HESI RN
HESI RN Exit Exam Capstone Questions
Question 1 of 5
The healthcare provider prescribes an IV infusion of isoproterenol in D5W at 300 mcg/hour. How many ml/hour should the nurse set the pump to?
Correct Answer: B
Rationale: In this scenario, the correct answer is B) 75 ml/hour. To calculate the infusion rate, we need to consider the concentration of the medication in the solution. Isoproterenol is ordered at 300 mcg/hour and is diluted in D5W. To determine the mL/hour rate, we need to convert the mcg to mg (1 mcg = 0.001 mg) and then calculate the total volume of the solution. Considering the concentration of isoproterenol and the diluent, the correct calculation is as follows: 300 mcg/hour = 0.3 mg/hour 0.3 mg x 1000 mcg = 300 mcg in 1 ml So, 0.3 mg is in 1 ml of the solution. Therefore, the nurse should set the pump to 75 ml/hour to deliver the prescribed dose of isoproterenol. Now, let's analyze the other options: A) 100 ml/hour: This is incorrect because it does not consider the concentration of the medication and would result in an incorrect dosage. C) 60 ml/hour: This option is incorrect as it does not account for the correct rate of infusion needed for the prescribed dose. D) 125 ml/hour: This option is incorrect as it would result in an incorrect dosage due to not considering the concentration of the medication. Understanding medication calculations is crucial for nurses to ensure patient safety and provide accurate care. Nurses must be able to calculate infusion rates correctly to administer medications safely and effectively. Practice and proficiency in medication calculations are essential skills for nursing practice.
Question 2 of 5
A client is admitted with ascites, malnutrition, and recent complaints of spitting up blood. What assessment finding warrants immediate intervention by the nurse?
Correct Answer: C
Rationale: In this scenario, the assessment finding that warrants immediate intervention by the nurse is option C) Round and tight abdomen. This finding indicates a potential complication of ascites, such as abdominal compartment syndrome, which can lead to impaired circulation, respiratory compromise, and even organ failure. Immediate intervention is crucial to prevent further deterioration of the client's condition. Option A) Capillary refill of 8 seconds is a concerning finding but is not as critical as a round and tight abdomen in this context. It may indicate issues with perfusion, but it does not directly address the immediate threat posed by a tense abdomen. Option B) Bruises on arms and legs may suggest a bleeding disorder or trauma but do not directly address the urgent issue of a round and tight abdomen. Option D) Pitting edema in lower legs is a common finding in clients with ascites and may be related to fluid retention, but it does not indicate the same level of urgency as a tense abdomen. Educationally, understanding the significance of different assessment findings in clients with ascites is crucial for nurses caring for these patients. Recognizing the signs of complications like abdominal compartment syndrome and knowing when to intervene promptly can help prevent adverse outcomes and improve patient care.
Question 3 of 5
While palpating the gallbladder of a mildly obese client, the nurse expects what finding if the gallbladder is inflamed?
Correct Answer: A
Rationale: In this scenario, the correct answer is A) Severe tenderness and guarding. When the gallbladder is inflamed, it typically results in acute cholecystitis, which presents with severe tenderness and guarding upon palpation. This is due to the inflammation of the gallbladder wall, causing localized pain and sensitivity to touch. Option B) Slight discomfort upon palpation is incorrect because inflammation of the gallbladder usually elicits more than just slight discomfort. The severity of the tenderness is typically more pronounced in cases of cholecystitis. Option C) A sensation of fullness is incorrect because a sensation of fullness is not a characteristic finding associated with an inflamed gallbladder. The key feature is tenderness and guarding due to the inflammatory process. Option D) No symptoms unless the gallbladder is extremely inflamed is incorrect because even mild inflammation of the gallbladder can present with symptoms such as tenderness and guarding upon palpation. Educationally, understanding the signs and symptoms of gallbladder inflammation is crucial for nurses to assess and intervene promptly, especially in patients with risk factors for gallbladder disease. Recognizing the specific manifestations of gallbladder inflammation helps in timely diagnosis and treatment to prevent complications such as gallbladder rupture or infection.
Question 4 of 5
Where should the nurse consider starting a screening program for hypothyroidism?
Correct Answer: B
Rationale: In the context of starting a screening program for hypothyroidism, the nurse should consider beginning at an African-American senior citizens' center (Option B) for several reasons. Firstly, hypothyroidism is more prevalent among older adults, making a senior citizens' center a suitable location for screening. African-Americans also have a higher risk of developing hypothyroidism compared to other ethnic groups, further supporting the choice of this demographic. Additionally, older adults may have limited access to healthcare services and may benefit from on-site screenings. Options A, C, and D are not ideal choices for starting a screening program for hypothyroidism. A business and professional women's group (Option A) may not represent a demographic with a high prevalence of hypothyroidism. Similarly, a daycare center in a Hispanic neighborhood (Option C) and an after-school center for Native American teens (Option D) cater to populations that are not typically at high risk for hypothyroidism. From an educational perspective, this question highlights the importance of considering demographic factors and prevalence rates when planning health screening programs. It emphasizes the need for targeted and strategic approaches to healthcare interventions, especially when dealing with conditions that disproportionately affect specific populations. Nurses and healthcare providers must be knowledgeable about epidemiological data and cultural considerations to effectively address community health needs.
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: In this scenario, the correct answer is B) Observe the antecubital fossa for inflammation. This assessment is crucial because a fever in a client with a PICC line could indicate phlebitis, which is inflammation of the vein. Observing the antecubital fossa can help the nurse identify early signs of inflammation, such as redness, warmth, and swelling, which are indicative of phlebitis. Option A is incorrect because while inspecting the PICC insertion site for signs of infection is important, in this case, the focus is on assessing for inflammation in the antecubital fossa. Option C, auscultating lung sounds for signs of respiratory distress, is not directly related to the assessment of a fever in a client with a PICC line. Option D, checking for signs of phlebitis or thrombosis along the catheter site, seems relevant but does not specifically address the immediate concern of assessing for inflammation in the antecubital fossa. Educationally, this question highlights the importance of understanding the implications of a fever in a client with a PICC line and the significance of assessing for early signs of phlebitis. It emphasizes the need for nurses to be thorough in their assessments to promptly identify and address potential complications in clients with invasive devices.