HESI RN Exit Exam 2024 Capstone

HESI RN Exit Exam 2024 Capstone Related

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A male client with hypertension, who received new antihypertensive prescriptions at his last visit returns to the clinic two weeks later to evaluate his blood pressure (BP). His BP is 158/106, and he admits that he has not been taking the prescribed medication because the drugs make him feel bad. In explaining the need for hypertension control, the nurse should stress that an elevated BP places the client at risk for which pathophysiological condition?

  • A. Stroke secondary to hemorrhage
  • B. Myocardial infarction
  • C. Heart failure
  • D. Renal failure
Correct Answer: A

Rationale: Stroke is a major complication of uncontrolled hypertension. Elevated BP, especially at levels like 158/106, can cause damage to blood vessels in the brain, leading to a hemorrhagic stroke. Controlling BP is essential to prevent such life-threatening events. Myocardial infarction (choice B) is more commonly associated with coronary artery disease, while heart failure (choice C) and renal failure (choice D) can be complications of uncontrolled hypertension but are not directly related to the elevated BP leading to a hemorrhagic stroke.

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A client has burns covering 40% of their total body surface area (TBSA). What is the nurse's priority action?

  • A. Monitor the client's urinary output hourly.
  • B. Apply cool, moist dressings to the burned areas.
  • C. Administer pain medication to reduce discomfort.
  • D. Administer IV fluids to prevent hypovolemia.
Correct Answer: A

Rationale: The correct answer is A: Monitor the client's urinary output hourly. Clients with burns covering a large percentage of their total body surface area are at high risk for hypovolemia due to fluid loss. Monitoring urinary output is crucial because it helps assess kidney function and fluid balance, providing essential information about the client's hemodynamic status. Applying cool, moist dressings (choice B) is important but not the priority over assessing fluid balance. Administering pain medication (choice C) is essential for comfort but not the priority over monitoring for potential complications like hypovolemia. Administering IV fluids (choice D) is important to prevent hypovolemia, but monitoring urinary output should be the priority to guide fluid resuscitation.

An older client with a long history of coronary artery disease, HTN, and HF arrives in the ED in respiratory distress. The healthcare provider prescribes furosemide IV. Which therapeutic response to furosemide should the nurse expect in the client with acute HF?

  • A. Decreased heart rate
  • B. Improved blood pressure
  • C. Increased urine output
  • D. Reduced preload
Correct Answer: D

Rationale: The correct answer is D: Reduced preload. Furosemide is a diuretic that reduces fluid overload in heart failure, which lowers the preload (the volume of blood in the ventricles before contraction). By reducing this volume, furosemide improves symptoms of heart failure. While furosemide may lead to increased urine output and lower blood pressure, these effects are secondary to the reduction in preload. Decreased heart rate is not a direct effect of furosemide in heart failure.

Which task could be safely delegated by the nurse to an unlicensed assistive personnel (UAP)?

  • A. Accompanying a client who self-administers insulin
  • B. Cleansing and dressing a small decubitus ulcer
  • C. Monitoring a client's response to passive range of motion exercises
  • D. Applying and caring for a client's rectal pouch
Correct Answer: D

Rationale: The correct answer is D because tasks like applying and caring for a client's rectal pouch are within the UAP's scope of practice, as they do not require clinical judgment. Choices A, B, and C involve more complex assessments or interventions that require clinical judgment and should be performed by licensed nursing staff.

A client with anemia is prescribed iron supplements. What teaching should the nurse provide?

  • A. Take iron supplements with meals to prevent stomach upset.
  • B. Take iron supplements with milk to improve absorption.
  • C. Expect black, tarry stools as a side effect of iron supplements.
  • D. Take iron supplements with vitamin C to improve absorption.
Correct Answer: D

Rationale: The correct answer is D: Take iron supplements with vitamin C to improve absorption. Vitamin C enhances iron uptake, making it more bioavailable for the body. It is essential to avoid taking iron supplements with milk (choice B) as calcium-rich foods can hinder iron absorption. Taking iron supplements with meals (choice A) can help reduce stomach upset, but the optimal way to enhance absorption is with vitamin C. Black, tarry stools (choice C) are not a typical side effect of iron supplements and should be reported to the healthcare provider.

A client is scheduled for a spiral CT scan with contrast to evaluate for pulmonary embolism. Which information in the client's history requires follow-up by the nurse?

  • A. Is allergic to shellfish
  • B. Has a history of smoking
  • C. Takes metformin for type 2 diabetes mellitus
  • D. Has hypertension controlled with medication
Correct Answer: A

Rationale: An allergy to shellfish often indicates an allergy to iodine, which is used in contrast dyes for CT scans. This poses a significant risk of an allergic reaction during the procedure. The nurse must ensure appropriate precautions or alternative imaging are considered. Choices B, C, and D are not directly contraindicated for a CT scan with contrast. Smoking history, metformin use, and controlled hypertension do not typically impact the safety or feasibility of the procedure.

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