HESI RN
HESI RN CAT Exit Exam 1
1. Which client requires careful nursing assessment for signs and symptoms of hypomagnesaemia?
- A. A young adult client with intractable vomiting due to food poisoning
- B. A client who developed hyperparathyroidism in late adolescence
- C. A middle-aged male client in renal failure following an unsuccessful kidney transplant
- D. A female client who excessively consumes simple carbohydrates
Correct answer: C
Rationale: The correct answer is C. Clients in renal failure are at high risk for hypomagnesemia due to their impaired kidney function. Renal failure can lead to decreased excretion of magnesium, resulting in its buildup in the body and potential hypomagnesemia. This client requires careful nursing assessment for signs and symptoms of hypomagnesemia to prevent complications. Choices A, B, and D are not as directly associated with renal failure and its impact on magnesium levels. Intractable vomiting, hyperparathyroidism, and excessive consumption of simple carbohydrates may have other health implications but are not as strongly linked to hypomagnesemia as renal failure.
2. When the nurse enters the room to change the dressing of a male client with cancer, he asks, 'Have you ever been with someone when they died?' What is the nurse's best response to him?
- A. Yes, I have. Do you have some questions about dying?
- B. Several times. Now, let's get your dressing changed.
- C. A few times. It was peaceful and there was no pain.
- D. Yes, but you're doing great. Are you concerned about dying?
Correct answer: A
Rationale: The correct response is to acknowledge the client's question and open the door for further discussion by asking if they have questions about dying. This approach allows the nurse to address the client's concerns and fears, promoting open communication and providing emotional support. Choices B and C do not encourage further dialogue about the client's feelings and concerns regarding death. Choice D briefly acknowledges the question but does not actively invite the client to express their thoughts and emotions regarding dying.
3. While teaching a group of adults about health promotion activities, a nurse identifies a behavior that poses the most significant risk factor for the development of skin cancer. Which behavior should the nurse address?
- A. Consuming a high-fat diet
- B. Using tanning beds
- C. Smoking cigarettes
- D. Drinking alcohol
Correct answer: B
Rationale: Using tanning beds is the most significant risk factor for developing skin cancer. Ultraviolet (UV) radiation from tanning beds damages the skin and increases the risk of skin cancer. Consuming a high-fat diet, smoking cigarettes, and drinking alcohol are unhealthy behaviors but are not directly linked to the development of skin cancer like UV exposure from tanning beds.
4. A client in acute renal failure has a serum potassium of 7.5 mEq/L. Based on this finding, the nurse should anticipate implementing which action?
- A. Administer an IV of normal saline rapidly and NPH insulin subcutaneously.
- B. Administer a retention enema of Kayexalate.
- C. Add 40 mEq of KCL (potassium chloride) to the present IV solution.
- D. Administer a lidocaine bolus IV push.
Correct answer: B
Rationale: In acute renal failure with a high serum potassium level, the priority intervention is to lower potassium levels to prevent complications like cardiac arrhythmias. Administering a retention enema of Kayexalate is the correct action as it helps lower high potassium levels by exchanging sodium for potassium in the intestines. Options A, C, and D are incorrect. Administering normal saline rapidly and NPH insulin or adding more potassium to the IV solution can further increase potassium levels, worsening the condition. Lidocaine is not indicated for treating hyperkalemia.
5. A nurse is planning care for a client who is receiving chemotherapy. Which intervention should the nurse include to manage the client's nausea?
- A. Administer an antiemetic before meals
- B. Provide frequent mouth care
- C. Encourage small, frequent meals
- D. Offer clear liquids
Correct answer: A
Rationale: Administering an antiemetic before meals is a crucial intervention to manage chemotherapy-induced nausea. Antiemetics are medications specifically designed to prevent or relieve nausea and vomiting. By administering the antiemetic before meals, the nurse can help prevent the onset of nausea, allowing the client to eat more comfortably. Providing frequent mouth care (Choice B) is important for maintaining oral hygiene but does not directly address nausea. Encouraging small, frequent meals (Choice C) and offering clear liquids (Choice D) are generally recommended for clients experiencing nausea, but administering an antiemetic is a more targeted approach to specifically address and manage the symptom.
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