HESI RN
HESI Fundamentals Practice Exam
1. After ensuring correct tube placement, what action should the nurse take next when administering medications through a nasogastric tube (NGT) connected to suction?
- A. Clamp the tube for 20 minutes.
- B. Flush the tube with water.
- C. Administer the medications as prescribed.
- D. Crush the tablets and dissolve in sterile water.
Correct answer: B
Rationale: After ensuring the correct placement of the NGT, the nurse should flush the tube with water to prevent any obstructions and ensure proper medication delivery. Flushing the tube is essential before, after, and in between each medication administration. Clamping the tube for 20 minutes should be done after all medications are administered to prevent clogging. Administering medications as prescribed and preparing medications by crushing tablets and dissolving them in sterile water should only be done after the tube has been appropriately flushed to maintain its patency and effectiveness.
2. Following a cardiac catheterization and placement of a stent in the right coronary artery, the nurse administers prasugrel, a platelet inhibitor, to the client. To monitor for adverse effects from the medication, which assessment is most important for the nurse to include in this client's care plan?
- A. Check platelet count
- B. Observe the color of urine
- C. Review liver function tests
- D. Monitor for bleeding
Correct answer: D
Rationale: Prasugrel is a platelet inhibitor, which increases the risk of bleeding. Monitoring for bleeding, particularly at the catheterization site and in other areas, is the most important assessment following administration of the drug. Checking platelet count and observing urine color are relevant but not as immediate. Reviewing liver function tests is not directly related to the adverse effects of prasugrel.
3. A client with chronic kidney disease (CKD) is scheduled for a renal biopsy. Which laboratory value should the nurse review before the procedure?
- A. Serum potassium
- B. Serum creatinine
- C. Hemoglobin
- D. White blood cell count
Correct answer: B
Rationale: Before a renal biopsy, the nurse should review the serum creatinine level. Serum creatinine is a key indicator of kidney function. In clients with chronic kidney disease (CKD), monitoring creatinine levels is crucial as elevated levels may indicate worsening kidney function, which could impact the safety and outcome of the biopsy. Hemoglobin (choice C) is important for assessing oxygen-carrying capacity but is not directly related to the kidney biopsy procedure. Serum potassium (choice A) is important to monitor in CKD but is not specifically crucial before a renal biopsy. White blood cell count (choice D) is more relevant for assessing infection or inflammation, which is not the primary concern before a renal biopsy.
4. A college student who is diagnosed with a vaginal infection and vulva irritation describes the vaginal discharge as having a 'cottage cheese' appearance. Which prescription should the nurse implement first?
- A. Cleanse the perineum with warm soapy water 3 times per day
- B. Instill the first dose of nystatin (Mycostatin) vaginally per applicator
- C. Perform a glucose measurement using a capillary blood sample
- D. Obtain a blood specimen for sexually transmitted diseases (STDs)
Correct answer: B
Rationale: The correct answer is to instill the first dose of nystatin vaginally per applicator. Nystatin is an antifungal medication used to treat yeast infections, which are characterized by 'cottage cheese' discharge. Cleansing the perineum with warm soapy water may help with hygiene but does not address the underlying infection. Performing a glucose measurement is not relevant to the diagnosis of a vaginal infection. Obtaining a blood specimen for STDs is not the priority in this scenario as the symptoms described are indicative of a yeast infection.
5. The healthcare provider is assessing a client with hypothyroidism. Which of the following symptoms would the provider expect to find?
- A. Weight loss
- B. Heat intolerance
- C. Bradycardia
- D. Diarrhea
Correct answer: C
Rationale: Bradycardia is a common symptom of hypothyroidism because the condition leads to a decreased metabolic rate. Weight loss (Choice A) is more commonly associated with hyperthyroidism, where the metabolic rate is increased. Heat intolerance (Choice B) is also more indicative of hyperthyroidism due to increased sensitivity to heat. Diarrhea (Choice D) is not a typical symptom of hypothyroidism; rather, constipation is more common due to the slow-down of the digestive system.