HESI RN
HESI RN Exit Exam Capstone
1. The nurse is caring for a client with a chest tube following surgery. The nurse should intervene if which of the following is observed?
- A. The chest tube is securely taped at the insertion site.
- B. The water seal chamber is filled to the correct level.
- C. The chest drainage system is below chest level.
- D. There are no air leaks in the system.
Correct answer: C
Rationale: The correct answer is C. The chest drainage system should always be kept below chest level to ensure proper drainage. Having the system above chest level can result in ineffective drainage. Choices A, B, and D are all correct actions to maintain the integrity and functionality of the chest tube system. Securing the chest tube at the insertion site, maintaining the water seal chamber at the correct level, and ensuring there are no air leaks are all essential components of caring for a client with a chest tube post-surgery.
2. Where should the healthcare provider consider starting a screening program for hypothyroidism?
- A. A business and professional women’s group.
- B. An African-American senior citizens' center.
- C. A daycare center in a Hispanic neighborhood.
- D. An after-school center for Native American teens.
Correct answer: B
Rationale: An African-American senior citizens' center is the most appropriate location to start a screening program for hypothyroidism. Older adults are at an increased risk of hypothyroidism, and African-Americans are more likely to be underserved in healthcare. Therefore, targeting this group can help in early detection and management of hypothyroidism. The other options, such as a business and professional women’s group, a daycare center in a Hispanic neighborhood, and an after-school center for Native American teens, do not align as closely with the demographic at higher risk for hypothyroidism.
3. A 48-year-old client with chronic alcoholism is admitted to the hospital. The nurse would anticipate that the client may be deficient in which vitamins?
- A. Vitamin B and vitamin C
- B. Vitamin D and vitamin E
- C. Vitamin K and vitamin A
- D. Vitamin A and vitamin E
Correct answer: A
Rationale: The correct answer is A. Chronic alcoholism commonly leads to deficiencies in B vitamins, particularly thiamine, and vitamin C. Thiamine deficiency can result in serious neurological issues like Wernicke-Korsakoff syndrome, while vitamin C deficiency can lead to scurvy. Choices B, C, and D are incorrect because vitamin D and E deficiencies are not typically associated with chronic alcoholism.
4. A client with type 1 diabetes reports blurry vision. What is the most important assessment the nurse should perform?
- A. Assess the client’s most recent blood glucose levels.
- B. Check the client’s hemoglobin A1C level.
- C. Check the client’s blood pressure for signs of hypertension.
- D. Examine the client’s feet for signs of neuropathy.
Correct answer: A
Rationale: Blurry vision in clients with type 1 diabetes may indicate hyperglycemia, which requires prompt assessment of recent blood glucose levels to determine the cause and appropriate intervention. Checking the client’s hemoglobin A1C level (Choice B) is useful for assessing long-term glucose control, not for immediate management of blurry vision. Monitoring blood pressure (Choice C) is important in diabetes care but is not the most crucial assessment when blurry vision is reported. Examining the client’s feet for signs of neuropathy (Choice D) is important in diabetic foot care but is not the priority when dealing with blurry vision.
5. A client has suspected compartment syndrome of the right lower leg. What is the nurse’s priority intervention?
- A. Elevate the right leg to reduce swelling.
- B. Loosen any restrictive dressings on the leg.
- C. Prepare the client for emergency surgery.
- D. Administer pain medication as prescribed.
Correct answer: B
Rationale: In a suspected case of compartment syndrome, the nurse's priority intervention is to loosen any restrictive dressings on the leg. This action helps to relieve pressure within the affected compartment, improve circulation, and prevent permanent damage. Elevating the leg may further increase pressure, preparing for emergency surgery is premature without proper assessment and diagnosis, and administering pain medication should come after addressing the primary issue of relieving pressure.
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