HESI RN
HESI RN Exit Exam Capstone Questions
Question 1 of 5
A client with heart failure is prescribed spironolactone. What is the nurse's priority intervention?
Correct Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic, so the nurse should closely monitor for signs of hyperkalemia, which can lead to cardiac arrhythmias.
Question 2 of 5
The nurse is caring for a client with a chest tube following surgery. The nurse should intervene if which of the following is observed?
Correct Answer: C
Rationale: The chest drainage system should always be kept below chest level to ensure proper drainage.
Question 3 of 5
An older client is admitted to the intensive care unit unconscious after several days of vomiting and diarrhea. The nurse inserts a urinary catheter and observes dark amber urine output. Which intervention should the nurse implement first?
Correct Answer: C
Rationale: A fluid bolus is the first step in stabilizing a client with hypovolemic symptoms.
Question 4 of 5
A client admitted with left-sided heart failure presents with shortness of breath and pink frothy sputum. Which assessment finding requires immediate intervention?
Correct Answer: C
Rationale: Pink frothy sputum is a sign of pulmonary edema, which needs immediate intervention to prevent respiratory failure.
Question 5 of 5
A client with a peripherally inserted central catheter (PICC) line has a fever. What client assessment is most important for the nurse to perform?
Correct Answer: B
Rationale: Observing the antecubital fossa for inflammation can indicate infection or complications related to the PICC line, which is critical to assess in clients with a fever.
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