HESI 799 RN Exit Exam Capstone

HESI 799 RN Exit Exam Capstone Related

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A client with myasthenia gravis (MG) is receiving immunosuppressive therapy. Recent lab tests show decreased serum magnesium. What nursing action is most important?

  • A. Observe rhythm on telemetry monitor.
  • B. Check for visual difficulties.
  • C. Assess for hip and hand joint pain.
  • D. Note the most recent hemoglobin level.
Correct Answer: A

Rationale: Magnesium plays a crucial role in maintaining normal cardiac rhythms, particularly in patients with cardiac conditions. Abnormal levels can lead to arrhythmias, which is why continuous monitoring of the heart's electrical activity is important. Magnesium's effect on neuromuscular and cardiac function makes it essential to monitor its levels, and any discrepancies can impact treatment decisions. Checking for visual difficulties (choice B) may be important in MG but is not the priority in the context of decreased serum magnesium. Assessing for hip and hand joint pain (choice C) is not directly related to the issue of decreased serum magnesium. Noting the most recent hemoglobin level (choice D) is not the priority in this situation compared to monitoring the cardiac rhythm due to low magnesium levels.

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A client with hypertension has been prescribed a calcium channel blocker. What should the nurse include in the client's teaching plan?

  • A. Monitor heart rate regularly
  • B. Avoid potassium-rich foods
  • C. Increase fluid intake to avoid dehydration
  • D. Take the medication with food
Correct Answer: A

Rationale: Corrected Rationale: Calcium channel blockers can cause bradycardia, so it is important for the client to monitor their heart rate regularly. This helps detect any significant changes in heart rate that may require medical attention. Choice B is incorrect because there is no need to avoid potassium-rich foods with calcium channel blockers. Choice C is incorrect as increasing fluid intake is not specifically related to calcium channel blockers. Choice D is incorrect as calcium channel blockers are usually taken with or without food, depending on the specific medication, but not specifically on an empty stomach.

A client with dyspnea is being admitted to the medical unit. To best prepare for the client's arrival, the nurse should ensure that the client's bed is in which position?

  • A. Trendelenburg
  • B. Supine
  • C. Prone
  • D. Fowler's
Correct Answer: D

Rationale: Fowler's position (head elevated at 45-60 degrees) improves oxygenation by expanding the lungs, making it the best position for clients with dyspnea. Supine or prone positions restrict lung expansion, and Trendelenburg position (head down) can exacerbate breathing difficulties by increasing pressure on the lungs and diaphragm.

The nurse administers an antibiotic for a respiratory tract infection. To evaluate the medication's effectiveness, which laboratory values should the nurse monitor?

  • A. Platelet count and red blood cell count.
  • B. White blood cell count and sputum culture.
  • C. Hemoglobin A1c and glucose tolerance test.
  • D. Arterial blood gases and serum electrolytes.
Correct Answer: B

Rationale: The correct answer is B: White blood cell count and sputum culture. Monitoring white blood cell count and sputum cultures is essential to assess the effectiveness of the antibiotic in treating the respiratory tract infection. Changes in white blood cell count can indicate the body's response to infection, while sputum cultures help determine if the antibiotic is targeting the specific pathogens causing the infection. Choices A, C, and D are incorrect because platelet count, red blood cell count, hemoglobin A1c, glucose tolerance test, arterial blood gases, and serum electrolytes are not directly related to evaluating the effectiveness of an antibiotic in treating a respiratory tract infection.

The nurse prepares to teach clients about blood glucose monitoring. When should clients always check glucose, regardless of age or type of diabetes?

  • A. Before going to bed.
  • B. After meals.
  • C. During acute illness.
  • D. Prior to exercising.
Correct Answer: C

Rationale: The correct answer is C: During acute illness. Checking blood glucose during acute illness is crucial as stress can elevate glucose levels. This monitoring is essential regardless of the client's age or the type of diabetes they have. Checking before going to bed (choice A) may be important for some individuals, but it's not as universally necessary as during acute illness. Checking after meals (choice B) and prior to exercising (choice D) are important times for monitoring blood glucose, but they are not as universally applicable as during acute illness.

A client with heart failure is receiving furosemide. What assessment finding indicates the medication is effective?

  • A. Increased urine output and weight loss.
  • B. Increased heart rate and blood pressure.
  • C. Decreased edema and improved peripheral pulses.
  • D. Decreased shortness of breath and clear lung sounds.
Correct Answer: C

Rationale: The correct answer is C: 'Decreased edema and improved peripheral pulses.' In a client with heart failure, furosemide is a diuretic that helps reduce fluid overload. Therefore, a decrease in edema (swelling due to fluid retention) and improved peripheral pulses (indicating better circulation) are signs that the medication is effective. Choices A, B, and D are incorrect. Increased urine output and weight loss (Choice A) may indicate the diuretic effect of furosemide but do not specifically reflect its effectiveness in heart failure. Increased heart rate and blood pressure (Choice B) are not desired effects of furosemide and may suggest adverse reactions. Decreased shortness of breath and clear lung sounds (Choice D) are related to improved respiratory status and may not directly reflect the effectiveness of furosemide in addressing fluid overload.

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