HESI RN Exit Exam Capstone

Questions 101

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HESI RN Exit Exam Capstone Questions

Question 1 of 5

A client who is bedridden after a stroke is at risk for developing pressure ulcers. Which nursing intervention is most important in preventing this complication?

Correct Answer: B

Rationale: Repositioning the client every 2 hours is essential in preventing pressure ulcers in bedridden clients.

Question 2 of 5

A client is receiving lactulose for signs of hepatic encephalopathy. To evaluate the therapeutic response, which assessment should the nurse obtain?

Correct Answer: D

Rationale: Lactulose is used to reduce ammonia levels, so consciousness is an indicator of efficacy.

Question 3 of 5

A postoperative client with a history of diabetes mellitus is showing signs of hyperglycemia. What should the nurse assess first?

Correct Answer: C

Rationale: Hyperglycemia in postoperative clients, especially those with diabetes, can be a sign of infection. The nurse should assess blood glucose levels to confirm hyperglycemia.

Question 4 of 5

A client is scheduled for a colonoscopy. Which preparation is the most important for the nurse to implement?

Correct Answer: D

Rationale: Verifying that the client has completed bowel prep ensures the colon is clear for accurate visualization during the procedure.

Question 5 of 5

A teenager presents to the emergency department with palpitations after vaping at a party. The client is anxious, fearful, and hyperventilating. Which acid-base imbalance does the nurse anticipate the client developing?

Correct Answer: B

Rationale: Hyperventilation from anxiety or fear causes an excessive loss of CO2, leading to respiratory alkalosis. This shift in pH results from the rapid, shallow breathing that reduces the level of carbon dioxide in the blood. Respiratory acidosis would occur in cases of poor ventilation or CO2 retention, while metabolic acidosis/alkalosis relates to disturbances in bicarbonate, not breathing patterns.

Similar Questions

A teenager presents to the emergency department with palpitations after vaping at a party. The client is anxious, fearful, and hyperventilating. Which acid-base imbalance does the nurse anticipate the client developing?
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?
The nurse is providing care for a client with severe anemia. Which assessment finding requires immediate intervention?
A client with a deep vein thrombosis (DVT) is prescribed enoxaparin. What teaching should the nurse provide?
A nurse is caring for a client with a chest tube following lung surgery. What is the most important intervention to ensure the chest tube functions properly?

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