HESI RN Exit Exam Capstone

Questions 101

HESI RN

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HESI RN Exit Exam Capstone Questions

Question 1 of 5

A female client with acute respiratory distress syndrome (ARDS) is sedated and on a ventilator with 50% FIO2. What assessment finding warrants immediate intervention?

Correct Answer: B

Rationale: Diminished breath sounds in a sedated client with ARDS and on a ventilator indicate collapsed alveoli, which requires immediate intervention, such as chest tube insertion, to prevent further lung damage.

Question 2 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 3 of 5

A client with a peripherally inserted central catheter (PICC) line has a fever. What client assessment is most important for the nurse to perform?

Correct Answer: B

Rationale: Observing the antecubital fossa for inflammation can indicate infection or complications related to the PICC line, which is critical to assess in clients with a fever.

Question 4 of 5

A male client with heart failure presents with shortness of breath, audible wheezing, and pink frothy sputum. What action should the nurse take?

Correct Answer: B

Rationale: Morphine is needed to reduce the client's distress and should be given as prescribed.

Question 5 of 5

A client admitted with left-sided heart failure presents with shortness of breath and pink frothy sputum. Which assessment finding requires immediate intervention?

Correct Answer: C

Rationale: Pink frothy sputum is a sign of pulmonary edema, which needs immediate intervention to prevent respiratory failure.

Similar Questions

A client admitted with left-sided heart failure presents with shortness of breath and pink frothy sputum. Which assessment finding requires immediate intervention?
While assessing a client who is admitted with heart failure and pulmonary edema, the nurse identifies dependent peripheral edema, an irregular heart rate, and a persistent cough that produces pink blood-tinged sputum. After initiating continuous telemetry and positioning the client, which intervention should the nurse implement?
The nurse is caring for a preterm newborn with nasal flaring, grunting, and sternal retractions. After administering surfactant, which assessment is most important for the nurse to monitor?
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?
The nurse is caring for a client with pancreatitis who is receiving total parenteral nutrition (TPN). Which assessment finding requires immediate intervention by the nurse?

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