HESI RN
HESI RN Exit Exam Capstone Questions
Question 1 of 5
A client with adrenal insufficiency is admitted to the ICU with acute adrenal crisis. The client's vital signs include heart rate 138 bpm and BP 80/60. What is the nurse's first intervention?
Correct Answer: B
Rationale: An IV fluid bolus stabilizes blood pressure during adrenal crisis.
Question 2 of 5
A male client with HIV on saquinavir and other antiretrovirals reports increased hunger and thirst but weight loss. Which action should the nurse take?
Correct Answer: A
Rationale: Increased thirst and hunger while losing weight may indicate hyperglycemia. Blood glucose should be checked.
Question 3 of 5
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?
Correct Answer: C
Rationale: Keeping the chest tube drainage system below chest level ensures that gravity assists with drainage and prevents fluid or air from flowing back into the pleural space, which could compromise lung function.
Question 4 of 5
Which intervention should the nurse include in the care plan for a child with tetanus?
Correct Answer: D
Rationale: Tetanus causes severe muscle spasms and sensitivity to stimuli, so minimizing stimuli like light, sound, and touch can help prevent painful spasms. Monitoring vital signs and administering antibiotics are important but managing stimuli is crucial for the child's comfort and safety.
Question 5 of 5
A client with a recent myocardial infarction is prescribed a beta-blocker. What side effect should the nurse monitor for?
Correct Answer: B
Rationale: Beta-blockers can cause hypotension, so it's important to monitor the client's blood pressure closely.
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