HESI RN
HESI RN Exit Exam 2024 Quizlet
1. A client with type 1 diabetes is admitted with diabetic ketoacidosis (DKA). Which laboratory value requires immediate intervention?
- A. Serum glucose of 300 mg/dl
- B. Serum potassium of 5.5 mEq/L
- C. Serum bicarbonate of 18 mEq/L
- D. Serum sodium of 135 mEq/L
Correct answer: C
Rationale: A serum bicarbonate level of 18 mEq/L requires immediate intervention in a client with diabetic ketoacidosis (DKA). A low serum bicarbonate level indicates metabolic acidosis, which can be life-threatening. This condition needs urgent correction to restore acid-base balance. Serum glucose of 300 mg/dl, serum potassium of 5.5 mEq/L, and serum sodium of 135 mEq/L are abnormal values, but they do not pose an immediate threat to the client's life compared to the metabolic acidosis indicated by the low serum bicarbonate level.
2. A client with chronic liver disease develops jaundice. What is the most important assessment the nurse should perform?
- A. Assess the client’s skin for lesions or sores.
- B. Monitor the client’s liver function tests.
- C. Assess for changes in mental status and behavior.
- D. Monitor the client’s urine output closely.
Correct answer: D
Rationale: In a client with chronic liver disease developing jaundice, the most important assessment the nurse should perform is to monitor the client’s urine output closely. Jaundice can indicate worsening liver function, so monitoring urine output helps assess kidney function and fluid balance, which are critical in chronic liver disease. Assessing the client’s skin for lesions or sores (Choice A) may be relevant for dermatological conditions but is not the priority in this case. Monitoring liver function tests (Choice B) is important but may not provide immediate information on the client’s current status. Assessing for changes in mental status and behavior (Choice C) is important for detecting hepatic encephalopathy but does not directly address the immediate concern of fluid balance and kidney function in the presence of jaundice.
3. Which of the following processes produces nicotinamide adenine dinucleotide (NADH) and flavin adenine dinucleotide (FADH2) for the electron transport chain during cellular respiration?
- A. Electron transport chain
- B. Glycolysis
- C. Citric acid cycle (the Krebs cycle)
- D. None of these
Correct answer: C
Rationale: The correct answer is C, the citric acid cycle (the Krebs cycle). This cycle generates NADH and FADH2, which play a crucial role in providing electrons to the electron transport chain during cellular respiration. Choice A, the electron transport chain itself, is where NADH and FADH2 donate their electrons, not where they are produced. Choice B, glycolysis, produces NADH but not FADH2. Choice D, 'None of these,' is incorrect as the citric acid cycle specifically produces NADH and FADH2.
4. Following admission for cardiac catheterization, the nurse is providing discharge teaching to the parents of a 2-year-old toddler with tetralogy of Fallot. What instruction should the nurse give the parents if their child becomes pale, cool, and lethargic?
- A. Encourage oral electrolyte solution intake
- B. Assist the child to a recumbent position
- C. Contact their healthcare provider immediately
- D. Provide a quiet time by holding or rocking the toddler
Correct answer: C
Rationale: If a child with tetralogy of Fallot becomes pale, cool, and lethargic, these symptoms may indicate a hypoxic episode or worsening condition. It is crucial to contact the healthcare provider immediately for further evaluation and management to ensure the child's safety and well-being. Option A is incorrect because electrolyte solution intake is not the immediate action needed for these symptoms. Option B is incorrect as positioning alone may not address the underlying issue. Option D is incorrect as providing a quiet time is not appropriate if the child is experiencing concerning symptoms that require prompt medical attention.
5. The nurse is caring for a client with a suspected myocardial infarction (MI). Which laboratory test result is most indicative of a recent MI?
- A. Elevated troponin levels
- B. Increased white blood cell count
- C. Increased lactate dehydrogenase (LDH)
- D. Elevated C-reactive protein (CRP)
Correct answer: A
Rationale: Elevated troponin levels are the most specific and sensitive indicator of myocardial infarction. Troponin levels increase within hours of an MI and remain elevated for several days. White blood cell count, lactate dehydrogenase (LDH), and C-reactive protein (CRP) are not specific markers for MI. An increased white blood cell count may indicate inflammation or infection, increased LDH levels can be seen in various conditions like liver disease or muscle injury, and elevated CRP is a general marker of inflammation rather than specific to MI.