HESI RN
HESI RN Exit Exam
1. A female client receives a prescription for alendronate sodium (Fosamax) to treat her newly diagnosed osteoporosis. What instruction should the nurse include in the client's teaching plan?
- A. Take on an empty stomach with a full glass of water.
- B. Take with food to avoid stomach upset.
- C. Take before bedtime with a light snack.
- D. Take with milk to enhance absorption.
Correct answer: A
Rationale: The correct answer is to take alendronate on an empty stomach with a full glass of water. This instruction is essential to ensure proper absorption and prevent esophageal irritation. Taking alendronate with food, before bedtime with a light snack, or with milk can interfere with its absorption and effectiveness, leading to potential side effects or reduced therapeutic benefits.
2. A client with a history of adrenal insufficiency is admitted with acute adrenal crisis. The client complains of nausea and joint pain, vital signs show a temperature of 102°F, heart rate of 138, and blood pressure of 80/60. Which intervention should the nurse implement first?
- A. Obtain an analgesic prescription.
- B. Infuse an intravenous fluid bolus.
- C. Administer PRN oral antipyretic.
- D. Cover the client with a cooling blanket.
Correct answer: B
Rationale: In acute adrenal crisis, the priority intervention is to infuse an intravenous fluid bolus to address the hypotension (blood pressure of 80/60) and help stabilize the client's condition. Adequate fluid volume is crucial in managing adrenal insufficiency crisis. Options A, C, and D do not directly address the hypotension and fluid volume depletion that are critical in this situation. Analgesics, antipyretics, and cooling blankets may be considered later, but the immediate focus should be on fluid resuscitation.
3. The census on the unit is 90 percent, and there are no private rooms available. An elderly client with influenza is admitted. Which of the following rooms would it be appropriate to assign this client?
- A. A double room with a client admitted for impetigo.
- B. A double room with another client with the same diagnosis.
- C. A four-bed room with three clients who have had orthopedic surgery.
- D. A double room with an elderly client with a diagnosis of chickenpox.
Correct answer: B
Rationale: When a private room is not an option, the best choice is to assign the elderly client with influenza to a double room with another client diagnosed with the same condition. This is ideal as droplet precautions would likely already be in place for the other client, reducing the risk of spreading the infection to other clients in the unit. Choice A is not appropriate as impetigo does not require the same precautions as influenza. Choice C is not ideal as orthopedic surgery does not involve respiratory precautions. Choice D is incorrect because chickenpox requires airborne precautions, which could pose a risk to the elderly client with influenza.
4. When planning care for a client newly diagnosed with open-angle glaucoma, the nurse identifies a priority nursing problem of 'visual sensory/perceptual alterations.' This problem is based on which etiology?
- A. Blurred distance vision
- B. Limited eye movement
- C. Decreased peripheral vision
- D. Photosensitivity
Correct answer: C
Rationale: The correct answer is 'C: Decreased peripheral vision.' Open-angle glaucoma leads to a gradual loss of peripheral vision due to damage to the optic nerve. This loss of peripheral vision is a hallmark sign of the condition and a primary reason for the visual sensory/perceptual alterations experienced by the client. Blurred distance vision (choice A) may occur but is not the priority nursing problem. Limited eye movement (choice B) and photosensitivity (choice D) are not typically associated with the sensory/perceptual alterations seen in open-angle glaucoma.
5. A nurse is preparing to administer insulin to a client with DM. The nurse understands that the peak time for rapid-acting insulin, such as lispro (Humalog), is:
- A. 30 minutes to 1 hour after administration.
- B. 1 to 2 hours after administration.
- C. 2 to 4 hours after administration.
- D. 3 to 5 hours after administration.
Correct answer: A
Rationale: The correct answer is A: 30 minutes to 1 hour after administration. Rapid-acting insulins like lispro, such as Humalog, peak quickly within 30 minutes to 1 hour after administration. This peak time is crucial to monitor for potential hypoglycemia, which is most likely to occur during this period. Choice B is incorrect as it suggests a longer peak time for rapid-acting insulin, which is inaccurate. Choices C and D are also incorrect because they indicate even longer peak times, which do not align with the rapid onset and peak action of lispro insulin.