HESI RN
HESI RN Exit Exam 2023
1. To reduce staff nurse role ambiguity, which strategy should the nurse-manager implement?
- A. Review the staff nurse job description to ensure that it is clear, accurate, and current.
- B. Conduct regular meetings to clarify roles.
- C. Increase communication between team members.
- D. Provide additional training for new nurses.
Correct answer: A
Rationale: The correct answer is A: Review the staff nurse job description to ensure that it is clear, accurate, and current. By ensuring that job descriptions are clear and up-to-date, nurse-managers can reduce ambiguity and confusion about roles and responsibilities. Choice B, conducting regular meetings to clarify roles, may help but may not address the root cause of ambiguity. Choice C, increasing communication between team members, is important but may not specifically target role ambiguity. Choice D, providing additional training for new nurses, is valuable but may not directly address role ambiguity among existing staff.
2. During orientation, a newly hired nurse demonstrates suctioning of a tracheostomy in a skills class. After the demonstration, the supervising nurse expresses concern that the demonstrated procedure increased the client's risk for which problem?
- A. Infection
- B. Hypoxia
- C. Bleeding
- D. Bronchospasm
Correct answer: A
Rationale: The correct answer is A: Infection. Improper suctioning techniques can introduce pathogens, increasing the risk of infection. Choice B, Hypoxia, is incorrect as it is more related to inadequate oxygen supply. Choice C, Bleeding, is not typically associated with suctioning a tracheostomy unless done too aggressively. Choice D, Bronchospasm, is not directly linked to suctioning but may occur due to other triggers in patients with sensitive airways.
3. A 7-year-old boy is brought to the clinic because of facial edema. He reports that he has been voiding small amounts of dark, cloudy, tea-colored urine. The parents state that their son had a sore throat 2 weeks earlier, but it has resolved. After assessing the child's vital signs and weight, what intervention should the nurse implement next?
- A. Perform an otoscopic examination
- B. Measure the child's abdominal girth
- C. Collect a urine specimen for routine urinalysis
- D. Obtain a blood specimen for serum electrolytes
Correct answer: C
Rationale: Collecting a urine specimen for routine urinalysis is the next appropriate intervention. The symptoms described, including facial edema and tea-colored urine, are indicative of glomerulonephritis, a condition affecting the kidneys. A urine specimen can help assess renal function and the presence of blood and protein in the urine, which are common in glomerulonephritis. Performing an otoscopic examination (Choice A) is not relevant to the presenting symptoms. Measuring the child's abdominal girth (Choice B) is not necessary at this point as it does not directly address the urinary symptoms. Obtaining a blood specimen for serum electrolytes (Choice D) may provide information about electrolyte imbalances but is not the most appropriate initial step in this case.
4. The nurse is assisting the mother of a child with phenylketonuria (PKU) to select foods that are in keeping with the child's dietary restrictions. Which foods are contraindicated for this child?
- A. Wheat products
- B. Foods sweetened with aspartame
- C. High-fat foods
- D. High-calorie foods
Correct answer: B
Rationale: The correct answer is B: Foods sweetened with aspartame. Aspartame should not be consumed by a child with PKU because it is converted to phenylalanine in the body, which can be harmful to individuals with PKU. Choice A (Wheat products) is not specifically contraindicated for PKU. Choice C (High-fat foods) and Choice D (High-calorie foods) are not typically restricted in PKU diets unless they contain high levels of phenylalanine.
5. The nurse is preparing to administer an intramuscular injection to a client with muscle wasting in the gluteal region. What is the most appropriate site for the injection?
- A. Dorsogluteal site
- B. Ventrogluteal site
- C. Deltoid site
- D. Vastus lateralis site
Correct answer: D
Rationale: The vastus lateralis site is the most appropriate for an IM injection in a client with muscle wasting in the gluteal region. Administering the injection in the vastus lateralis ensures effective medication delivery due to muscle wasting in the gluteal region, preventing potential complications associated with the dorsogluteal or ventrogluteal sites, which may not be suitable in this specific client case. The deltoid site is mainly used for smaller volumes of medication and may not be ideal for this scenario.
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