HESI RN Exit Exam 2024 Quizlet

Correct Answer: A

Rationale: A serum potassium level of 6.0 mEq/L is most concerning in a client with ESRD scheduled for hemodialysis as it indicates hyperkalemia, which can lead to serious cardiac complications such as arrhythmias and cardiac arrest. Immediate intervention is required to lower potassium levels. Choice B, serum creatinine of 2.5 mg/dL, is elevated but expected in ESRD due to impaired kidney function. Choice C, serum calcium of 8.0 mg/dL, is within the normal range and not typically a priority in this situation. Choice D, hemoglobin of 10 g/dL, is slightly low but not an immediate concern for a client scheduled for hemodialysis unless significantly lower and causing severe symptoms.

Correct Answer: A

Rationale: The correct answer is A. Tented skin turgor is a sign of dehydration, which can be exacerbated by the use of antidiarrheals in clients with gastroenteritis. In dehydration, the skin loses its elasticity and becomes less resilient when pinched. Therefore, the nurse should take immediate action upon noticing tented skin turgor to prevent further complications. Choices B, C, and D are incorrect because decreased bowel sounds, persistent diarrhea, and dehydration are expected findings in a client with gastroenteritis who has been administered an antidiarrheal agent.

Correct Answer: A

Rationale: The best response for the nurse to provide is that dialysis would need to be resumed if chronic rejection becomes a reality. Chronic rejection of a transplanted kidney can lead to kidney failure, necessitating the need for dialysis until another transplant is possible. Choice B is incorrect because although immunosuppressive therapy may be adjusted, the immediate concern is the potential need for dialysis. Choice C is incorrect because scheduling a second transplant immediately is not typically the first step following chronic rejection. Choice D is also incorrect as close monitoring of kidney function is essential but does not address the immediate need for dialysis if chronic rejection occurs.

Correct Answer: A

Rationale: A warm shower can help alleviate stiffness, allowing the client to be more comfortable and mobile before the procedure. This intervention promotes increased comfort and mobility, which may help the client proceed with the procedure later in the day. Administering anti-inflammatory medication (Choice B) may be helpful but may take time to be effective, while range-of-motion exercises (Choice C) may be challenging for the client due to stiffness. Rescheduling the procedure (Choice D) does not address the immediate need to alleviate stiffness.

Correct Answer: D

Rationale: The best initial response by the nurse when the client reports muscle weakness is to ask the client to describe the changes that have occurred. This approach allows the nurse to gain a better understanding of the client's experience, the extent of weakness, any associated symptoms, and potential triggers. By actively listening to the client's description, the nurse can gather valuable information that will aid in a comprehensive assessment and development of a tailored care plan. Choice A is incorrect because assuming muscle weakness is solely due to aging without further assessment can lead to overlooking potential underlying causes. Choice B is incorrect as observing for signs of muscle atrophy should come after gathering information directly from the client. Choice C is incorrect as reviewing diagnostic test results should not be the initial step when the client's current experience is being shared.