HESI 799 RN Exit Exam Capstone

HESI 799 RN Exit Exam Capstone Related

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A client presents to the emergency department with a severe exacerbation of asthma. The nurse notes that the client is using accessory muscles to breathe and has an oxygen saturation of 86%. Which intervention should the nurse implement first?

  • A. Place the client in a high-Fowler's position
  • B. Obtain a peak flow reading
  • C. Administer a bronchodilator
  • D. Administer oxygen therapy
Correct Answer: D

Rationale: The first priority in an acute asthma exacerbation is to administer oxygen to improve the client's oxygen saturation. In this scenario, the client has a low oxygen saturation level of 86%, indicating hypoxemia, which can be life-threatening. Administering oxygen therapy will help improve oxygenation and support vital organ function. Once the oxygen levels are stabilized, further interventions such as bronchodilators can be implemented. Placing the client in a high-Fowler's position may also be beneficial, but ensuring adequate oxygenation takes precedence in this critical situation. Obtaining a peak flow reading is important for asthma management but is not the first intervention needed in a client with severe hypoxemia.

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A nurse is caring for a 73-year-old male client with Alzheimer's disease. Which action should the nurse take to enhance the client's nutritional intake?

  • A. Encourage the client to eat large meals in one sitting.
  • B. Offer the client frequent snacks of foods he enjoys.
  • C. Provide the client with foods high in fiber to improve digestion.
  • D. Discourage eating late at night to prevent weight gain.
Correct Answer: B

Rationale: Offering frequent snacks of foods the client enjoys is the most appropriate action to enhance the nutritional intake of a client with Alzheimer's disease. This approach helps to ensure that the client receives an adequate amount of nutrients throughout the day, especially when larger meals might be challenging for individuals with Alzheimer's. Encouraging large meals in one sitting (Choice A) may overwhelm the client and lead to decreased food intake. While foods high in fiber (Choice C) are beneficial for digestion, the primary focus should be on providing foods the client enjoys to increase intake. Discouraging eating late at night (Choice D) is not directly related to enhancing nutritional intake in this scenario.

Which information is a priority for the RN to reinforce to an older client after intravenous pyelography?

  • A. Eat a light diet for the remainder of the day
  • B. Rest for the next 24 hours as the preparation and the test are tiring
  • C. Drink at least 1 8-ounce glass of fluid every waking hour for the next 2 days
  • D. Measure the urine output for the next day and promptly notify the healthcare provider if it decreases
Correct Answer: D

Rationale: After intravenous pyelography, it is crucial for the client to measure urine output in the next day to monitor for any potential complications, such as kidney issues. Promptly notifying the healthcare provider in case of decreased urine output is essential for timely intervention. While rest and hydration are important post-procedure, monitoring urine output takes precedence due to its direct correlation with potential complications.

A client with Cushing's syndrome presents with excessive bruising and elevated blood glucose. What action should the nurse take first?

  • A. Check the client's blood glucose level.
  • B. Administer insulin per sliding scale protocol.
  • C. Administer intravenous fluids.
  • D. Check the client's skin for signs of bruising.
Correct Answer: A

Rationale: Excessive bruising and elevated blood glucose are common symptoms of Cushing's syndrome. The nurse should first check the client's blood glucose level to assess and address the hyperglycemia promptly. Administering insulin or IV fluids would be premature without knowing the current blood glucose level. Checking the skin for bruising, although important for overall assessment, does not address the immediate concern of elevated blood glucose.

A client is diagnosed with Meniere's disease. Which problem should the nurse identify as most important in the plan of care?

  • A. Social isolation related to hearing loss
  • B. Risk for injury related to vertigo
  • C. Impaired verbal communication
  • D. Impaired hearing related to ear disease
Correct Answer: B

Rationale: Vertigo is the primary symptom of Meniere's disease and can lead to falls and other injuries. Ensuring safety and addressing the risk of injury is the nurse's top priority. While social isolation and impaired hearing are significant concerns associated with Meniere's disease, the immediate danger of falls due to vertigo takes precedence in the plan of care. Impaired verbal communication, although important, is not as urgent as preventing injuries caused by vertigo.

A young male client is admitted to rehabilitation following a right above-knee amputation (AKA) and reports aching in his right foot. Which intervention is most important for the nurse to implement?

  • A. Encourage discussion about feelings of limb loss.
  • B. Administer a prescription for gabapentin.
  • C. Teach the client how to wrap the stump with an elastic bandage.
  • D. Offer assistance to move to a quiet room to relax.
Correct Answer: B

Rationale: The correct answer is B: Administer a prescription for gabapentin. Gabapentin is used to treat phantom limb pain, which is common after amputations. Encouraging discussion about feelings of limb loss (choice A) is important for emotional support but does not address the physical pain. Teaching the client how to wrap the stump with an elastic bandage (choice C) is not indicated for aching in the 'right foot' as described. Offering assistance to move to a quiet room to relax (choice D) may provide comfort but does not address the underlying issue of phantom limb pain.

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