HESI 799 RN Exit Exam Capstone

HESI 799 RN Exit Exam Capstone Related

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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.

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A client with hypertension is being educated on lifestyle changes by a nurse. Which recommendation is the most important to reduce blood pressure?

  • A. Increase water intake
  • B. Avoid alcohol consumption
  • C. Exercise regularly
  • D. Reduce sodium intake
Correct Answer: D

Rationale: Reducing sodium intake is crucial in managing hypertension as high sodium levels can lead to fluid retention and increased blood pressure. While increasing water intake is beneficial for overall health, reducing sodium has a more significant impact on blood pressure. Regular exercise is important for cardiovascular health but does not have as direct an impact on blood pressure as sodium reduction. Avoiding alcohol is also important, but in terms of managing blood pressure, reducing sodium intake takes precedence.

The psychiatric nurse is caring for clients in an adolescent unit. Which client requires the nurse's immediate attention?

  • A. A 17-year-old client with schizophrenia who is pacing the hallways
  • B. An 18-year-old client with antisocial behavior who is being yelled at by other clients
  • C. A 16-year-old client with depression who refuses to eat meals
  • D. A 15-year-old client with anxiety who is quietly reading in a corner
Correct Answer: B

Rationale: The client with antisocial behavior being yelled at by peers may escalate the situation, potentially leading to violence or self-harm. Addressing the situation quickly helps prevent harm and de-escalates the conflict. Choices A, C, and D do not present immediate risks that require urgent intervention compared to the potential danger of a conflict escalating to violence with the client exhibiting antisocial behavior.

What pathophysiological events occur sequentially in the development of atherosclerosis?

  • A. Foam cells release growth factors.
  • B. Smooth muscle grows over fatty streaks creating fibrous plaques.
  • C. Macrophages consume low-density lipoprotein (LDL) and create foam cells.
  • D. Arterial endothelium injury causes inflammation.
Correct Answer: D

Rationale: The correct sequence of pathophysiological events in the development of atherosclerosis starts with arterial endothelium injury causing inflammation. This inflammation triggers the formation of foam cells by macrophages consuming low-density lipoprotein (LDL). Subsequently, smooth muscle grows over fatty streaks, creating fibrous plaques. Therefore, option D is the correct answer. Choices A, B, and C are incorrect because they do not reflect the accurate chronological order of events in the pathogenesis of atherosclerosis.

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 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.

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