HESI RN
HESI RN Exit Exam Capstone Questions
Question 1 of 5
A client is suspected of having a stroke. What is the nurse's priority action?
Correct Answer: B
Rationale: A neurological assessment is the priority when a stroke is suspected to determine the extent of brain injury and identify any immediate risks, such as impaired airway, speech deficits, or loss of motor function. Early recognition of these signs is essential for timely intervention and to guide further treatment like the administration of tPA, if appropriate.
Question 2 of 5
A client is admitted to the emergency department after a motor vehicle accident. The client has a Glasgow Coma Scale (GCS) score of 10. What does this score indicate?
Correct Answer: B
Rationale: A Glasgow Coma Scale score of 10 falls into the range of moderate impairment, indicating the need for further assessment and monitoring.
Question 3 of 5
An older adult client with eye dryness reports itching and excessive tearing. Which medication group is most likely to have produced this client's symptoms?
Correct Answer: D
Rationale: Anticholinergics often cause dryness of secretions and could lead to these symptoms.
Question 4 of 5
The nurse is caring for a client with deep vein thrombosis (DVT) who is receiving anticoagulant therapy. Which intervention should the nurse implement to prevent complications?
Correct Answer: A
Rationale: Elevating the affected leg helps reduce swelling and improve venous return, which is important for preventing complications in clients with DVT. Other interventions, such as ambulation, are secondary to leg elevation.
Question 5 of 5
A client is admitted with ascites, malnutrition, and recent complaints of spitting up blood. What assessment finding warrants immediate intervention by the nurse?
Correct Answer: C
Rationale: A round and tight abdomen suggests fluid accumulation from ascites, which could signal a more severe underlying condition requiring immediate intervention.
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