HESI RN
HESI RN Exit Exam 2024 Quizlet Capstone
1. An older client with type 1 diabetes arrives at the clinic with abdominal cramping, vomiting, lethargy, and confusion. What should the nurse implement first?
- A. Start an IV infusion of normal saline.
- B. Obtain a serum potassium level.
- C. Administer the client's usual dose of insulin.
- D. Assess the pupillary response to light.
Correct answer: A
Rationale: The correct answer is A: Start an IV infusion of normal saline. The client is showing signs of dehydration, such as abdominal cramping, vomiting, lethargy, and confusion, which can be exacerbated by hyperglycemia. Rehydration is the initial priority to address the fluid imbalance. Option B, obtaining a serum potassium level, though important in the management of diabetes, is not the immediate priority over rehydration. Option C, administering the client's usual dose of insulin, should only be done after addressing the dehydration and confirming the client's blood glucose levels. Option D, assessing the pupillary response to light, is not the most urgent intervention needed in this situation compared to rehydration to correct fluid imbalance.
2. The nurse is caring for a client with chronic kidney disease (CKD) who is receiving erythropoietin therapy. Which laboratory value should be monitored closely?
- A. Serum potassium
- B. Hemoglobin
- C. Serum sodium
- D. White blood cell count
Correct answer: A
Rationale: The correct answer is A: Serum potassium. When a client with chronic kidney disease is undergoing erythropoietin therapy, monitoring serum potassium levels is crucial. Erythropoietin can stimulate red blood cell production, which may lead to an increase in potassium levels, predisposing the client to hyperkalemia. Monitoring serum potassium levels helps in early detection of hyperkalemia and appropriate intervention. Choices B, C, and D are incorrect because although hemoglobin, serum sodium, and white blood cell count are important parameters to monitor in various clinical conditions, they are not specifically associated with erythropoietin therapy in chronic kidney disease.
3. Which of the following clinical findings would be most concerning in a client with hypothyroidism?
- A. Bradycardia
- B. Dry skin
- C. Constipation
- D. Depression
Correct answer: A
Rationale: Bradycardia in a client with hypothyroidism is the most concerning finding as it may indicate severe hypothyroidism, leading to decreased heart rate. Bradycardia can be a sign of myxedema coma, a life-threatening condition that requires immediate medical attention. Dry skin, constipation, and depression are common symptoms associated with hypothyroidism but are not as acutely concerning as bradycardia.
4. A client with end-stage renal disease (ESRD) is scheduled for hemodialysis. Which clinical finding requires immediate intervention?
- A. Fever of 100.4°F
- B. Heart rate of 110 beats per minute
- C. Blood pressure of 140/90 mmHg
- D. Respiratory rate of 24 breaths per minute
Correct answer: A
Rationale: A fever of 100.4°F is a clinical finding that requires immediate intervention in a client with ESRD scheduled for hemodialysis. Fever may indicate an underlying infection, which can be severe in individuals with compromised renal function. Prompt assessment and treatment are essential to prevent worsening of the infection and potential complications. Heart rate, blood pressure, and respiratory rate are also important parameters to monitor in clients with ESRD, but in this scenario, the fever takes precedence due to its potential to indicate a critical condition that requires urgent attention.
5. For the first 72 hours after thyroidectomy surgery, nurse Jamie would assess the female client for Chvostek's sign and Trousseau's sign because they indicate which of the following?
- A. Hypocalcemia
- B. Hypercalcemia
- C. Hypokalemia
- D. Hyperkalemia
Correct answer: A
Rationale: Chvostek's and Trousseau's signs are clinical manifestations that suggest hypocalcemia, a common complication following thyroidectomy. Chvostek's sign is elicited by tapping the facial nerve, resulting in facial muscle contraction, while Trousseau's sign is provoked by inflating a blood pressure cuff, leading to carpal spasm. Both signs are indicative of low calcium levels in the blood. Therefore, options B, C, and D are incorrect as they do not correlate with the signs specifically associated with hypocalcemia.