HESI RN
RN HESI Exit Exam Capstone
1. When assessing a client, why is it important for the nurse to be informed about cultural issues related to the client's background?
- A. Normal patterns of behavior may be labeled as deviant, immoral, or insane
- B. The meaning of the client's behavior can be derived from conventional wisdom
- C. Personal values will guide the interaction between individuals from different cultures
- D. The nurse should rely on her knowledge of different developmental mental stages
Correct answer: A
Rationale: Being aware of cultural differences is crucial because normal behaviors in one culture may be perceived as deviant, immoral, or insane in another. This awareness helps the nurse avoid misunderstandings or misinterpretations of behaviors that are considered acceptable in the client's cultural context but may be viewed differently in another. Choices B, C, and D are incorrect because understanding cultural issues goes beyond deriving meanings from conventional wisdom, personal values guiding interactions, or relying solely on knowledge of developmental mental stages.
2. A female client experiences a sudden loss of consciousness and is taken to the emergency department. Initial assessment indicates her blood glucose level is critically low. Once stabilized, she reports being treated for anorexia nervosa. What intervention is most important for the nurse to include in the client’s discharge plan?
- A. Encourage a high-protein, low-carbohydrate diet.
- B. Encourage her to join a group focusing on self-esteem.
- C. Schedule an outpatient psychosocial assessment.
- D. Teach relaxation techniques to manage stress.
Correct answer: B
Rationale: Joining a group that focuses on self-esteem is the most important intervention for the nurse to include in the client's discharge plan. This can help the client address underlying emotional issues related to her anorexia nervosa and improve her mental health. Choice A is incorrect because a high-protein, low-carbohydrate diet may not address the psychological factors contributing to anorexia nervosa. Choice C is incorrect as scheduling an outpatient psychosocial assessment is important but not the most crucial intervention for discharge planning in this case. Choice D is also not the priority as teaching relaxation techniques, although beneficial, may not directly address the self-esteem and emotional issues that need to be tackled in this situation.
3. A client presents with severe dehydration due to prolonged vomiting. What is the nurse's priority intervention?
- A. Encourage the client to drink clear fluids.
- B. Assess the client's skin turgor and mucous membranes.
- C. Monitor the client's vital signs frequently.
- D. Administer an antiemetic as prescribed.
Correct answer: B
Rationale: The correct answer is to assess the client's skin turgor and mucous membranes. When a client presents with severe dehydration, assessing skin turgor (elasticity of the skin) and mucous membranes (such as checking for dryness in the mouth) is crucial in determining the extent of dehydration. Encouraging the client to drink clear fluids (Choice A) may be important but assessing dehydration severity takes precedence. Monitoring vital signs (Choice C) is essential but assessing dehydration status comes first. Administering an antiemetic (Choice D) addresses vomiting but does not directly assess dehydration.
4. Which of the following statements reflects appropriate teaching to prevent injury in a client with rheumatoid arthritis?
- A. Use heat applications to relieve swelling and stiffness.
- B. Take warm showers before activity.
- C. Use cold packs to relieve joint pain.
- D. Take prescribed anti-inflammatory medications with meals.
Correct answer: C
Rationale: The correct answer is C. Using cold packs to relieve joint pain is appropriate for clients with rheumatoid arthritis as cold therapy is more effective at reducing inflammation and pain in these conditions. Heat applications may exacerbate the symptoms by increasing swelling. Taking warm showers before activity may provide comfort but does not directly address joint pain or prevent injury. While anti-inflammatory medications are commonly prescribed, they are not directly related to preventing injury in clients with rheumatoid arthritis.
5. 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.
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