HESI RN
HESI RN Exit Exam 2024 Quizlet Questions
Question 1 of 5
An older female client tells the nurse that her muscles have gradually been getting weaker. What is the best initial response by the nurse?
Correct Answer: D
Rationale: The best initial response by the nurse when the client reports muscle weakness is to ask the client to describe the changes that have occurred. This approach allows the nurse to gain a better understanding of the client's experience, the extent of weakness, any associated symptoms, and potential triggers. By actively listening to the client's description, the nurse can gather valuable information that will aid in a comprehensive assessment and development of a tailored care plan. Choice A is incorrect because assuming muscle weakness is solely due to aging without further assessment can lead to overlooking potential underlying causes. Choice B is incorrect as observing for signs of muscle atrophy should come after gathering information directly from the client. Choice C is incorrect as reviewing diagnostic test results should not be the initial step when the client's current experience is being shared.
Question 2 of 5
A female client reports that she drank a liter of a solution to cleanse her intestines but vomited immediately. How many ml of fluid intake should the nurse document?
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 3 of 5
Progressive kyphoscoliosis leading to respiratory distress is evident in a client with muscular dystrophy. Which finding warrants immediate intervention by the nurse?
Correct Answer: D
Rationale: The correct answer is D: Evidence of hypoventilation. In a client with muscular dystrophy and progressive kyphoscoliosis, hypoventilation indicates respiratory muscle weakness and can lead to life-threatening respiratory distress. Immediate intervention is crucial to prevent complications. Choices A, B, and C are incorrect because while extremity muscle weakness, bilateral eyelid drooping, and inability to swallow pills are concerning symptoms in muscular dystrophy, evidence of hypoventilation poses a more immediate threat to the client's respiratory status.
Question 4 of 5
During the initial visit to a client with MS who is bed-bound and lifted by a hoist, which intervention is most important for the nurse to implement?
Correct Answer: A
Rationale: During the initial visit, the most crucial intervention for the nurse is to determine how the client is cared for when the caregiver is not present. This is essential to ensure the client's safety and well-being, especially during times when the caregiver is not available. Option B is not the most important as it focuses on assessment rather than immediate safety concerns. Option C, while important, is secondary to ensuring continuous care. Option D is less critical during the initial visit compared to ensuring care continuity in the caregiver's absence.
Question 5 of 5
An adult female client with chronic kidney disease (CKD) asks the nurse if she can continue taking her over-the-counter medications. Which medication poses the greatest threat to this client?
Correct Answer: A
Rationale: The correct answer is A, Magnesium hydroxide (Maalox). In clients with chronic kidney disease (CKD), magnesium can accumulate to toxic levels as the kidneys are unable to excrete it efficiently. This can lead to hypermagnesemia, causing serious and potentially life-threatening complications. Birth control pills (choice B) are metabolized mainly by the liver and do not pose a significant threat to clients with CKD. Cough syrup containing codeine (choice C) should be used cautiously in CKD due to the risk of respiratory depression but does not pose as great a threat as magnesium accumulation. Cold medication containing alcohol (choice D) should be avoided in CKD but does not present the same level of danger as magnesium toxicity.