HESI RN
HESI Exit Exam RN Capstone
1. A nurse is reviewing the medication list for a client with heart failure. Which medication should the nurse question?
- A. Furosemide
- B. Digoxin
- C. Ibuprofen
- D. Carvedilol
Correct answer: C
Rationale: The correct answer is C: Ibuprofen. Ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), can cause fluid retention, which may worsen heart failure symptoms. It should be used with caution or avoided in clients with heart failure. Furosemide (choice A) is a diuretic commonly used in heart failure to reduce fluid overload. Digoxin (choice B) is a medication that helps the heart beat stronger and slower, often used in heart failure. Carvedilol (choice D) is a beta-blocker that is beneficial in heart failure management. Therefore, Ibuprofen is the medication that the nurse should question in this scenario.
2. The nurse is caring for a group of clients with the help of a PN. Which nursing actions should the nurse assign to the PN?
- A. All of the above
- B. Administer a dose of insulin per sliding scale for a client with Type 2 DM
- C. Obtain postoperative vital signs for a client one day following unilateral knee arthroplasty
- D. Perform daily surgical dressing change for a client who had an abdominal hysterectomy
Correct answer: A
Rationale: All of these tasks fall within the PN's scope of practice, which includes performing surgical dressing changes, taking postoperative vital signs, and administering insulin under supervision. The RN can delegate these tasks to the PN safely. Choice A is the correct answer because all the tasks mentioned are appropriate for delegation to a PN. Choice B should not be assigned to a PN as only RNs should administer insulin. Choice C is suitable for delegation to a PN as obtaining vital signs falls within their scope of practice. Choice D is also appropriate for delegation to a PN as performing surgical dressing changes is within their scope of practice.
3. A 48-year-old client with chronic alcoholism is admitted to the hospital. The nurse would anticipate that the client may be deficient in which vitamins?
- A. Vitamin B and vitamin C
- B. Vitamin D and vitamin E
- C. Vitamin K and vitamin A
- D. Vitamin A and vitamin E
Correct answer: A
Rationale: The correct answer is A. Chronic alcoholism commonly leads to deficiencies in B vitamins, particularly thiamine, and vitamin C. Thiamine deficiency can result in serious neurological issues like Wernicke-Korsakoff syndrome, while vitamin C deficiency can lead to scurvy. Choices B, C, and D are incorrect because vitamin D and E deficiencies are not typically associated with chronic alcoholism.
4. A 4-year-old child falls off a tricycle and is admitted for observation. How can the nurse best facilitate the child's cooperation during the assessment?
- A. Ask the parent to hold the child during the assessment.
- B. Allow the child to play with a syringe without a needle.
- C. Ask the child to blow out the penlight as if to simulate success.
- D. Explain the function of each organ during the assessment.
Correct answer: C
Rationale: Engaging the child in blowing out the penlight simulates play and can reduce fear, helping with cooperation during the assessment. Choice A is not recommended as it may increase anxiety by separating the child from the parent. Choice B is not appropriate as it involves playing with a syringe, which may not be safe or suitable. Choice D is not ideal for a 4-year-old child as understanding organ functions may be beyond their developmental level.
5. The nurse is caring for a client with fluid overload. The most reliable indicator of fluid volume status is
- A. Body weight
- B. Intake and output
- C. Daily weight
- D. Skin turgor
Correct answer: C
Rationale: Daily weight is the most reliable indicator of fluid volume status as it reflects changes in body fluid balance accurately. Body weight alone can fluctuate due to various factors, including food intake and bowel movements, which may not accurately represent fluid status. Intake and output provide information on fluid balance over time but may not reflect immediate changes. Skin turgor is a physical assessment finding that indicates hydration status, not overall fluid volume status.
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