HESI RN
HESI RN CAT Exit Exam Questions
Question 1 of 5
The nurse is caring for a client who is receiving heparin therapy. Which laboratory value should the nurse monitor to determine the effectiveness of the therapy?
Correct Answer: C
Rationale: Rationale: 1. Heparin primarily affects the intrinsic pathway of the coagulation cascade, monitored by PTT. 2. However, PTT can be influenced by various factors. 3. INR is a standardized measure of PT, more reliable for monitoring heparin therapy effectiveness. 4. Thus, INR is the most appropriate choice for monitoring heparin therapy. Other options are not as specific to heparin's action.
Question 2 of 5
The nurse is planning care for a client receiving chemotherapy. Which intervention should the nurse include to manage the client's nausea?
Correct Answer: A
Rationale: The correct answer is A: Administer an antiemetic before meals. Administering an antiemetic before meals helps prevent nausea in clients receiving chemotherapy by blocking the signals that trigger nausea and vomiting. By taking the antiemetic before meals, the client is less likely to experience nausea during or after eating. This proactive approach is effective in managing chemotherapy-induced nausea. Summary: - B: Providing frequent mouth care is important for oral hygiene but does not directly address the nausea caused by chemotherapy. - C: Encouraging small, frequent meals can help manage nausea, but administering an antiemetic before meals is a more targeted intervention. - D: Offering clear liquids may help with hydration but does not specifically address the nausea associated with chemotherapy.
Question 3 of 5
A 59-year-old male client is brought to the emergency room where he is assessed to have a Glasgow Coma Scale of 3. Based on this assessment, how should the nurse characterize the client's condition?
Correct Answer: D
Rationale: The correct answer is D because a Glasgow Coma Scale of 3 indicates severe neurological impairment, which is consistent with a comatose state and suggests a poor prognosis. The Glasgow Coma Scale ranges from 3 to 15, with lower scores indicating more severe impairment. A score of 3 is the lowest possible score, indicating deep unconsciousness. This client is not conscious, as indicated by the GCS score of 3, making choice C incorrect. Choice A is also incorrect as increased intracranial pressure may lead to altered consciousness but is not specifically indicated by a GCS score of 3. Choice B is incorrect as a GCS score of 3 indicates a very poor prognosis for recovery, not a good prognosis.
Question 4 of 5
A college student who is diagnosed with a vaginal infection and vulva irritation describes the vaginal discharge as having a 'cottage cheese' appearance. Which prescription should the nurse implement first?
Correct Answer: B
Rationale: The correct answer is B: Instill the first dose of nystatin (Mycostatin) vaginally per applicator. This is the first step because the description of the vaginal discharge as having a 'cottage cheese' appearance is indicative of a yeast infection, which is commonly caused by Candida species. Nystatin is an antifungal medication that targets Candida, making it the appropriate initial treatment for this type of infection. Cleansing the perineum with warm soapy water (choice A) may provide temporary relief but does not address the underlying infection. Performing a glucose measurement (choice C) is not relevant in this case unless diabetes is suspected. Obtaining a blood specimen for STD testing (choice D) is not necessary based on the symptoms described.
Question 5 of 5
The nurse-manager of a perinatal unit is notified that one client from the medical-surgical unit needs to be transferred to make room for new admissions. Which client should the nurse recommend for transfer to the antepartal unit?
Correct Answer: B
Rationale: The correct answer is B, a 35-year-old with lupus erythematosus, because the antepartal unit specializes in caring for pregnant women. Clients with chronic hepatitis B, rubella, and herpes lesions of the vulva do not require transfer to the antepartal unit as their conditions are not directly related to pregnancy. Lupus erythematosus, however, is a systemic autoimmune disease that can have implications for pregnancy outcomes, such as increased risk of preterm birth and preeclampsia. Therefore, transferring the client with lupus to the antepartal unit ensures specialized care and monitoring during pregnancy.