HESI RN
HESI RN Exit Exam 2024 Capstone
1. A toddler presenting with a history of intermittent skin rashes, hives, abdominal pain, and vomiting that occurs after ingesting milk products arrives at the clinic accompanied by the parents. Which type of testing should the nurse educate the toddler's family about?
- A. Complete blood count
- B. Lactose tolerance test
- C. Skin allergy testing
- D. Serum immunoglobulin E
Correct answer: D
Rationale: The correct answer is D, Serum immunoglobulin E (IgE) testing. This test can help diagnose food allergies, including milk protein allergies, in toddlers presenting with symptoms like skin rashes, hives, abdominal pain, and vomiting after consuming milk products. Skin allergy testing is used for allergies but may not be suitable for this age group due to developmental factors. Lactose intolerance, which is different from a milk allergy, is assessed through a lactose tolerance test, not IgE testing. A complete blood count (CBC) would not provide specific information related to food allergies.
2. The nurse is managing the care of a client with Cushing's syndrome. Which interventions should the nurse delegate to the UAP?
- A. Report any client complaint of pain or discomfort
- B. Weigh the client and report any weight gain
- C. Note and report the client's food and liquid intake during meals and snacks
- D. All of the above
Correct answer: D
Rationale: The UAP can be tasked with reporting complaints, monitoring weight gain, and tracking food and fluid intake, all of which are important in managing a client with Cushing's syndrome. These tasks fall within the UAP's scope of practice. Reporting client complaints helps in early identification of complications, monitoring weight is crucial due to fluid retention in Cushing's syndrome, and tracking food and fluid intake assists in dietary management. Choices A, B, and C are all necessary components of care for a client with Cushing's syndrome, making option D the correct answer.
3. A client with peripheral artery disease reports pain while walking. What intervention should the nurse recommend?
- A. Encourage the client to increase physical activity.
- B. Instruct the client to take rest breaks during walking.
- C. Apply warm compresses to the legs to improve circulation.
- D. Massage the affected leg to relieve the pain.
Correct answer: B
Rationale: Clients with peripheral artery disease often experience claudication (leg pain during walking) due to decreased blood flow. Encouraging rest breaks during walking helps to manage pain and improve circulation. Rest breaks allow the muscles to recover from ischemia caused by inadequate blood supply. Increasing physical activity without breaks may worsen the symptoms. Applying warm compresses can potentially lead to burns or skin damage in individuals with compromised circulation. Massaging the affected leg is contraindicated in peripheral artery disease as it can further compromise blood flow.
4. A client with diabetes mellitus is experiencing diabetic ketoacidosis (DKA). What laboratory result should the nurse monitor closely?
- A. White blood cell count of 15,000.
- B. Blood glucose level of 320 mg/dL.
- C. Sodium level of 145 mEq/L.
- D. Serum creatinine level of 1.0 mg/dL.
Correct answer: B
Rationale: A blood glucose level of 320 mg/dL indicates the need for insulin to manage diabetic ketoacidosis.
5. The nurse is assessing a client 2 hours postoperatively following an appendectomy. The nurse should intervene for which abnormal finding?
- A. Heart rate of 88 beats per minute
- B. Blood pressure of 100/60
- C. Oxygen saturation of 94%
- D. Respiratory rate of 16
Correct answer: C
Rationale: The correct answer is C. Oxygen saturation levels below 95% indicate hypoxia and require immediate intervention. A heart rate of 88 beats per minute, a blood pressure of 100/60, and a respiratory rate of 16 are within normal ranges and do not require immediate intervention. Oxygen saturation is a critical parameter reflecting the client's oxygenation status.
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