HESI 799 RN Exit Exam

HESI 799 RN Exit Exam Related

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An 11-year-old client is admitted to the mental health unit after trying to run away from home and threatening self-harm. The nurse establishes a goal to promote effective coping and plans to ask the client to verbalize three ways to deal with stress. Which activity is best to establish rapport and accomplish this therapeutic goal?

  • A. Play a board game with the client and begin talking about stressors
  • B. Conduct a formal therapy session
  • C. Ask the client to write down their feelings
  • D. Have a group discussion about stress management
Correct Answer: A

Rationale: Playing a board game with the client and initiating a conversation about stressors is the best choice to establish rapport and achieve the therapeutic goal of helping the client verbalize ways to cope with stress. Board games provide a relaxed and non-threatening environment, allowing the client to feel more comfortable and open up about their stressors. Choice B, conducting a formal therapy session, might be too structured and intimidating for the client, hindering open communication. Choice C, asking the client to write down their feelings, lacks the interactive and engaging aspect that a board game provides. Choice D, having a group discussion about stress management, may not be as effective initially as one-on-one interaction to build trust and rapport with the client.

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A client with a history of chronic heart failure is admitted with shortness of breath and crackles in the lungs. Which diagnostic test should the nurse anticipate preparing the client for first?

  • A. Chest X-ray
  • B. Arterial blood gases (ABGs)
  • C. Echocardiogram
  • D. Electrocardiogram (ECG)
Correct Answer: C

Rationale: The correct answer is C: Echocardiogram. An echocardiogram should be performed first to assess ventricular function and evaluate the cause of shortness of breath and crackles in a client with heart failure. An echocardiogram provides valuable information about the heart's structure and function, helping to identify potential issues related to heart failure. Chest X-ray (Choice A) may be done to assess for changes in heart size or fluid in the lungs but does not directly assess heart function. Arterial blood gases (Choice B) may provide information about oxygenation but do not directly evaluate heart function. An electrocardiogram (Choice D) assesses the heart's electrical activity but does not provide detailed information about ventricular function, which is crucial in heart failure management.

A client with chronic kidney disease (CKD) is admitted with hyperkalemia. Which assessment finding is most concerning?

  • A. Bradycardia
  • B. Muscle weakness
  • C. Peaked T waves on the ECG
  • D. Decreased deep tendon reflexes
Correct Answer: C

Rationale: The correct answer is C: Peaked T waves on the ECG. In hyperkalemia, elevated potassium levels can affect the heart's electrical activity, leading to changes on the ECG such as peaked T waves. This finding is concerning as it can progress to serious cardiac arrhythmias, including ventricular tachycardia and fibrillation. Bradycardia (choice A) and decreased deep tendon reflexes (choice D) are not typically associated with hyperkalemia. While muscle weakness (choice B) can occur in hyperkalemia due to its effect on neuromuscular function, the most concerning assessment finding indicating the need for immediate intervention in this scenario is peaked T waves on the ECG.

A male client with cancer, who is receiving antineoplastic drugs, is admitted to the hospital. What findings are most often manifested in this condition?

  • A. Ecchymosis and hematemesis
  • B. Weight loss and alopecia
  • C. Weakness and activity intolerance
  • D. Sore throat and fever
Correct Answer: A

Rationale: The correct answer is A: Ecchymosis and hematemesis. These findings are often manifested in a client receiving antineoplastic drugs due to their potential side effects, including increased bleeding tendencies. Choice B, weight loss, and alopecia are more commonly associated with the side effects of cancer itself rather than antineoplastic drugs. Choice C, weakness, and activity intolerance can be seen in cancer patients but are not specific to antineoplastic drug therapy. Choice D, sore throat, and fever are less likely to be directly related to antineoplastic drugs and are more often linked to infections or other conditions.

The nurse is caring for a client with a history of myocardial infarction who is complaining of chest pain. Which intervention should the nurse implement first?

  • A. Administer oxygen therapy as prescribed.
  • B. Administer nitroglycerin sublingually as prescribed.
  • C. Obtain an electrocardiogram (ECG).
  • D. Assess the client's level of consciousness.
Correct Answer: C

Rationale: Obtaining an electrocardiogram (ECG) is the first priority in assessing for ischemia or infarction in a client with chest pain and a history of myocardial infarction. This diagnostic test provides crucial information about the heart's electrical activity and helps in identifying any acute cardiac changes. Administering oxygen therapy and nitroglycerin can be important interventions, but obtaining an ECG takes precedence as it directly assesses the client's cardiac status. Assessing the client's level of consciousness is also essential, but in this scenario, assessing for cardiac indications through an ECG is the initial step.

A client with end-stage renal disease (ESRD) is scheduled for hemodialysis. Which laboratory value should be closely monitored before the procedure?

  • A. Serum creatinine of 2.0 mg/dl
  • B. Serum potassium of 5.5 mEq/L
  • C. Serum calcium of 8.0 mg/dl
  • D. Hemoglobin of 12 g/dl
Correct Answer: B

Rationale: A serum potassium level of 5.5 mEq/L is concerning in a client with ESRD scheduled for hemodialysis as it indicates hyperkalemia, which can lead to serious cardiac complications. Hyperkalemia can be exacerbated during hemodialysis, making it crucial to closely monitor serum potassium levels before the procedure. Monitoring serum creatinine, serum calcium, or hemoglobin levels is important in managing ESRD but is not the immediate focus before hemodialysis. Therefore, option B is the correct choice.

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