HESI RN
HESI RN Exit Exam Capstone
1. A young woman with multiple sclerosis just received several immunizations in preparation for moving into a college dormitory. Two days later, she reports to the nurse that she is experiencing increasing fatigue and visual problems. What teaching should the nurse provide?
- A. Immunizations can trigger a relapse of the disease, so get plenty of extra rest
- B. Visual problems are unrelated to the recent immunizations
- C. Increase fluid intake to reduce symptoms of fatigue
- D. Consult the healthcare provider immediately for steroid therapy
Correct answer: A
Rationale: Immunizations can sometimes trigger relapses in multiple sclerosis due to the activation of the immune system. Extra rest can help manage these symptoms. Choice B is incorrect because visual problems can be associated with the immune response triggered by immunizations in individuals with multiple sclerosis. While increasing fluid intake is generally good advice, in this case, the nurse should focus on explaining the possible connection between the immunizations and the symptoms experienced. Choice D is not the immediate course of action; educating the patient on the potential link between immunizations and symptom exacerbation is more appropriate at this stage.
2. Which of the following molecules contains the code required for replication?
- A. Deoxyribonucleic acid (DNA)
- B. Transfer RNA (tRNA)
- C. Messenger RNA (mRNA)
- D. Ribonucleic acid (RNA)
Correct answer: A
Rationale: The correct answer is A: Deoxyribonucleic acid (DNA). DNA contains the genetic information essential for replication, ensuring the accurate transmission of genetic material from one generation to the next. Choice B, Transfer RNA (tRNA), is involved in protein synthesis, not replication. Choice C, Messenger RNA (mRNA), carries genetic information from DNA to the ribosome but does not contain the code for replication. Choice D, Ribonucleic acid (RNA), is a broader category that includes both mRNA and tRNA, but the specific molecule containing the code required for replication is DNA.
3. The nurse notes a serum calcium level of 7.9 mg/dL for a patient who has chronic malnutrition. Which action should the nurse take next?
- A. Monitor ionized calcium level.
- B. Give oral calcium citrate tablets.
- C. Check parathyroid hormone level.
- D. Administer vitamin D supplements.
Correct answer: A
Rationale: This patient with chronic malnutrition is likely to have a low serum albumin level, which will affect the total serum calcium. A more accurate reflection of calcium balance is the ionized calcium level. Most of the calcium in the blood is bound to protein (primarily albumin). Alterations in serum albumin levels affect the interpretation of total calcium levels. Low albumin levels result in a drop in the total calcium level, although the level of ionized calcium is not affected. The nurse should monitor the ionized calcium level to get a clearer picture of the patient's calcium status. Giving oral calcium citrate tablets, checking parathyroid hormone level, or administering vitamin D supplements may be necessary based on the ionized calcium results, but they are not the immediate next step in assessment and management.
4. When caring for a 4-year-old child diagnosed with celiac disease, the parent asks about foods to avoid. Which response by the nurse is correct?
- A. Avoid all dairy products
- B. Avoid foods containing wheat, barley, and rye
- C. Avoid all foods high in sugar
- D. Avoid foods with artificial coloring
Correct answer: B
Rationale: Celiac disease is managed with a strict gluten-free diet, necessitating the avoidance of foods containing wheat, barley, and rye. Gluten is found in these grains and can trigger an immune response in individuals with celiac disease, leading to damage to the small intestine. Therefore, it is essential for individuals with celiac disease, including children, to carefully avoid gluten-containing foods to maintain their health and well-being.
5. A client is admitted to the emergency department after a motor vehicle accident. The client has a Glasgow Coma Scale (GCS) score of 10. What does this score indicate?
- A. Mild impairment
- B. Moderate impairment
- C. Severe impairment
- D. Normal
Correct answer: B
Rationale: A Glasgow Coma Scale score of 10 falls into the range of moderate impairment, indicating the need for further assessment and monitoring. A GCS score of 10 suggests that the client is moderately impaired neurologically. Choices A, C, and D are incorrect because a GCS score of 10 does not indicate mild impairment, severe impairment, or normal neurological status, respectively.