HESI RN
HESI Exit Exam RN Capstone
1. The nurse is providing teaching to a client with gastroesophageal reflux disease (GERD). Which instruction should the nurse include?
- A. Eat large meals to decrease acid production
- B. Avoid lying down immediately after eating
- C. Limit fluid intake with meals
- D. Drink carbonated beverages to aid digestion
Correct answer: B
Rationale: The correct instruction for a client with GERD is to avoid lying down immediately after eating. This helps prevent stomach acid from flowing back into the esophagus, which can worsen symptoms. Eating large meals can actually increase acid production and exacerbate GERD. Limiting fluid intake with meals may be beneficial for some individuals, but it is not a key instruction for managing GERD. Drinking carbonated beverages can trigger reflux symptoms and should be avoided by individuals with GERD.
2. A client is admitted to the hospital with a diagnosis of pneumonia. Which laboratory test result should the nurse monitor to evaluate the client’s respiratory function?
- A. Arterial blood gases (ABGs)
- B. Complete blood count (CBC)
- C. Blood glucose levels
- D. Serum electrolyte levels
Correct answer: A
Rationale: Arterial blood gases (ABGs) are the most appropriate laboratory test to monitor respiratory function in a client with pneumonia. ABGs provide valuable information on oxygenation status, acid-base balance, and how well the lungs are exchanging gases. This information helps in assessing the effectiveness of ventilation and oxygenation, guiding treatment decisions, and evaluating the overall respiratory status of the client.
3. After completing her first chemotherapy treatment, what behavior indicates that a female client with breast cancer understands her discharge care needs?
- A. She refuses to take anti-nausea medication.
- B. She rents movies and borrows books to pass time at home.
- C. She plans to resume strenuous physical activity immediately.
- D. She reports severe fatigue and inability to perform daily activities.
Correct answer: B
Rationale: Renting movies and borrowing books for use during recovery indicates the client is planning restful activities at home, which aligns with appropriate post-chemotherapy care. Choices A, C, and D are incorrect because refusing anti-nausea medication can lead to complications, resuming strenuous physical activity immediately can be harmful, and reporting severe fatigue and inability to perform daily activities may indicate a need for medical attention rather than understanding discharge care needs.
4. A patient is diagnosed with Mycoplasma pneumonia. Which antibiotic will the nurse expect the provider to order to treat this infection?
- A. Azithromycin (Zithromax)
- B. Clarithromycin (Biaxin)
- C. Erythromycin (E-Mycin)
- D. Fidaxomicin (Dificid)
Correct answer: C
Rationale: Erythromycin is the drug of choice for treating Mycoplasma pneumonia. Mycoplasma pneumonia is typically sensitive to macrolide antibiotics, with erythromycin being one of the first-line agents. Azithromycin and clarithromycin are also effective in treating Mycoplasma pneumonia, but erythromycin is specifically mentioned as the drug of choice in this context. Fidaxomicin, on the other hand, is not indicated for the treatment of Mycoplasma pneumonia and is primarily used to treat Clostridium difficile infections.
5. A client with tuberculosis is prescribed rifampin. What side effect should the nurse inform the client about?
- A. Report orange-colored urine as a sign of kidney dysfunction.
- B. Expect red-orange discoloration of urine as a harmless side effect.
- C. Monitor for signs of liver toxicity.
- D. Call the healthcare provider if vision changes occur.
Correct answer: B
Rationale: The correct answer is B. Rifampin can cause red-orange discoloration of bodily fluids, including urine, saliva, and tears. This is a harmless side effect, but clients should be informed beforehand to prevent alarm. Choice A is incorrect as orange-colored urine is not a sign of kidney dysfunction related to rifampin. Choice C is incorrect because rifampin is more commonly associated with liver toxicity rather than kidney dysfunction. Choice D is incorrect as vision changes are not a typical side effect of rifampin.