HESI RN
HESI RN Exit Exam Capstone Questions
Question 1 of 5
The nurse is providing care for a client with schizophrenia who receives haloperidol decanoate 75 mg IM every 4 weeks. The client begins developing a puckering and smacking of the lips and facial grimacing. Which intervention should the nurse implement?
Correct Answer: C
Rationale: These symptoms are characteristic of tardive dyskinesia, a side effect of long-term antipsychotic use. The nurse should assess the severity of these movements using the AIMS scale and report to the healthcare provider for further management.
Question 2 of 5
A client with heart failure is prescribed spironolactone. What is the nurse's priority intervention?
Correct Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic, so the nurse should closely monitor for signs of hyperkalemia, which can lead to cardiac arrhythmias.
Question 3 of 5
A client is admitted with ascites, malnutrition, and recent complaints of spitting up blood. What assessment finding warrants immediate intervention by the nurse?
Correct Answer: C
Rationale: A round and tight abdomen suggests fluid accumulation from ascites, which could signal a more severe underlying condition requiring immediate intervention.
Question 4 of 5
The mother of a 2-day-old infant girl expresses concern about a 'flea bite' type rash on her daughter's body. The nurse identifies a pink papular rash with vesicles superimposed over the thorax, back, buttocks, and abdomen. Which explanation should the nurse offer?
Correct Answer: C
Rationale: The rash described is typical of erythema toxicum neonatorum, a common and benign newborn rash that resolves on its own within a few days. No treatment is necessary, and the nurse should reassure the mother.
Question 5 of 5
A client is experiencing chest pain and is prescribed nitroglycerin. What should the nurse assess before administering the medication?
Correct Answer: B
Rationale: Before administering nitroglycerin, which can lower blood pressure and heart rate, it is important to assess both to avoid exacerbating hypotension or bradycardia. Nitroglycerin helps relieve chest pain by dilating coronary arteries, but its vasodilating effect can also cause a significant drop in blood pressure, which can be dangerous for some clients.
Similar Questions
Join Our Community Today!
Join Over 10,000+ nursing students using Nurselytic. Access Comprehensive study Guides curriculum for HESI-RN and 3000+ practice questions to help you pass your HESI-RN exam.
Subscribe for Unlimited Access