HESI RN
HESI RN CAT Exit Exam Questions
Question 1 of 5
A client who has had three spontaneous abortions is requesting information about possible causes. The nurse's response should be based on which information?
Correct Answer: A
Rationale: The correct answer is A. Chromosomal abnormalities are the most common cause of early spontaneous abortions. This is because genetic defects in the embryo are a significant factor in early pregnancy loss. Chromosomal abnormalities can prevent the embryo from developing properly, leading to spontaneous abortion. B: Incompetent cervix is a cause of late miscarriages, not early spontaneous abortions. C: Infections can cause spontaneous abortions, but they are not the most common cause. D: While nutritional deficiencies can impact pregnancy outcomes, chromosomal abnormalities are more prevalent in early spontaneous abortions.
Question 2 of 5
A nurse is planning care for a client in the late stage of amyotrophic lateral sclerosis (ALS). Which nursing diagnosis has the highest priority?
Correct Answer: B
Rationale: The correct answer is B: Ineffective breathing pattern. In late-stage ALS, respiratory muscle weakness leads to ineffective breathing, posing the highest risk to the client's immediate survival. Priority is given to maintaining adequate oxygenation. Impaired physical mobility (A) is important but not life-threatening. Impaired skin integrity (C) and risk for infection (D) can be managed once the client's breathing is stabilized.
Question 3 of 5
The nurse assesses a client who is receiving an infusion of 5% dextrose in water with 20 mEq of potassium chloride. The client has oliguria and a serum potassium level of 6.5 mEq/L. What action should the nurse implement first?
Correct Answer: C
Rationale: The correct action for the nurse to implement first is to stop the infusion (Choice C). Oliguria and high serum potassium level indicate potential renal impairment or potassium retention, which can lead to hyperkalemia. Stopping the infusion is crucial to prevent further potassium buildup and worsening kidney function. Notifying the healthcare provider (Choice A) can be done after stopping the infusion. Decreasing the infusion rate (Choice B) may not be sufficient to address the immediate risk of hyperkalemia. Administering sodium polystyrene sulfonate (Kayexalate) (Choice D) is a treatment for hyperkalemia but should not be the initial action in this situation.
Question 4 of 5
The nurse is administering total parenteral nutrition (TPN) via a central line at 75 ml/hour to a client who had a bowel resection 4 days ago. Which laboratory finding requires the most immediate intervention by the nurse?
Correct Answer: D
Rationale: The correct answer is D: Serum calcium of 7.8 mg/dL. This finding indicates hypocalcemia, which can lead to serious complications like tetany or seizures. Hypocalcemia is a common complication after bowel resection due to impaired absorption. Immediate intervention is crucial to prevent further complications. A: Blood glucose of 140 mg/dL is within normal range and does not require immediate intervention. B: White blood cell count of 8000/mm³ is within normal range and does not require immediate intervention. C: Serum potassium of 3.8 mEq/L is within normal range and does not require immediate intervention.
Question 5 of 5
The nurse is evaluating the health status of an older client. Which finding is most important for the nurse to report to the healthcare provider?
Correct Answer: C
Rationale: The correct answer is C because pain in the lower back in an older client can be indicative of a serious underlying issue such as a kidney infection, kidney stones, or spinal issues. The nurse should report this finding to the healthcare provider promptly for further evaluation and intervention to prevent potential complications. Choice A is not as urgent as it may indicate dehydration or renal issues, but it is not as critical as the potential issues related to back pain. Choice B, loss of appetite, is important but may not be as urgent as potential kidney or spinal issues. Choice D, a persistent cough, is also important but may not be as immediately concerning as the possibility of a serious condition related to lower back pain in an older client.