HESI RN
RN HESI Exit Exam Capstone
1. The nurse is assessing a client with a new diagnosis of hyperthyroidism. Which assessment finding should the nurse expect?
- A. Decreased heart rate
- B. Increased appetite
- C. Cold intolerance
- D. Weight gain
Correct answer: B
Rationale: In hyperthyroidism, there is an increase in metabolism, leading to symptoms such as increased appetite, weight loss, and heat intolerance. Therefore, the nurse should expect an increased appetite in a client with hyperthyroidism. Choices A, C, and D are incorrect because decreased heart rate and cold intolerance are more commonly associated with hypothyroidism, while weight gain is not typically seen in hyperthyroidism.
2. A client with diabetes mellitus is experiencing diabetic ketoacidosis (DKA). What laboratory result should the nurse monitor closely?
- A. White blood cell count of 15,000.
- B. Blood glucose level of 320 mg/dL.
- C. Sodium level of 145 mEq/L.
- D. Serum creatinine level of 1.0 mg/dL.
Correct answer: B
Rationale: A blood glucose level of 320 mg/dL indicates the need for insulin to manage diabetic ketoacidosis.
3. The nurse is administering a new medication to a client. What is the priority action before administering the drug?
- A. Verify the client's allergies
- B. Check the client's blood pressure
- C. Assess the client's pain level
- D. Provide client education on the medication
Correct answer: A
Rationale: Verifying the client's allergies is the priority action before administering any medication. It is crucial to identify any known allergies to prevent potential allergic reactions, which can be severe and life-threatening. Checking the client's blood pressure, assessing pain levels, and providing education on the medication are important aspects of client care but verifying allergies is essential for ensuring the safety of the client.
4. A child has a nosebleed (epistaxis) while playing soccer. In what position should the nurse place the child?
- A. Position the child lying flat and apply pressure to the bridge of the nose.
- B. Position the child sitting up and leaning forward.
- C. Have the child tilt the head back and pinch the nose.
- D. Position the child lying on their side and apply ice to the nose.
Correct answer: B
Rationale: The correct answer is to position the child sitting up and leaning forward. This position helps prevent blood from flowing down the throat, reducing the risk of choking or vomiting. Choice A is incorrect because lying flat can cause blood to flow down the throat. Choice C is wrong as tilting the head back may lead to blood entering the throat. Choice D is also incorrect as applying ice is not recommended for nosebleeds and lying on the side may not prevent blood from flowing down the throat.
5. A client with multiple sclerosis is experiencing fatigue. What is the nurse's priority intervention?
- A. Encourage the client to increase physical activity.
- B. Encourage the client to take rest breaks during activities.
- C. Administer a stimulant medication to reduce fatigue.
- D. Advise the client to use energy conservation techniques.
Correct answer: D
Rationale: The correct answer is D: Advise the client to use energy conservation techniques. Energy conservation techniques are crucial in managing fatigue in multiple sclerosis. These techniques involve prioritizing activities, pacing oneself, and taking rest breaks to prevent overexertion, which can exacerbate fatigue. Encouraging the client to increase physical activity (choice A) may worsen fatigue if not done with proper energy conservation. Taking rest breaks during activities (choice B) is important but falls secondary to teaching energy conservation techniques. Administering a stimulant medication to reduce fatigue (choice C) should not be the priority as non-pharmacological interventions like energy conservation should be attempted first.
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