HESI RN
HESI RN Exit Exam Capstone Questions
Question 1 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 2 of 5
A client with diabetes insipidus is admitted due to a pituitary tumor. What complication should the nurse monitor for closely?
Correct Answer: D
Rationale: In this scenario, the correct answer is D) Monitor for hypokalemia. Diabetes insipidus, caused by a pituitary tumor, leads to excessive urination and subsequent loss of water and electrolytes, particularly sodium and potassium. As a result, hypokalemia (low potassium levels) is a common complication that the nurse should closely monitor for. Option A) Monitoring for elevated blood pressure is not directly related to the pathophysiology of diabetes insipidus caused by a pituitary tumor. While diabetes insipidus can lead to dehydration, impacting blood pressure, it is not the most significant complication to monitor in this case. Option B) Monitoring for ketonuria is more relevant in conditions like diabetic ketoacidosis, which is not typically associated with diabetes insipidus. Option C) Monitoring for peripheral edema is more commonly seen in conditions like heart failure or renal issues, rather than diabetes insipidus. Understanding the specific electrolyte imbalances and complications associated with diabetes insipidus due to a pituitary tumor is crucial for nurses caring for these patients. Monitoring potassium levels closely can prevent potentially serious consequences such as cardiac arrhythmias and muscle weakness.
Question 3 of 5
The nurse observes that a client's wrist restraint is secured to the side rail of the bed. What action should the nurse take?
Correct Answer: B
Rationale: In this scenario, the nurse should reposition the restraint tie onto the bedframe (Option B). This is the correct action because securing the restraint to the side rail of the bed poses a risk of entrapment or injury to the client. By moving the restraint tie to the bedframe, the client can still be safely immobilized without the risk of harm. Option A is incorrect because ensuring that the restraint is snug against the client's wrist does not address the issue of securing it to the side rail. Option C, double knotting the restraint, is also incorrect as it does not address the improper placement of the restraint. Option D is wrong because leaving the restraint in place could lead to potential harm for the client. Educationally, this question highlights the importance of proper restraint use and positioning for client safety. Nurses must be aware of correct restraint application to prevent harm and ensure the well-being of their patients. It reinforces the need for vigilant monitoring and adherence to safety protocols in healthcare settings.
Question 4 of 5
A female client with acute respiratory distress syndrome (ARDS) is sedated and on a ventilator with 50% FIO2. What assessment finding warrants immediate intervention?
Correct Answer: B
Rationale: In this scenario, the correct answer is B) Diminished left lower lobe sounds. This finding warrants immediate intervention because it indicates a potential complication such as a possible pneumothorax, which can be life-threatening for the client with ARDS. As the left lower lobe sounds are diminished, it suggests a problem with ventilation in that area, requiring prompt assessment and action. Option A) Assess the client's lung sounds bilaterally, while important, does not specifically address the critical issue of diminished sounds in a specific lobe. Option C) Monitoring ventilator settings for changes in oxygen levels is essential but does not directly address the urgent need for intervention indicated by diminished lung sounds. Option D) Increased sputum production and shortness of breath are concerning symptoms but do not address the immediate need for intervention indicated by diminished left lower lobe sounds. Educationally, understanding the significance of assessing lung sounds comprehensively and recognizing specific abnormal findings is crucial for nurses caring for clients with ARDS. This knowledge can help prioritize interventions and prevent potential complications in critically ill patients.
Question 5 of 5
A client is newly prescribed lithium for bipolar disorder. Which finding is most important to report to the healthcare provider?
Correct Answer: B
Rationale: In this scenario, the correct answer is B) Fine hand tremors noted after starting the medication. It is crucial to report this finding to the healthcare provider because hand tremors can be an early sign of lithium toxicity, which can be a serious and potentially life-threatening side effect of lithium therapy. Option A, a serum lithium level of 1.2 mEq/L, is within the therapeutic range for lithium and does not indicate toxicity. Option C, a blood pressure of 110/60 mmHg, is within normal limits and not directly related to lithium therapy. Option D, a serum sodium level of 140 mEq/L, is also within normal limits and not a priority concern when compared to potential lithium toxicity. Educationally, understanding the side effects and monitoring parameters of lithium therapy is essential for nurses caring for clients with bipolar disorder. Recognizing early signs of lithium toxicity, such as hand tremors, and knowing when to escalate concerns to the healthcare provider is critical in promoting patient safety and optimal outcomes.