HESI RN
HESI RN Exit Exam Capstone
1. The nurse is administering an intradermal injection for a tuberculosis skin test. Which technique should the nurse use?
- A. Use a 25-gauge needle at a 90-degree angle
- B. Use a 27-gauge needle at a 15-degree angle
- C. Use a 22-gauge needle at a 45-degree angle
- D. Use a 20-gauge needle at a 90-degree angle
Correct answer: B
Rationale: An intradermal injection for a tuberculosis skin test should be administered using a 27-gauge needle at a 15-degree angle. This technique ensures that the medication is delivered into the dermis layer of the skin. Choice A is incorrect because a 25-gauge needle is too large for an intradermal injection. Choice C is incorrect as a 22-gauge needle is also too large and the angle is too steep for an intradermal injection. Choice D is incorrect as a 20-gauge needle is too large for an intradermal injection, and a 90-degree angle would not deliver the medication accurately into the dermis.
2. A client with hypothyroidism is prescribed levothyroxine. What symptom indicates that the dosage may need adjustment?
- A. Increased appetite and weight gain.
- B. Increased sensitivity to cold and dry skin.
- C. Increased heart palpitations and sweating.
- D. Increased shortness of breath and rapid heart rate.
Correct answer: B
Rationale: Increased sensitivity to cold and dry skin may indicate that the dosage of levothyroxine is too low, requiring adjustment. This symptom is typical of hypothyroidism when the body's metabolism slows down, leading to feeling cold and having dry skin. Choices A, C, and D present symptoms more commonly associated with hyperthyroidism, where the body is in a state of overactivity, leading to weight loss, increased heart rate, and sweating. Therefore, these symptoms would not indicate the need for dosage adjustment in a client with hypothyroidism.
3. After receiving hemodialysis, what is the nurse's priority assessment for a client with chronic kidney disease?
- A. Monitor the client's potassium level.
- B. Assess the client's blood pressure.
- C. Check the client's hemoglobin and hematocrit levels.
- D. Monitor for signs of infection.
Correct answer: A
Rationale: The correct answer is to monitor the client's potassium level. During hemodialysis, there is a risk of potassium shifting, which can lead to life-threatening arrhythmias if not properly managed. Assessing the potassium level is crucial to prevent complications. While assessing blood pressure, checking hemoglobin and hematocrit levels, and monitoring for signs of infection are important aspects of care for a client with chronic kidney disease, monitoring potassium levels takes precedence due to its immediate life-threatening potential post-dialysis.
4. A female client experiences a sudden loss of consciousness and is taken to the emergency department. Initial assessment indicates her blood glucose level is critically low. Once stabilized, she reports being treated for anorexia nervosa. What intervention is most important for the nurse to include in the client’s discharge plan?
- A. Encourage a high-protein, low-carbohydrate diet.
- B. Encourage her to join a group focusing on self-esteem.
- C. Schedule an outpatient psychosocial assessment.
- D. Teach relaxation techniques to manage stress.
Correct answer: B
Rationale: Joining a group that focuses on self-esteem is the most important intervention for the nurse to include in the client's discharge plan. This can help the client address underlying emotional issues related to her anorexia nervosa and improve her mental health. Choice A is incorrect because a high-protein, low-carbohydrate diet may not address the psychological factors contributing to anorexia nervosa. Choice C is incorrect as scheduling an outpatient psychosocial assessment is important but not the most crucial intervention for discharge planning in this case. Choice D is also not the priority as teaching relaxation techniques, although beneficial, may not directly address the self-esteem and emotional issues that need to be tackled in this situation.
5. The home care nurse visits a client who has cancer. The client reports having a good appetite but experiencing nausea when smelling food cooking. Which action should the nurse implement?
- A. Encourage family members to cook meals outdoors and bring the cooked food inside
- B. Provide anti-nausea medication prior to meals
- C. Suggest drinking cold water with meals to reduce nausea
- D. Recommend smaller, frequent meals
Correct answer: A
Rationale: In some cases, the smell of food cooking can trigger nausea in cancer patients. Cooking food outside reduces the intensity of odors that could trigger nausea, helping the client maintain adequate nutrition. Providing anti-nausea medication (Choice B) may not address the root cause of the nausea triggered by the smell of cooking food. Suggesting cold water (Choice C) or smaller, frequent meals (Choice D) may not directly address the issue of cooking odors triggering nausea, which is specific to this client's situation.
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