HESI RN
HESI 799 RN Exit Exam Capstone
1. What pathophysiological events occur sequentially in the development of atherosclerosis?
- A. Foam cells release growth factors.
- B. Smooth muscle grows over fatty streaks creating fibrous plaques.
- C. Macrophages consume low-density lipoprotein (LDL) and create foam cells.
- D. Arterial endothelium injury causes inflammation.
Correct answer: D
Rationale: The correct sequence of pathophysiological events in the development of atherosclerosis starts with arterial endothelium injury causing inflammation. This inflammation triggers the formation of foam cells by macrophages consuming low-density lipoprotein (LDL). Subsequently, smooth muscle grows over fatty streaks, creating fibrous plaques. Therefore, option D is the correct answer. Choices A, B, and C are incorrect because they do not reflect the accurate chronological order of events in the pathogenesis of atherosclerosis.
2. The nurse is instructing the client on insulin administration. The client's morning dose of insulin is 10 units of regular and 22 units of NPH. The nurse checks the dose accuracy with the client. The nurse determines that the client has prepared the correct dose when the syringe reads how many units?
- A. 10 units.
- B. 22 units.
- C. 32 units.
- D. 24 units.
Correct answer: C
Rationale: The correct dose would be 32 units, which is the sum of 10 units of regular insulin and 22 units of NPH. It is essential to combine the doses of both types of insulin to ensure the client administers the correct total dose. Choices A and B represent the individual doses of regular and NPH insulin, respectively, not the combined total. Choice D is incorrect as it does not reflect the sum of both insulin doses.
3. A client on long-term corticosteroid therapy for rheumatoid arthritis presents with weakness and hypotension. What is the nurse's first action?
- A. Administer a PRN dose of corticosteroids.
- B. Place the client in a supine position.
- C. Encourage oral fluid intake.
- D. Review the client's recent medication history.
Correct answer: A
Rationale: Administering a PRN dose of corticosteroids is the correct first action when a client on long-term corticosteroid therapy presents with weakness and hypotension. In this scenario, the client is likely experiencing adrenal insufficiency due to prolonged corticosteroid use. Administering corticosteroids promptly can help correct this insufficiency and improve the client's symptoms. Placing the client in a supine position may be necessary for symptomatic hypotension, but addressing the root cause with corticosteroids is more crucial initially. Encouraging oral fluid intake is important for many conditions but is not the priority in this case. Reviewing the client's recent medication history can provide valuable information but is not the first action needed to address the client's current presentation.
4. An adolescent with a history of bipolar disorder is hospitalized during a manic episode. Which intervention is most appropriate for the nurse to include in the care plan?
- A. Encourage high levels of physical activity.
- B. Provide a quiet and structured environment.
- C. Engage the client in creative arts activities.
- D. Allow the client to make decisions about their schedule.
Correct answer: B
Rationale: During a manic episode, individuals with bipolar disorder may experience heightened energy levels, decreased need for sleep, and racing thoughts. Providing a quiet and structured environment is crucial in managing these symptoms as it helps reduce external stimuli, prevent overstimulation, and promote a sense of calmness. Encouraging high levels of physical activity may exacerbate the manic symptoms by further increasing stimulation and excitement. Engaging the client in creative arts activities might be beneficial during stable periods but may not be the most appropriate intervention during a manic episode. Allowing the client to make decisions about their schedule could potentially lead to impulsivity and poor judgment, which are common characteristics of mania.
5. When evaluating the preoperative teaching of a client scheduled for arthroscopic anterior cruciate ligament repair, which statement by the client indicates that the teaching was effective?
- A. I will use crutches to keep my weight off my knee
- B. I will stay home until a wheelchair is delivered
- C. I can use the trapeze bar and side rails on the bed to help me turn regularly
- D. I can put my full weight on my foot starting the day after surgery
Correct answer: A
Rationale: The correct answer is A. Using crutches indicates an understanding of weight-bearing restrictions post-surgery. Choice B is incorrect because waiting for a wheelchair is not related to postoperative mobility instructions. Choice C is incorrect as turning in bed using the trapeze bar and side rails does not address weight-bearing restrictions. Choice D is incorrect because putting full weight on the foot immediately after surgery contradicts the need to keep weight off the knee.