HESI RN
HESI RN Exit Exam Capstone Questions
Question 1 of 5
A client is receiving 30 mg of enoxaparin subcutaneously twice a day. In assessing adverse effects of the medication, which serum laboratory value is most important for the nurse to monitor?
Correct Answer: B
Rationale: In the context of a client receiving enoxaparin, a low molecular weight heparin, monitoring the platelet count is crucial. Enoxaparin works by inhibiting blood clot formation, which can lead to a condition called heparin-induced thrombocytopenia (HIT), characterized by a significant drop in platelet count. Monitoring platelet levels helps detect this potentially life-threatening adverse effect early. Hemoglobin level (Option A) is not directly affected by enoxaparin and is not the most important value to monitor in this case. Activated partial thromboplastin time (aPTT) (Option C) and Prothrombin time (PT) (Option D) are more commonly used to monitor the effects of unfractionated heparin, not enoxaparin, which has a more predictable anticoagulant response and does not require routine monitoring based on these values. In an educational context, understanding the rationale behind monitoring specific laboratory values for patients on anticoagulant therapy is critical for nurses to provide safe and effective care. Emphasizing the importance of monitoring platelet count in this scenario can help nurses recognize and respond promptly to adverse effects, ultimately improving patient outcomes.
Question 2 of 5
The nurse is caring for a preterm newborn with nasal flaring, grunting, and sternal retractions. After administering surfactant, which assessment is most important for the nurse to monitor?
Correct Answer: C
Rationale: In this scenario, the correct answer is C) Arterial blood gases. After administering surfactant to a preterm newborn with respiratory distress symptoms like nasal flaring, grunting, and sternal retractions, monitoring arterial blood gases is crucial. Arterial blood gases provide vital information about the newborn's oxygenation and ventilation status, helping the nurse assess the effectiveness of the surfactant therapy in improving gas exchange. Option A) Bowel sounds, while important for assessing gastrointestinal function, is not the priority in this case where the focus is on respiratory distress. Option B) Heart rate, though important for overall assessment, is not as directly related to the effectiveness of surfactant therapy in improving respiratory function. Option D) Apnea episodes are significant in preterm newborns but in this context, monitoring arterial blood gases takes precedence as it directly reflects the respiratory status and the impact of surfactant therapy on oxygenation and ventilation. Educationally, this question underscores the importance of prioritizing assessments based on the patient's condition and the interventions provided, highlighting the critical role of arterial blood gases in evaluating respiratory function in neonates with respiratory distress.
Question 3 of 5
The nurse has received funding to design a health promotion project for African American women who are at risk for developing breast cancer. Which resource is most important in designing this program?
Correct Answer: A
Rationale: In designing a health promotion project for African American women at risk for developing breast cancer, the most important resource is the participation of community leaders in planning the program (Option A). This is because community leaders have a deep understanding of the specific needs, cultural nuances, and barriers faced by the target population. Their involvement ensures that the program is culturally sensitive, relevant, and effectively reaches the intended audience. The other options are not as crucial for designing this specific health promotion project. While the latest research on breast cancer risk factors (Option B) is important for informing evidence-based interventions, without the input and guidance of community leaders, the program may not effectively resonate with the African American women it aims to serve. Partnership with local healthcare providers (Option C) is valuable for service provision but may not address the unique community-level factors that influence health behaviors. Health surveys of African American women in the community (Option D) can provide insights but may lack the overarching community perspective that leaders can offer. In an educational context, this question highlights the significance of community engagement and cultural competence in developing health interventions. It underscores the importance of involving key stakeholders from the target population in program planning to ensure its success and impact. Students can learn how community collaboration enhances the relevance and effectiveness of health promotion initiatives, particularly in addressing health disparities among diverse populations.
Question 4 of 5
Which activity is most important for a client recovering from a hip replacement to avoid during the first few weeks of recovery?
Correct Answer: B
Rationale: In the context of a client recovering from a hip replacement surgery, it is crucial to emphasize the importance of avoiding actions that could jeopardize the healing process and potentially lead to complications. Crossing the legs while sitting, as mentioned in option B, should be avoided during the initial weeks of recovery because it can place stress on the hip joint and the surrounding tissues, increasing the risk of dislocation or strain. Option A, sitting in a chair for short periods, is a recommended activity as it promotes rest and allows the hip to recover without excessive strain. Option C, walking with assistance, is also beneficial for promoting circulation and preventing complications such as blood clots, as long as the proper precautions and weight-bearing restrictions are followed. Option D, performing light stretching exercises, can be beneficial in the later stages of recovery to improve flexibility and strength but should be avoided initially to prevent undue stress on the healing hip joint. Educationally, this question highlights the importance of understanding post-operative care guidelines specific to hip replacement surgery. It reinforces the significance of patient education regarding movement restrictions to ensure a smooth recovery process and reduce the risk of complications. By choosing the correct answer, students demonstrate their grasp of essential post-operative precautions for hip replacement patients.
Question 5 of 5
The nurse is assessing a client with chronic obstructive pulmonary disease (COPD) who has been experiencing increasing shortness of breath. Which finding requires immediate intervention?
Correct Answer: D
Rationale: In this scenario, the correct answer is option D: A pulse oximetry reading of 88%. This finding indicates that the client's oxygen saturation level is below the normal range (usually 95-100%), which is a critical concern in a patient with COPD experiencing increasing shortness of breath. Immediate intervention is necessary to prevent hypoxia and its detrimental effects on vital organs. Option A, a respiratory rate of 26 breaths per minute, while elevated, may be a compensatory mechanism for hypoxia and is not as immediately concerning as low oxygen saturation. Option B, the use of accessory muscles for breathing, is a sign of increased work of breathing but does not indicate the severity of hypoxia. Option C, a barrel chest appearance, is a chronic finding in COPD due to hyperinflation of the lungs and is not an acute sign requiring immediate intervention. Educationally, this question highlights the importance of prioritizing assessments based on the urgency of the client's condition. Understanding the significance of oxygen saturation levels in respiratory distress is crucial for nurses caring for patients with COPD and other respiratory conditions. Early recognition and intervention in hypoxemic patients can prevent further deterioration and improve outcomes.