HESI RN
HESI Exit Exam RN Capstone
1. The nurse is evaluating the laboratory reports of a client with hypothyroidism. The nurse would expect which of the following laboratory values?
- A. Increased TSH
- B. Increased thyroxine (T4)
- C. Decreased TSH
- D. Decreased T3
Correct answer: A
Rationale: The correct answer is A: Increased TSH. In hypothyroidism, the thyroid gland is underactive, leading to low levels of thyroid hormones. As a compensatory mechanism, the pituitary gland releases more thyroid-stimulating hormone (TSH) to try to stimulate the thyroid gland to produce more hormones. Therefore, increased TSH levels are expected in hypothyroidism. Choice B is incorrect because in hypothyroidism, thyroxine (T4) levels are usually decreased, not increased. Choice C is incorrect as hypothyroidism is characterized by increased TSH levels, not decreased. Choice D is also incorrect because in hypothyroidism, T3 levels may be decreased, but TSH is a more sensitive indicator for diagnosis.
2. A client reports gastrointestinal upset after taking oral tetracycline. Which snack should the nurse recommend?
- A. Yogurt with fruit
- B. Toast with jelly
- C. Crackers with peanut butter
- D. Oatmeal with raisins
Correct answer: B
Rationale: The correct answer is B: Toast with jelly. Tetracycline can cause gastrointestinal upset when taken with dairy products. Yogurt with fruit (Choice A) contains dairy, which can worsen the gastrointestinal upset. Crackers with peanut butter (Choice C) and oatmeal with raisins (Choice D) are also not the best choices as they may not be gentle enough on the stomach. Toast with jelly is a simple snack that does not contain dairy and is less likely to exacerbate the gastrointestinal upset.
3. The nurse is caring for a client with deep vein thrombosis (DVT) who is receiving anticoagulant therapy. Which intervention should the nurse implement to prevent complications?
- A. Elevate the affected leg
- B. Encourage early ambulation
- C. Perform frequent range-of-motion exercises
- D. Apply ice packs to the affected leg
Correct answer: A
Rationale: Elevating the affected leg is crucial in managing deep vein thrombosis (DVT) as it helps to reduce swelling and improve venous return. This intervention is essential for preventing complications such as pulmonary embolism. Encouraging early ambulation is generally beneficial for preventing DVT but is secondary to leg elevation. Performing range-of-motion exercises can be helpful for maintaining joint mobility but is not the priority intervention in this case. Applying ice packs to the affected leg is not recommended in DVT management as it can cause vasoconstriction and potentially worsen the condition.
4. The nurse is developing a plan of care for a client who reports tingling in the feet and who is newly diagnosed with peripheral vascular disease. Which outcome should the nurse include in the plan of care for this client?
- A. The client will walk 30 minutes three times a week
- B. The client will demonstrate understanding of proper shoe fit
- C. The client will perform foot care daily
- D. The client's blood pressure readings will be less than 160/90 mmHg
Correct answer: D
Rationale: Controlling blood pressure is critical in managing peripheral vascular disease, as elevated pressure can exacerbate vascular damage and complications. While foot care, shoe fit, and exercise are important, lowering blood pressure is a primary goal. Proper blood pressure management helps in preventing further damage to the blood vessels and reduces the risk of complications associated with peripheral vascular disease, making it the most crucial outcome to include in the plan of care for this client.
5. 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.
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