HESI RN
HESI RN Exit Exam Capstone Questions
Question 1 of 5
A client with diabetes mellitus is experiencing diabetic ketoacidosis (DKA). What laboratory result should the nurse monitor closely?
Correct Answer: B
Rationale: In a client with diabetic ketoacidosis (DKA), the nurse should closely monitor the blood glucose level, making option B the correct answer. DKA is a serious complication of diabetes characterized by high blood sugar levels, dehydration, and ketone formation. Monitoring blood glucose levels is crucial in managing DKA as it indicates the effectiveness of treatment and helps prevent complications such as cerebral edema. Option A, a white blood cell count of 15,000, may indicate an infection but is not the most critical parameter to monitor in DKA. Option C, a sodium level of 145 mEq/L, is within normal range and not directly related to DKA management. Option D, a serum creatinine level of 1.0 mg/dL, assesses kidney function and may be important for overall health assessment but is not as immediately relevant as monitoring blood glucose levels in DKA. Educationally, understanding the importance of monitoring specific laboratory values in DKA highlights the critical thinking skills required in nursing practice. It reinforces the need for prioritization of care based on the client's condition and the significance of timely interventions to prevent complications and promote positive outcomes for the client.
Question 2 of 5
A client with deep vein thrombosis (DVT) is prescribed warfarin. What lab value should the nurse review before administering the medication?
Correct Answer: C
Rationale: In this scenario, the correct lab value that the nurse should review before administering warfarin to a client with deep vein thrombosis (DVT) is the International Normalized Ratio (INR). The INR is specifically used to monitor and adjust warfarin therapy, which is a common anticoagulant medication used to treat and prevent blood clots such as DVT. By checking the INR, the healthcare provider can assess the patient's blood clotting time and determine if the warfarin dosage is within the therapeutic range to effectively prevent clot formation without causing excessive bleeding. Regarding the other options: A) Prothrombin time (PT): While PT is related to warfarin therapy, INR is a more precise measure when monitoring patients on warfarin. B) Hemoglobin and hematocrit (H&H): These values are important for assessing anemia and blood volume but are not directly related to monitoring warfarin therapy. D) Partial thromboplastin time (PTT): PTT is more commonly used to monitor heparin therapy, another type of anticoagulant, not warfarin. Educationally, understanding the rationale behind selecting the correct lab value is crucial for nurses caring for patients on anticoagulant therapy. It ensures safe medication administration and effective management of conditions like DVT, highlighting the importance of monitoring and interpreting lab values accurately in clinical practice.
Question 3 of 5
A client is receiving a blood transfusion and reports feeling chilled and short of breath. What is the nurse's priority action?
Correct Answer: A
Rationale: In this scenario, the nurse's priority action should be to stop the transfusion and notify the healthcare provider immediately. This is the correct answer because the client is experiencing signs of a transfusion reaction, which can be life-threatening if not addressed promptly. By stopping the transfusion, the nurse can prevent further harm to the client. Option B, administering an antihistamine, is incorrect because antihistamines are not the first-line treatment for transfusion reactions. Option C, administering acetaminophen, and Option D, administering diphenhydramine, are also incorrect as they do not address the potential serious nature of the client's symptoms. Educationally, this question highlights the importance of prompt recognition and intervention in managing transfusion reactions, a critical aspect of nursing practice. It underscores the significance of prioritizing client safety and advocating for appropriate care in emergency situations. Nurses must be vigilant in monitoring clients during transfusions and prepared to act swiftly in response to any adverse reactions.
Question 4 of 5
A client with hypothyroidism is prescribed levothyroxine. What assessment finding suggests the medication dosage is too high?
Correct Answer: B
Rationale: In the context of hypothyroidism, the correct answer is B) Increased heart rate and palpitations. When a client is prescribed levothyroxine for hypothyroidism, the medication aims to supplement the deficient thyroid hormone. If the dosage is too high, it can lead to symptoms of hyperthyroidism, such as increased heart rate and palpitations, indicating the need for dose adjustment. Option A) Increased sensitivity to cold is a symptom of hypothyroidism, so it would not suggest an overdose of levothyroxine. Option C) Improved energy levels and Option D) Improved tolerance to heat are actually positive signs that the medication is effective in treating hypothyroidism and not indicative of an overdose. In an educational context, understanding the appropriate dosage and monitoring for signs of overmedication in hypothyroidism is crucial for nursing practice. Recognizing the symptoms of both hypo- and hyperthyroidism allows nurses to provide safe and effective care for clients with thyroid disorders. This rationale highlights the importance of accurate medication administration and vigilant assessment in managing thyroid conditions.
Question 5 of 5
A client who had a vasectomy is in the post recovery unit at an outpatient clinic. Which of these points is most important to be reinforced by the nurse?
Correct Answer: A
Rationale: The correct answer is option A: "Until the health care provider has determined that your ejaculate doesn't contain sperm, continue to use another form of contraception." This is the most important point to reinforce because after a vasectomy, it takes time and multiple ejaculations to clear the remaining sperm from the reproductive system. It is crucial for the client to understand that pregnancy can still occur until testing confirms the absence of sperm in the ejaculate. Option B is incorrect because it focuses on the physiological changes post-vasectomy but does not address the need for continued contraception until sperm absence is confirmed. Option C provides information on post-operative care and recovery but does not address the need for ongoing contraception. Option D discusses pain management post-vasectomy but does not address the importance of contraception or sperm testing. From an educational perspective, it is essential to emphasize the importance of clear communication and understanding regarding post-vasectomy care, including the need for continued contraception until sperm absence is confirmed. Reinforcing this point helps prevent unintended pregnancies and ensures the client's full comprehension of the post-operative instructions.