HESI RN
HESI RN Exit Exam Capstone Questions
Question 1 of 5
A young woman with multiple sclerosis just received several immunizations in preparation for moving into a college dormitory. Two days later, she reports to the nurse that she is experiencing increasing fatigue and visual problems. What teaching should the nurse provide?
Correct Answer: A
Rationale: In this scenario, the correct answer is option A) Immunizations can trigger a relapse of the disease, so get plenty of extra rest. This is the most appropriate response because immunizations can potentially stimulate an immune response that may exacerbate symptoms in individuals with autoimmune conditions like multiple sclerosis. Encouraging the young woman to rest can help her body recover and manage any potential flare-up more effectively. Option B is incorrect because visual problems could be related to the immunizations in the context of multiple sclerosis. Option C, increasing fluid intake, may be beneficial for overall health but is not directly addressing the potential relapse triggered by the immunizations. Option D, immediate consultation for steroid therapy, is not the first-line intervention and should be reserved for cases where symptoms worsen significantly or if there is a confirmed relapse. From an educational perspective, this scenario highlights the importance of understanding the potential effects of immunizations on individuals with autoimmune conditions. Nurses play a crucial role in providing tailored education and support to help patients manage their health proactively. It also emphasizes the significance of rest and self-care in managing chronic conditions like multiple sclerosis during potential exacerbations.
Question 2 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 3 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 4 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.
Question 5 of 5
The nurse is caring for a client with pancreatitis who is receiving total parenteral nutrition (TPN). Which assessment finding requires immediate intervention by the nurse?
Correct Answer: B
Rationale: In this scenario, the correct answer is option B) The client reports feeling weak and shaky, which requires immediate intervention by the nurse. This symptom could indicate hypoglycemia, a potential complication of TPN therapy in pancreatitis patients. Hypoglycemia can lead to serious consequences like seizures or loss of consciousness, thus necessitating prompt attention. Option A) Blood glucose level of 200 mg/dL may be slightly elevated but does not pose an immediate threat. Option C) The TPN bag is 5% dextrose could be a normal concentration for TPN and does not indicate an urgent issue. Option D) The client feeling thirsty may suggest dehydration, which is important to address but not as critical as potential hypoglycemia. From an educational perspective, this question highlights the importance of recognizing and prioritizing assessments in patients receiving TPN, especially those with pancreatitis. Nurses must be vigilant in monitoring for complications like hypoglycemia and be prepared to intervene promptly to ensure patient safety and well-being.