HESI RN
HESI RN Exit Exam 2024 Capstone
1. The nurse is providing education to a client who experiences recurrent levels of moderate anxiety in response to situations and perceived stress. In addition to information about prescribed medication and administration, which instruction should the nurse include in the teaching?
- A. Practice using muscle relaxation techniques
- B. Take medication only when anxiety is at its worst
- C. Avoid interactions that trigger stress
- D. Engage in exercise during anxious periods
Correct answer: A
Rationale: Teaching relaxation techniques, such as muscle relaxation, helps the client manage anxiety more effectively. These techniques can be practiced regularly to reduce overall anxiety and can complement prescribed medications. Choice B is incorrect because medication should be taken as prescribed, not only when anxiety is at its worst. Choice C is incorrect as avoiding interactions that trigger stress may not always be feasible and does not teach the client coping mechanisms. Choice D is incorrect as engaging in exercise during anxious periods may not be the most effective strategy for managing moderate anxiety levels.
2. A client with hypertension receives a prescription for enalapril, an angiotensin-converting enzyme (ACE) inhibitor. Which instruction should the nurse include in the medication teaching plan?
- A. Increase intake of potassium-rich foods.
- B. Report increased bruising or bleeding.
- C. Stop medication if a cough develops.
- D. Limit intake of leafy green vegetables.
Correct answer: B
Rationale: The correct instruction for the nurse to include in the medication teaching plan is to 'Report increased bruising or bleeding.' ACE inhibitors can cause thrombocytopenia, which lowers platelet count and increases the risk of bruising and bleeding. Choice A is incorrect because while ACE inhibitors may cause potassium levels to increase, the instruction should not be to increase intake of potassium-rich foods without healthcare provider guidance. Choice C is incorrect because a cough is a common side effect of ACE inhibitors due to bradykinin accumulation, and stopping the medication abruptly is not recommended without consulting the healthcare provider. Choice D is incorrect because there is no need to limit intake of leafy green vegetables specifically with ACE inhibitors; however, consistent intake of vitamin K-rich foods is recommended to maintain a stable INR for clients taking anticoagulants.
3. The nurse is caring for several patients who are receiving antibiotics. Which order will the nurse question?
- A. Azithromycin (Zithromax) 500 mg IV in 500 mL of fluid
- B. Azithromycin (Zithromax) 500 mg PO once daily
- C. Erythromycin 300 mg IM QID
- D. Erythromycin 300 mg PO QID
Correct answer: C
Rationale: The nurse should question the order for Erythromycin 300 mg IM QID. Erythromycin and other macrolides should not be given intramuscularly because they cause painful tissue irritation. Options A and B are correct routes for Azithromycin, either intravenously or orally. Option D is a correct route for Erythromycin, which is orally.
4. The nurse believes that a client who frequently requests pain medication may have a substance abuse problem. Which intervention reflects the nurse's value of client autonomy over veracity?
- A. Administer the prescribed analgesic when requested
- B. Enroll the client in a substance abuse program
- C. Collaborate with the healthcare provider to provide a placebo
- D. Document the frequency of medication requests
Correct answer: A
Rationale: Administering the prescribed analgesic when requested reflects the nurse's value of client autonomy over veracity. This choice respects the client's right to manage their pain as they see fit. Enrolling the client in a substance abuse program (Choice B) assumes substance abuse without evidence and infringes on the client's autonomy. Providing a placebo (Choice C) violates the principle of beneficence and autonomy by deceiving the client. Documenting the frequency of medication requests (Choice D) is important for assessment but does not directly address the client's autonomy in managing their pain.
5. The nurse is developing a program to educate parents on the importance of childhood immunizations. Which topic should be prioritized?
- A. the benefits of immunizations
- B. the potential side effects of vaccines
- C. the immunization schedule
- D. ways to comfort children during vaccinations
Correct answer: A
Rationale: The correct answer is A: the benefits of immunizations. Emphasizing the benefits of immunizations helps parents understand the importance of vaccines in protecting their children from preventable diseases. This choice should be prioritized as it focuses on the positive outcomes of immunizations, which can motivate parents to vaccinate their children. Choices B, C, and D are not the top priority because while it's important to address potential side effects, the immunization schedule, and comforting children during vaccinations, the main focus should be on highlighting the benefits to encourage parents to make informed decisions regarding their child's immunizations.