HESI RN
HESI 799 RN Exit Exam Capstone
1. A client with Type 1 diabetes reports feeling shaky and lightheaded. The nurse checks the client's blood glucose level and it is 60 mg/dL. What action should the nurse take first?
- A. Give the client a glucagon injection
- B. Encourage the client to eat a high-protein snack
- C. Recheck the blood glucose level in 15 minutes
- D. Administer 15 grams of a fast-acting carbohydrate
Correct answer: D
Rationale: The correct answer is D: Administer 15 grams of a fast-acting carbohydrate. The first step in treating hypoglycemia is to quickly raise the client's blood sugar level. Fast-acting carbohydrates like glucose tablets or juice are essential for this purpose. Giving a glucagon injection is typically reserved for severe hypoglycemia when the client is unable to take anything by mouth. Encouraging the client to eat a high-protein snack is not appropriate for immediate treatment of hypoglycemia. Rechecking the blood glucose level in 15 minutes is important after administering the fast-acting carbohydrate to ensure that the blood sugar has returned to a safe level.
2. The nurse is caring for a client with chronic renal failure who is receiving peritoneal dialysis. Which of the following findings should be reported immediately to the physician?
- A. Clear dialysate outflow.
- B. Increased blood pressure.
- C. Cloudy dialysate outflow.
- D. Decreased urine output.
Correct answer: C
Rationale: Cloudy dialysate outflow should be reported immediately to the physician. It is indicative of peritonitis, a severe infection of the peritoneal cavity and a serious complication of peritoneal dialysis. Prompt medical attention is crucial to prevent further complications or systemic infection. Clear dialysate outflow (Choice A) is a normal finding in peritoneal dialysis. Increased blood pressure (Choice B) and decreased urine output (Choice D) are common in clients with chronic renal failure and may not require immediate reporting unless they are significantly abnormal or accompanied by other concerning symptoms.
3. A client with asthma is prescribed an inhaled corticosteroid. What teaching should the nurse provide?
- A. Rinse the mouth with water after using the inhaler.
- B. Take the medication only during asthma attacks.
- C. Avoid using the inhaler before exercise.
- D. Clean the inhaler with hot water after each use.
Correct answer: A
Rationale: The correct teaching the nurse should provide to a client prescribed an inhaled corticosteroid is to rinse the mouth with water after using the inhaler. This helps prevent oral fungal infections, a common side effect of inhaled corticosteroids. Choice B is incorrect because inhaled corticosteroids are usually used regularly, not just during asthma attacks. Choice C is incorrect as using the inhaler before exercise can actually help prevent exercise-induced bronchospasm. Choice D is incorrect because cleaning the inhaler with hot water after each use is not necessary and may damage the device.
4. While removing staples from a male client's postoperative wound site, the nurse observes that the client's eyes are closed and his face and hands are clenched. The client states, 'I just hate having staples removed.' After acknowledging the client's anxiety, what action should the nurse implement?
- A. Attempt to distract the client with general conversation
- B. Administer a pain medication
- C. Continue with the procedure while reassuring the client
- D. Stop the procedure and notify the healthcare provider
Correct answer: A
Rationale: In this situation, the nurse should attempt to distract the client with general conversation. Distracting the client can help reduce anxiety and make the procedure less stressful. Administering pain medication (choice B) is not appropriate as the client's discomfort is related to anxiety, not physical pain. Continuing with the procedure while reassuring the client (choice C) may not address the client's anxiety effectively. Stopping the procedure and notifying the healthcare provider (choice D) is not necessary at this point since the client's anxiety can be managed by attempting to distract him.
5. Which of the following is true about effective leadership?
- A. Leadership traits can be learned through experience and reflection.
- B. Nurses can learn to become good leaders by acting as good leaders and reflecting on leadership qualities they have and those they can improve upon.
- C. Focus on leadership activities required for the day is essential for effective leadership.
- D. Taking advantage of every opportunity to be a leader is crucial, creating those opportunities as often as possible, especially after gaining experience as a nurse.
Correct answer: B
Rationale: Choice B is correct because nurses can develop effective leadership skills by actively engaging as good leaders and reflecting on their existing leadership qualities and areas for improvement. This process of self-assessment and continuous improvement is crucial in becoming a successful leader. Choice A is incorrect as leadership traits can be learned through experience and reflection rather than being impossible to acquire from a book. Choice C is incorrect as effective leadership involves focusing on long-term goals and strategies, not just daily activities. Choice D is incorrect because while seizing leadership opportunities is important, it should be done strategically and with a solid foundation of experience in nursing to ensure successful leadership outcomes.