HESI RN Exit Exam 2023

HESI RN Exit Exam 2023 Related

Review HESI RN Exit Exam 2023 related questions and content

A client with hypertension receives a prescription for enalapril, an angiotensin-converting enzyme (ACE) inhibitor. Which instruction should the nurse include in the medication teaching plan?

  • A. Increase intake of potassium-rich foods.
  • B. Report increased bruising or bleeding.
  • C. Stop medication if a cough develops.
  • D. Limit intake of leafy green vegetables.
Correct Answer: B

Rationale: The correct instruction for the nurse to include in the medication teaching plan is to 'Report increased bruising or bleeding.' ACE inhibitors can cause thrombocytopenia, which lowers platelet count and increases the risk of bruising and bleeding. Choice A is incorrect because while ACE inhibitors may cause potassium levels to increase, the instruction should not be to increase intake of potassium-rich foods without healthcare provider guidance. Choice C is incorrect because a cough is a common side effect of ACE inhibitors due to bradykinin accumulation, and stopping the medication abruptly is not recommended without consulting the healthcare provider. Choice D is incorrect because there is no need to limit intake of leafy green vegetables specifically with ACE inhibitors; however, consistent intake of vitamin K-rich foods is recommended to maintain a stable INR for clients taking anticoagulants.

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An adult client comes to the clinic and reports his concern over a lump that 'just popped up on my neck about a week ago.' In performing an examination of the lump, the nurse palpates a large, non-tender, hardened left subclavian lymph node. There is no overlying tissue inflammation. What do these findings suggest?

  • A. Malignancy
  • B. Infection
  • C. Benign cyst
  • D. Lymphadenitis
Correct Answer: A

Rationale: The findings of a large, non-tender, hardened lymph node, especially in the absence of overlying tissue inflammation, are indicative of malignancy. These characteristics raise suspicion for cancer, prompting the need for further investigation. Choice B, Infection, is incorrect because infection would typically present as a tender and possibly swollen lymph node. Choice C, Benign cyst, is incorrect as cysts are usually soft and movable. Choice D, Lymphadenitis, is incorrect as lymphadenitis usually presents with tender and enlarged lymph nodes in response to an infection.

During the infusion of a second unit of packed red blood cells, the client's temperature increases from 99 to 101.6 F. Which intervention should the nurse implement?

  • A. Stop the transfusion and start a saline infusion.
  • B. Administer antipyretics and continue the transfusion.
  • C. Monitor the client's vital signs every 15 minutes.
  • D. Notify the healthcare provider and continue the transfusion.
Correct Answer: A

Rationale: An increase in temperature during a transfusion may indicate a transfusion reaction, which can be serious. Stopping the transfusion and starting a saline infusion is the priority action to prevent further complications and address the potential adverse reaction. Administering antipyretics (choice B) may mask the symptoms of a transfusion reaction, delaying appropriate treatment. While monitoring vital signs (choice C) is important, stopping the transfusion takes precedence to prevent harm. Notifying the healthcare provider (choice D) is essential but should not delay the immediate intervention of stopping the transfusion and starting a saline infusion.

A client with heart failure is prescribed furosemide (Lasix). Which assessment finding should the nurse report to the healthcare provider immediately?

  • A. Heart rate of 60 beats per minute
  • B. Blood pressure of 100/60 mmHg
  • C. Presence of a new murmur
  • D. Crackles in the lungs
Correct Answer: D

Rationale: The correct answer is D: Crackles in the lungs. Crackles indicate fluid overload in the lungs, a critical sign in a client with heart failure. This finding suggests that the furosemide may not be effectively managing the fluid balance, and immediate intervention is required. Choices A, B, and C are not immediate concerns in this scenario. A heart rate of 60 beats per minute, a blood pressure of 100/60 mmHg, and the presence of a new murmur are findings that may require monitoring or intervention but are not as urgent as crackles in the lungs in a client with heart failure.

A client who is taking an oral dose of a tetracycline complains of gastrointestinal upset. What snack should the nurse instruct the client to take with the tetracycline?

  • A. Fruit-flavored yogurt
  • B. Cheese and crackers
  • C. Cold cereal with skim milk
  • D. Toasted wheat bread and jelly
Correct Answer: D

Rationale: The correct answer is D: Toasted wheat bread and jelly. Dairy products decrease the effect of tetracycline, so the nurse should instruct the client to avoid them. Toast, which contains no dairy products, may help decrease gastrointestinal symptoms. Choices A, B, and C contain dairy products, which should be avoided when taking tetracycline.

The healthcare provider is assessing a client with left-sided heart failure. Which laboratory value should be closely monitored?

  • A. Serum sodium level
  • B. Serum potassium level
  • C. Serum creatinine level
  • D. Serum glucose level
Correct Answer: B

Rationale: In a client with left-sided heart failure, monitoring serum potassium levels is crucial. This helps in assessing kidney function and fluid balance. Elevated potassium levels can result from impaired kidney function, which is common in heart failure. Monitoring sodium levels (choice A) is important in heart failure but not specifically related to left-sided heart failure. Serum creatinine (choice C) reflects kidney function but is not the most critical value to monitor in this case. Serum glucose level (choice D) is important but not the priority when assessing left-sided heart failure.

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