HESI RN
HESI RN Exit Exam 2023 Capstone
1. A male client reports numbness and tingling in his fingers and around his mouth. What laboratory value should the nurse review?
- A. Capillary glucose.
- B. Serum calcium.
- C. Urine specific gravity.
- D. White blood cell count.
Correct answer: B
Rationale: The correct answer is B, Serum calcium. Numbness and tingling in the fingers and around the mouth are indicative of hypocalcemia, a condition characterized by low calcium levels in the blood. Reviewing the client's serum calcium levels is crucial in this situation to assess for hypocalcemia. Choice A, Capillary glucose, is incorrect because symptoms described are not typically associated with glucose abnormalities. Choice C, Urine specific gravity, and Choice D, White blood cell count, are unrelated to the symptoms presented and are not indicative of the client's condition.
2. A client with acute pancreatitis is admitted with severe, piercing abdominal pain and an elevated serum amylase. Which additional information is the client most likely to report to the nurse?
- A. Pain radiates to the back
- B. Nausea and vomiting without relief
- C. Abdominal pain decreases when lying supine
- D. Abdominal pain is worse after eating
Correct answer: D
Rationale: The correct answer is D. In acute pancreatitis, abdominal pain typically worsens after eating due to the stimulation of the pancreas to release enzymes that irritate the inflamed tissues. Pain relief when lying supine is uncommon and usually exacerbates discomfort. While nausea and vomiting are common symptoms, they are not as indicative of changes in pain intensity. Pain radiating to the back is characteristic but does not specifically relate to exacerbation post-eating.
3. The nurse is caring for a preterm newborn with nasal flaring, grunting, and sternal retractions. After administering surfactant, which assessment is most important for the nurse to monitor?
- A. Bowel sounds
- B. Heart rate
- C. Arterial blood gases
- D. Apnea episodes
Correct answer: C
Rationale: Corrected Rationale: Surfactant therapy is used to improve lung function and gas exchange in premature infants with respiratory distress. Monitoring arterial blood gases is essential to assess the effectiveness of the treatment and ensure adequate oxygenation. While monitoring heart rate is important in neonatal care, assessing arterial blood gases will provide direct information regarding the infant's oxygenation status post-surfactant administration. Bowel sounds are not directly related to the respiratory distress symptoms described, and monitoring apnea episodes, although important in preterm infants, is not the most crucial assessment immediately following surfactant administration.
4. A client with diabetic ketoacidosis (DKA) is receiving an insulin infusion. Which finding indicates that the treatment is effective?
- A. Potassium level of 4.0 mEq/L.
- B. Blood glucose level of 180 mg/dL.
- C. Urine output of 50 mL/hour.
- D. Absence of ketones in the urine.
Correct answer: D
Rationale: The correct answer is D: Absence of ketones in the urine. In a client with diabetic ketoacidosis (DKA) receiving an insulin infusion, the absence of ketones in the urine indicates that ketoacidosis is resolving. This is a crucial finding as it shows that the insulin therapy is effectively addressing the metabolic imbalance causing DKA. Choices A, B, and C are incorrect: A potassium level of 4.0 mEq/L is within normal range but does not directly reflect the resolution of DKA; a blood glucose level of 180 mg/dL, while improved, is still high and does not specifically indicate the resolution of ketoacidosis; urine output of 50 mL/hour is within normal limits but does not directly point to the resolution of DKA.
5. During an acute exacerbation of asthma, what is the nurse's first action for a client experiencing this condition?
- A. Administer a bronchodilator as prescribed.
- B. Check the client's oxygen saturation.
- C. Reassure the client and encourage deep breathing.
- D. Provide emotional support to reduce anxiety.
Correct answer: A
Rationale: The correct first action when managing an acute exacerbation of asthma is to administer a bronchodilator as prescribed. Bronchodilators help open the airways and improve breathing in individuals experiencing an asthma exacerbation. Checking oxygen saturation (Choice B) is important but not the first action. Reassuring the client and encouraging deep breathing (Choice C) can be beneficial but should come after administering the bronchodilator. Providing emotional support to reduce anxiety (Choice D) is important but is not the initial priority in managing an acute exacerbation of asthma.
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