HESI RN
HESI RN CAT Exit Exam Questions
Question 1 of 5
A child with Leukemia is admitted for chemotherapy, and the nursing diagnosis, altered nutrition, less than body requirements related to anorexia, nausea, vomiting is identified. Which intervention should the nurse include in this child's plan of care?
Correct Answer: A
Rationale: Step 1: A child with Leukemia undergoing chemotherapy often experiences anorexia, nausea, and vomiting, leading to altered nutrition. Step 2: Allowing the child to eat foods desired and tolerated promotes intake, ensuring adequate nutrition. Step 3: Restricting foods (Choice B) can exacerbate the child's already limited intake and lead to nutritional deficiencies. Step 4: Recommending the same foods as siblings (Choice C) may not address the specific needs of the child undergoing chemotherapy. Step 5: Encouraging large portions of food (Choice D) may overwhelm the child and worsen their symptoms.
Question 2 of 5
A client with an electrical burn on the forearm asks the nurse why there is no feeling of pain from the burn. During the dressing change, the nurse determines that the burn is dry, waxy, and white. What information should the nurse provide this client?
Correct Answer: C
Rationale: The correct answer is C because full-thickness burns destroy nerve endings, resulting in the absence of pain sensation. The dry, waxy, and white appearance indicates tissue destruction extending through the epidermis and dermis. Choices A and D are incorrect because dry, waxy, and white appearance signifies a deeper burn, not a minor or superficial burn, and second-degree burns typically involve pain sensation. Choice B is incorrect as nerve compression does not explain the lack of pain sensation in a full-thickness burn.
Question 3 of 5
A client with type 2 diabetes mellitus is admitted for antibiotic treatment of a leg ulcer. Which signs and symptoms, indicative of hyperosmolar hyperglycemic nonketotic syndrome (HHNS), should the nurse report to the healthcare provider? (Select one that doesn't apply.)
Correct Answer: C
Rationale: The correct answer is C: Presence of uremic frost. HHNS is characterized by severe hyperglycemia leading to osmotic diuresis and dehydration, not uremia. A: Increased heart rate is a non-specific sign of stress. B: Visual disturbances can be seen in diabetic retinopathy but are not specific to HHNS. D: Decreased mentation is common in HHNS due to severe dehydration and hyperglycemia leading to altered mental status.
Question 4 of 5
The client diagnosed with a right fractured femur has skeletal traction applied to the right femur. Which interventions should the nurse implement?
Correct Answer: D
Rationale: The correct answer is D: Maintain skeletal pin sites and assess for signs of infection. This is important to prevent complications like infection, which can be severe. The nurse should regularly assess the pin sites for redness, swelling, or discharge. This intervention ensures early detection and prompt treatment of any signs of infection, reducing the risk of serious complications. Choice A is incorrect because performing passive range of motion to the right leg may disrupt the traction and interfere with the healing process. Choice B is incorrect because removing skeletal weights every shift can lead to loss of traction, compromising the fracture alignment and healing process. Choice C is incorrect because turning the client frequently from prone to supine positions may also disrupt the traction and increase the risk of complications.
Question 5 of 5
An angry client screams at the emergency department triage nurse, 'I've been waiting here for two hours! You and the staff are incompetent.' What is the best response for the nurse to make?
Correct Answer: D
Rationale: The correct answer is D because it demonstrates empathy and acknowledges the client's feelings without admitting fault. By saying "I understand you are frustrated with the wait time," the nurse validates the client's emotions and shows a willingness to listen and address concerns. This response can help de-escalate the situation and build rapport. Choice A is incorrect because it doesn't directly address the client's emotions. Choice B is incorrect as it prioritizes the client based on their anger rather than medical need. Choice C is incorrect as it may come off as dismissive of the client's feelings and lacks empathy.