HESI RN
HESI 799 RN Exit Exam Capstone
1. A nurse is caring for a 73-year-old male client with Alzheimer's disease. Which action should the nurse take to enhance the client's nutritional intake?
- A. Encourage the client to eat large meals in one sitting.
- B. Offer the client frequent snacks of foods he enjoys.
- C. Provide the client with foods high in fiber to improve digestion.
- D. Discourage eating late at night to prevent weight gain.
Correct answer: B
Rationale: Offering frequent snacks of foods the client enjoys is the most appropriate action to enhance the nutritional intake of a client with Alzheimer's disease. This approach helps to ensure that the client receives an adequate amount of nutrients throughout the day, especially when larger meals might be challenging for individuals with Alzheimer's. Encouraging large meals in one sitting (Choice A) may overwhelm the client and lead to decreased food intake. While foods high in fiber (Choice C) are beneficial for digestion, the primary focus should be on providing foods the client enjoys to increase intake. Discouraging eating late at night (Choice D) is not directly related to enhancing nutritional intake in this scenario.
2. 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.
3. The nursing student is discussing with a preceptor the delegation of tasks to an unlicensed assistive personnel (UAP). Which tasks, delegated to a UAP, indicates the student needs further teaching about the delegation process?
- A. Assist a client post cerebral vascular accident to ambulate
- B. Feed a 2-year-old in balanced skeletal traction
- C. Care for a client with discharge orders
- D. Collect a sputum specimen for acid-fast bacillus
Correct answer: C
Rationale: Caring for a client with discharge orders involves tasks that require critical thinking and clinical judgment, which are beyond the scope of a UAP. Delegating this task to a UAP can compromise patient safety and outcomes. The correct answer is C. Choices A, B, and D are appropriate tasks to delegate to a UAP based on their training and scope of practice. Assisting a client to ambulate, feeding a pediatric patient in traction, and collecting a sputum specimen are tasks that can be safely performed by a UAP under appropriate supervision.
4. A client with chronic kidney disease is receiving erythropoietin injections. What laboratory value should the nurse monitor to evaluate the effectiveness of the treatment?
- A. Serum potassium
- B. Hemoglobin
- C. White blood cell count
- D. Platelet count
Correct answer: B
Rationale: The correct answer is B: Hemoglobin. Erythropoietin stimulates the production of red blood cells, leading to an increase in hemoglobin levels. Monitoring hemoglobin is crucial to assess the effectiveness of the treatment. Choices A, C, and D are incorrect. Serum potassium levels are often monitored in chronic kidney disease, but it is not the primary parameter to evaluate the effectiveness of erythropoietin therapy. White blood cell count and platelet count are not directly influenced by erythropoietin injections for chronic kidney disease.
5. The client is being taught to choose foods rich in potassium to prevent digitalis toxicity. Which choice indicates the client understands dietary needs?
- A. Three apricots
- B. Medium banana
- C. Naval orange
- D. Baked potato
Correct answer: D
Rationale: The correct answer is D: Baked potato. Baked potatoes are rich in potassium, which is essential in preventing digitalis toxicity by helping to maintain normal electrolyte levels. Apricots, bananas, and oranges are also sources of potassium, but a baked potato has a higher potassium content compared to the other options, making it a more effective choice for preventing digitalis toxicity.
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