HESI RN
HESI RN Exit Exam Capstone
1. A scrub nurse preparing for the first surgery of the day asks if a 3-minute surgical hand scrub is adequate. What should the circulating nurse advise?
- A. Proceed with surgery preparation
- B. Extend scrub time to 5 minutes
- C. Use an alcohol-based hand sanitizer
- D. Scrub time depends on the type of surgery
Correct answer: B
Rationale: The circulating nurse should advise the scrub nurse to extend the hand scrub to 5 minutes for thorough preparation, especially for the first surgery of the day. Choice A is incorrect as it does not address the need for a longer scrub time. Choice C is incorrect as alcohol-based hand sanitizer is not a substitute for a thorough surgical hand scrub. Choice D is incorrect as while scrub time may vary based on the surgery, for the first surgery of the day, a longer scrub time is recommended as a standard practice.
2. The nurse is caring for a client with a chest tube following surgery. The nurse should intervene if which of the following is observed?
- A. The chest tube is securely taped at the insertion site.
- B. The water seal chamber is filled to the correct level.
- C. The chest drainage system is below chest level.
- D. There are no air leaks in the system.
Correct answer: C
Rationale: The correct answer is C. The chest drainage system should always be kept below chest level to ensure proper drainage. Having the system above chest level can result in ineffective drainage. Choices A, B, and D are all correct actions to maintain the integrity and functionality of the chest tube system. Securing the chest tube at the insertion site, maintaining the water seal chamber at the correct level, and ensuring there are no air leaks are all essential components of caring for a client with a chest tube post-surgery.
3. What breakfast selection indicates appropriate dietary management for osteoporosis?
- A. Pancakes with syrup and orange juice
- B. Bagel with jelly and skim milk
- C. Eggs with sausage and whole milk
- D. French toast with butter and syrup
Correct answer: B
Rationale: The correct answer is B. A bagel with jelly and skim milk is a calcium-rich and low-fat option that aligns with the dietary recommendations for managing osteoporosis. Osteoporosis is a condition characterized by weak and brittle bones, so it is essential to consume an adequate amount of calcium while avoiding excess fat intake. Choices A, C, and D are not ideal for osteoporosis management as they either lack sufficient calcium, contain high fat content, or both.
4. 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.
5. A client receiving chemotherapy has severe neutropenia. What snack is best for the nurse to recommend?
- A. Baked apples with raisins.
- B. Yogurt with fresh berries.
- C. Avocados and cheese.
- D. Fresh fruit salad.
Correct answer: B
Rationale: For a client with severe neutropenia, it is crucial to recommend a snack that is low in bacteria to reduce the risk of infection. Yogurt with fresh berries is an excellent choice as it is not only low in bacteria but also provides nutritional value. Baked apples with raisins (choice A) may not be ideal as the preparation process could introduce bacteria. Avocados and cheese (choice C) may not be the best option due to their potential bacterial content. Fresh fruit salad (choice D) may have a higher risk of bacterial contamination compared to yogurt with fresh berries.
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