HESI RN Exit Exam 2023

HESI RN Exit Exam 2023 Related

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A 7-year-old boy is brought to the clinic because of facial edema. He reports that he has been voiding small amounts of dark, cloudy, tea-colored urine. The parents state that their son had a sore throat 2 weeks earlier, but it has resolved. After assessing the child's vital signs and weight, what intervention should the nurse implement next?

  • A. Perform an otoscopic examination
  • B. Measure the child's abdominal girth
  • C. Collect a urine specimen for routine urinalysis
  • D. Obtain a blood specimen for serum electrolytes
Correct Answer: C

Rationale: Collecting a urine specimen for routine urinalysis is the next appropriate intervention. The symptoms described, including facial edema and tea-colored urine, are indicative of glomerulonephritis, a condition affecting the kidneys. A urine specimen can help assess renal function and the presence of blood and protein in the urine, which are common in glomerulonephritis. Performing an otoscopic examination (Choice A) is not relevant to the presenting symptoms. Measuring the child's abdominal girth (Choice B) is not necessary at this point as it does not directly address the urinary symptoms. Obtaining a blood specimen for serum electrolytes (Choice D) may provide information about electrolyte imbalances but is not the most appropriate initial step in this case.

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During the initial visit, which intervention is most important for the nurse to implement?

  • A. Determine how the client is cared for when the caregiver is not present.
  • B. Develop a client needs assessment and review it with the caregiver.
  • C. Evaluate the caregiver's ability to care for the client's needs.
  • D. Review with the caregiver the interventions provided each day.
Correct Answer: A

Rationale: The most important intervention for the nurse to implement during the initial visit is to determine how the client is cared for when the caregiver is not present. This is crucial for ensuring continuous and adequate care, especially for a bed-bound client with multiple sclerosis who relies heavily on the caregiver. While developing a client needs assessment (choice B) and evaluating the caregiver's ability (choice C) are important, understanding the care plan in the caregiver's absence takes precedence. Reviewing daily interventions with the caregiver (choice D) is valuable but not as critical as knowing the care plan during the caregiver's absence.

Following discharge teaching, a male client with a duodenal ulcer tells the nurse he will drink plenty of dairy products to help coat and protect his ulcer. What is the best follow-up action by the nurse?

  • A. Remind the client that it is also important to switch to decaffeinated coffee and tea.
  • B. Suggest that the client also plans to eat frequent small meals to reduce discomfort.
  • C. Review with the client the need to avoid foods that are rich in milk and cream.
  • D. Reinforce this teaching by asking the client to list a dairy food that he might select.
Correct Answer: C

Rationale: The correct answer is C because diets rich in milk and cream stimulate gastric acid secretion, which can exacerbate a duodenal ulcer. Therefore, it is essential to avoid foods that are rich in milk and cream. Choice A is incorrect because switching to decaffeinated coffee and tea does not address the issue of avoiding milk and cream products. Choice B is incorrect because while eating frequent small meals can help with discomfort, it does not address the specific issue of avoiding milk and cream. Choice D is incorrect as it does not address the need to avoid milk and cream products.

A woman with an anxiety disorder calls her obstetrician's office and tells the nurse of increased anxiety since the normal vaginal delivery of her son three weeks ago. Since she is breastfeeding, she stopped taking her antianxiety medications, but thinks she may need to start taking them again because of her increased anxiety. What response is best for the nurse to provide this woman?

  • A. Describe the transmission of drugs to the infant through breast milk
  • B. Encourage her to use stress-relieving alternatives, such as deep breathing exercises
  • C. Inform her that some antianxiety medications are safe to take while breastfeeding
  • D. Explain that anxiety is a normal response for the mother of a 3-week-old.
Correct Answer: C

Rationale: There are several antianxiety medications that are not contraindicated for breastfeeding mothers, so it is important to inform her of this option.

A client with a tracheostomy has thick, tenacious secretions. Which intervention should the nurse implement first?

  • A. Perform deep suctioning every 2 to 4 hours.
  • B. Encourage the client to drink plenty of fluids.
  • C. Increase humidity in the client's room.
  • D. Administer a mucolytic agent.
Correct Answer: C

Rationale: Increasing humidity in the client's room can help liquefy thick secretions and facilitate easier airway clearance in a client with a tracheostomy. This intervention should be implemented first as it is non-invasive and can often effectively address the issue of thick secretions. Performing deep suctioning (Choice A) should not be the first intervention as it is more invasive and should be done based on assessment findings. Encouraging the client to drink plenty of fluids (Choice B) is beneficial but may not provide immediate relief for thick secretions. Administering a mucolytic agent (Choice D) requires a healthcare provider's prescription and should be based on assessment data and the client's condition.

The nurse is assessing a primigravida at 39-weeks gestation during a weekly prenatal visit. Which finding is most important for the nurse to report to the healthcare provider?

  • A. Fetal heart rate of 200 beats/minute.
  • B. Mild ankle edema.
  • C. Complaints of back pain.
  • D. Decreased fetal movements.
Correct Answer: A

Rationale: A fetal heart rate of 200 beats per minute is significantly elevated and requires immediate medical attention. This finding could indicate fetal distress, tachycardia, or other serious issues that need prompt evaluation. Mild ankle edema, complaints of back pain, and decreased fetal movements are common in pregnancy but are not as urgent or concerning as a high fetal heart rate.

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