HESI RN
HESI RN Exit Exam 2023
1. An elderly male client is admitted to the urology unit with acute renal failure due to a postrenal obstruction. Which question best assists the nurse in obtaining relevant historical data?
- A. Have you had any difficulty starting your urinary stream?
- B. Do you have a history of kidney stones?
- C. How much fluid do you drink daily?
- D. Have you had any previous urinary tract infections?
Correct answer: A
Rationale: The correct answer is A: 'Have you had any difficulty starting your urinary stream?' This question is the most relevant as difficulty starting urination can indicate an obstruction, which aligns with the client's current condition of postrenal obstruction causing acute renal failure. Choice B is incorrect as a history of kidney stones may not be directly related to the current obstruction. Choice C, asking about daily fluid intake, is not specific to the current issue of postrenal obstruction. Choice D inquires about previous urinary tract infections, which are not directly related to the current acute renal failure caused by postrenal obstruction.
2. A nurse cares for adult clients who experience urge incontinence. For which client should the nurse plan a habit training program?
- A. A 78-year-old female who is confused
- B. A 65-year-old male with diabetes mellitus
- C. A 52-year-old female with kidney failure
- D. A 47-year-old male with arthritis
Correct answer: A
Rationale: For a bladder training program to succeed in a client with urge incontinence, the client must be alert, aware, and able to resist the urge to urinate. Habit training will work best for a confused client. This includes going to the bathroom (or being assisted to the bathroom) at set times. The other clients may benefit from other types of bladder training. A confused client may need structured assistance to establish a regular bathroom routine, which can help manage urge incontinence effectively. Clients with diabetes mellitus, kidney failure, or arthritis may require different strategies tailored to their specific conditions.
3. A combination multi-drug cocktail is being considered for an asymptomatic HIV-infected client with a CD4 cell count of 500. Which nursing assessment of the client is most crucial in determining whether therapy should be initiated?
- A. Presence of viral symptoms
- B. Engages in high-risk behaviors
- C. Willingness to comply with complex drug schedules
- D. History of opportunistic infections
Correct answer: C
Rationale: The most crucial nursing assessment in determining whether therapy should be initiated for an asymptomatic HIV-infected client with a CD4 cell count of 500 is the client's willingness to comply with complex drug schedules. Adherence to antiretroviral therapy is essential for its effectiveness. Assessing the client's willingness and ability to comply with the complex medication regimen is crucial to ensure successful treatment and prevent drug resistance. Choices A, B, and D, although important in the overall care of the client, are not as crucial as assessing the client's willingness to adhere to the prescribed drug regimen.
4. Before administering furosemide (Lasix) to a client with heart failure, what is the most important laboratory test result for the nurse to check?
- A. Potassium level
- B. Creatinine level
- C. Cholesterol level
- D. Blood urea nitrogen
Correct answer: A
Rationale: The correct answer is to check the potassium level before administering furosemide (Lasix) to a client with heart failure. Furosemide is a loop diuretic that can cause hypokalemia, so it is crucial to assess the potassium level to prevent complications like cardiac arrhythmias associated with low potassium levels.
5. A nurse is caring for a client who has type 1 diabetes mellitus. Which of the following should the nurse recommend to the client as an appropriate sweetener?
- A. Corn syrup
- B. Natural honey
- C. Nonnutritive sugar substitute
- D. Agave nectar
Correct answer: C
Rationale: Nonnutritive sugar substitutes are suitable for individuals with diabetes, such as type 1 diabetes mellitus, as they do not affect blood glucose levels. Corn syrup and agave nectar contain high levels of sugar that can spike blood glucose levels, making them unsuitable for diabetes management. While natural honey is a natural sweetener, it can still impact blood sugar levels and is not the optimal choice for individuals with diabetes.