HESI RN
HESI RN Exit Exam 2024 Capstone
1. During an initial assessment, a healthcare provider notes that a client has elevated blood pressure. Which of the following findings is considered a major risk factor for coronary artery disease?
- A. Elevated HDL cholesterol
- B. Low LDL cholesterol
- C. Elevated blood pressure
- D. Low triglyceride levels
Correct answer: C
Rationale: Elevated blood pressure is a significant risk factor for coronary artery disease because it increases the strain on the arteries, leading to potential damage and a higher risk of developing coronary artery disease. Elevated HDL cholesterol (Choice A) is actually considered beneficial as it helps reduce the risk of heart disease. Low LDL cholesterol (Choice B) is also beneficial as high levels of LDL are associated with an increased risk of coronary artery disease. Low triglyceride levels (Choice D) are not typically considered a major risk factor for coronary artery disease.
2. A client receiving total parenteral nutrition (TPN) reports nausea and dizziness. What action should the nurse take first?
- A. Check the client's blood glucose level.
- B. Check the client's vital signs and blood pressure.
- C. Decrease the infusion rate of TPN.
- D. Administer antiemetic medication as prescribed.
Correct answer: B
Rationale: When a client receiving total parenteral nutrition (TPN) reports symptoms like nausea and dizziness, the first action the nurse should take is to check the client's vital signs and blood pressure. This assessment helps determine the client's overall stability and can provide crucial information to guide further interventions. Checking the blood glucose level (Choice A) may be relevant but is not the priority in this situation. Decreasing the infusion rate of TPN (Choice C) may be necessary but should be based on assessment findings. Administering antiemetic medication (Choice D) should not be the initial action without first assessing the client's vital signs.
3. 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.
4. Before administering digoxin to a client with heart failure, what is the most important assessment for the nurse to perform?
- A. Check the client's blood pressure
- B. Monitor the client's heart rate
- C. Assess the client's respiratory rate
- D. Review the client's potassium level
Correct answer: B
Rationale: The correct answer is to monitor the client's heart rate. Digoxin slows the heart rate, so it is crucial to assess the heart rate before administering the medication. If the heart rate is below 60 beats per minute, the dose should be held, and the healthcare provider should be notified. Checking the blood pressure (Choice A) is important but not as crucial as monitoring the heart rate in this case. Assessing the respiratory rate (Choice C) is not directly related to the action of digoxin. Reviewing the client's potassium level (Choice D) is important for clients taking digoxin due to the risk of hypokalemia, but assessing the heart rate takes priority.
5. 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.
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