors to produce enzymatic actions that affect protein, fat, and carbohydrate metabolism.
- D. It regulates the threshold for water reabsorption in the kidneys.
Correct answer: C
Rationale: Corticotropin (ACTH) stimulates the adrenal cortex to secrete cortisol and other hormones, affecting protein, fat, and carbohydrate metabolism. Choice A is incorrect because corticotropin does not decrease cAMP production; instead, it stimulates enzymatic actions. Choice B is incorrect because corticotropin does not inhibit enzymatic actions but rather produces enzymatic actions. Choice D is incorrect because corticotropin's mechanism of action does not involve regulating the threshold for water reabsorption in the kidneys.