HESI RN
Community Health HESI 2023
1. The healthcare provider is caring for a client with diabetes insipidus. Which finding indicates that the treatment is effective?
- A. Urine output is decreased.
- B. Thirst is decreased.
- C. Weight loss is observed.
- D. Urine specific gravity is within the normal range.
Correct answer: D
Rationale: In diabetes insipidus, the body loses excessive amounts of water, leading to diluted urine with low specific gravity. Therefore, when the urine specific gravity is within the normal range, it indicates that the kidneys are properly concentrating urine, which is a sign of effective treatment for diabetes insipidus. Choices A, B, and C are incorrect because in diabetes insipidus, there is polyuria (excessive urination), persistent thirst due to fluid loss, and potential weight loss due to fluid imbalance, so these findings would not indicate effective treatment.
2. A client with severe acne is seen in the clinic, and the healthcare provider prescribes isotretinoin. The nurse reviews the client's medication record and would contact the healthcare provider if the client is taking which medication?
- A. Vitamin A
- B. Digoxin (Lanoxin)
- C. Furosemide (Lasix)
- D. Phenytoin (Dilantin)
Correct answer: A
Rationale: Isotretinoin is a metabolite of vitamin A, which can lead to toxicity when taken together. Therefore, it is crucial to avoid concurrent use of vitamin A supplements with isotretinoin. Contacting the healthcare provider to discuss discontinuing vitamin A supplements is important to prevent potential adverse effects. Choices B, C, and D are incorrect as they are not known to interact significantly with isotretinoin.
3. A client with chronic kidney disease is prescribed a low-sodium diet. What is the nurse's priority teaching?
- A. Choose fresh fruits and vegetables.
- B. Restrict fluid intake to 1500 mL per day.
- C. Limit sodium intake to 2 grams per day.
- D. Increase potassium intake to prevent hypokalemia.
Correct answer: C
Rationale: The correct answer is C: 'Limit sodium intake to 2 grams per day.' For a client with chronic kidney disease, limiting sodium intake is crucial because it helps prevent fluid retention and reduces the workload on the kidneys. Choice A, 'Choose fresh fruits and vegetables,' is generally a healthy dietary recommendation but not the priority when focusing on a low-sodium diet. Choice B, 'Restrict fluid intake to 1500 mL per day,' is important but secondary to limiting sodium intake. Choice D, 'Increase potassium intake to prevent hypokalemia,' is not the priority teaching for a client with chronic kidney disease on a low-sodium diet.
4. A health care provider (HCP) writes a prescription for digoxin (Lanoxin), 0.25 mg daily. The nurse teaches the client about the medication and tells the client that it is important to:
- A. Count the radial and carotid pulses every morning.
- B. Check the blood pressure every morning and evening.
- C. Stop taking the medication if the pulse is higher than 100 beats per minute.
- D. Withhold the medication and call the HCP if the pulse is less than 60 beats per minute.
Correct answer: D
Rationale: When taking digoxin, monitoring the pulse rate is essential due to its potential effects on heart rate. Digoxin can lead to bradycardia, where the pulse rate drops significantly. Withholding the medication and promptly contacting the healthcare provider if the pulse falls below 60 beats per minute is crucial to prevent severe complications and ensure appropriate management. Choices A, B, and C are incorrect because counting radial and carotid pulses, checking blood pressure, or stopping the medication based on a pulse rate higher than 100 beats per minute are not the primary monitoring parameters for a client taking digoxin.
5. A client is leaving the hospital against medical advice (AMA) and voluntarily signs the AMA form. Which nursing action is essential prior to the client leaving?
- A. Remove the client's peripheral IV access
- B. Administer requested pain relief medication
- C. Obtain the client's neurological vital signs
- D. Provide the client with the hospital's phone number
Correct answer: A
Rationale: Removing the client's peripheral IV access is essential before the client leaves against medical advice to prevent complications such as infection, thrombosis, or bleeding. Administering pain relief medication (choice B) can be important but not essential at this point. Obtaining neurological vital signs (choice C) is not specifically required before the client leaves. Providing the client with the hospital's phone number (choice D) may be helpful but is not as essential as ensuring the safe removal of IV access.