HESI RN
HESI RN Exit Exam 2024 Capstone
1. An older client who had a subtotal parathyroidectomy is preparing for discharge. What finding requires immediate provider notification?
- A. Afebrile with a normal pulse.
- B. No bowel movement since surgery.
- C. No appetite for breakfast.
- D. A positive Chvostek's sign.
Correct answer: D
Rationale: A positive Chvostek's sign indicates hypocalcemia, a complication after parathyroid surgery that requires immediate attention. This sign is manifested by facial muscle twitching when the facial nerve in front of the ear is tapped, indicating neuromuscular irritability due to low calcium levels. Afebrile with a normal pulse (Choice A) is a normal finding and does not require immediate notification. No bowel movement since surgery (Choice B) is common postoperatively due to anesthesia effects and pain medications and usually resolves within a few days; it does not require immediate notification unless accompanied by other concerning symptoms. No appetite for breakfast (Choice C) is a common postoperative finding and does not require immediate notification unless it persists and leads to dehydration or malnutrition.
2. The healthcare professional is preparing a presentation on the impact of substance abuse on families. Which approach is most effective for engaging the audience?
- A. showing statistical data on substance abuse rates
- B. sharing personal stories from individuals affected by substance abuse
- C. distributing informational brochures on substance abuse
- D. providing a list of local substance abuse treatment centers
Correct answer: B
Rationale: Sharing personal stories from individuals affected by substance abuse is the most effective approach for engaging the audience. Personal stories evoke emotions, create empathy, and make the impact of substance abuse more relatable and tangible for the audience. This approach helps in fostering a deeper understanding of the real-life consequences of substance abuse on families. The other options, such as showing statistical data (choice A), distributing informational brochures (choice C), and providing a list of treatment centers (choice D), may be informative but may not engage the audience on an emotional level as effectively as personal stories.
3. Inevitable abortion occurs when:
- A. The ovum dies in utero and the decidua capsularis remains intact.
- B. The cervix is open, and the products of conception are about to be expelled.
- C. The products of conception are expelled before the 20th week of gestation.
- D. The fetus dies and is expelled in the first trimester.
Correct answer: B
Rationale: Inevitable abortion occurs when the cervix is open, and the products of conception are about to be expelled. This is a critical point in the process of spontaneous abortion, indicating that expulsion of the products of conception is imminent. Choice A is incorrect as it describes a missed abortion where the ovum dies but the decidua capsularis remains intact. Choice C is incorrect as it describes an incomplete abortion where the products of conception are expelled before the completion of 20 weeks of gestation. Choice D is incorrect as it describes a missed abortion where the fetus dies and is expelled in the first trimester.
4. A nurse is preparing to administer an intramuscular injection to a client. Which action should the nurse take to reduce the client's risk of injury?
- A. Use a 1-inch needle
- B. Select a large muscle for the injection
- C. Aspirate for blood return before injecting
- D. Massage the injection site
Correct answer: C
Rationale: The correct answer is to aspirate for blood return before injecting. This action helps ensure that the needle is not in a blood vessel, reducing the risk of injury. Using a 1-inch needle (Choice A) is a standard length for intramuscular injections but does not directly reduce the risk of injury. Selecting a large muscle for the injection (Choice B) is important for proper medication absorption but does not directly reduce the risk of injury. Massaging the injection site (Choice D) can help with medication absorption but does not reduce the risk of injury.
5. A client with acute pancreatitis is admitted with severe abdominal pain. Which assessment finding requires immediate intervention?
- A. Severe abdominal distention
- B. Decreased urine output
- C. Decreased bowel sounds
- D. Increased heart rate
Correct answer: A
Rationale: Severe abdominal distention is a sign of worsening pancreatitis and can indicate complications like bowel obstruction or fluid accumulation. Immediate intervention is necessary to prevent further deterioration. Decreased urine output (Choice B) could indicate renal impairment, decreased bowel sounds (Choice C) are expected in pancreatitis due to paralytic ileus, and an increased heart rate (Choice D) is a common response to pain or stress in acute pancreatitis but may not require immediate intervention unless it is extremely high or persistent.