HESI Exit Exam RN Capstone

Correct Answer: D

Rationale: The correct answer is D: Monitor blood glucose levels. Clients with acute pancreatitis are prone to hyperglycemia due to impaired insulin production. Monitoring blood glucose levels is crucial to prevent complications like diabetic ketoacidosis. While assessing bowel sounds, urine output, and abdominal tenderness are important in the overall care of a client with acute pancreatitis, monitoring blood glucose levels takes priority to address the immediate risk of hyperglycemia.

Correct Answer: D

Rationale: The correct answer is D: Potassium. Spironolactone is a potassium-sparing diuretic, which can lead to hyperkalemia. Monitoring potassium levels is crucial to prevent complications like cardiac arrhythmias. Choices A, B, and C are incorrect because sodium, calcium, and magnesium levels are not directly affected by spironolactone use for managing ascites in cirrhosis.

Correct Answer: C

Rationale: A potassium level of 6.2 mEq/L indicates hyperkalemia, which is dangerous and requires immediate treatment. Administering a potassium-binding medication will help lower potassium levels and prevent life-threatening complications.

Correct Answer: C

Rationale: The correct answer is C: Ibuprofen. Ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), can cause fluid retention, which may worsen heart failure symptoms. It should be used with caution or avoided in clients with heart failure. Furosemide (choice A) is a diuretic commonly used in heart failure to reduce fluid overload. Digoxin (choice B) is a medication that helps the heart beat stronger and slower, often used in heart failure. Carvedilol (choice D) is a beta-blocker that is beneficial in heart failure management. Therefore, Ibuprofen is the medication that the nurse should question in this scenario.

Correct Answer: B

Rationale: The correct answer is B: "The client's ammonia level decreases." In hepatic encephalopathy, elevated ammonia levels contribute to neurological symptoms. Lactulose works by promoting the excretion of ammonia in the stool, leading to decreased serum ammonia levels. Therefore, a decrease in ammonia levels indicates that lactulose is effectively reducing ammonia buildup, improving hepatic encephalopathy symptoms. Choices A, C, and D are incorrect because improvement in level of consciousness, bowel movements, or normalization of liver enzymes may not directly reflect the effectiveness of lactulose in reducing ammonia levels and improving hepatic encephalopathy.