RN HESI Exit Exam Remediation Latest Update for 2023 with Rationales Graded A

RN HESI Exit Exam Remediation Latest Update for 2023 with Rationales Graded A The nurse is caring for a client who has a fiberglass long leg cast on the right leg. Which nursing actions should be implemented in the cast care of this client? SATA a) Smelling the cast and feeling for the presence of hot spots on the cast. b) Checking neurovascular status of the right exposed foot and toes every four hours. c) Using a soft cotton-tipped 6-inch swab to help scratch beneath the cast. d) Placing the nurse's finger in the client's cast while performing cast care. e) Covering the perineal area of the cast with plastic before client uses the fracture bedpan. a) Smelling the cast and feeling for the presence of hot spots on the cast. b) Checking neurovascular status of the right exposed foot and toes every four hours. d) Placing the nurse's finger in the client's cast while performing cast care. e) Covering the perineal area of the cast with plastic before client uses the fracture bedpan. Rationale Cast care should include ensuring the cast is not too tight, by placing a finger between the client's skin and cast; by protecting the cast from being soiled by placing a protective plastic covering in the perineal area before the client uses a bedpan; by smelling for a foul odor coming from the cast; by palpating for hot spots on the cast every shift; and by performing neurovascular checks distal to the cast every four hours. Nothing should be placed in the cast to facilitate scratching beneath the cast. The nurse is caring for an older client being treated for a cardiac condition who has developed "dry eyes". Which medication may be contributing to this condition? a) Procainamide (Procanbid). b) Iron supplements. c) Atenolol (Tenormin). d) Lipitor (Atorvastatin). c) Atenolol (Tenormin). Rationale Dry eyes is an annoying side effect of some medications that can cause a client to feel like they have something in their eye or a continuous scratchy sensation. This condition can cause eye strain and discomfort to a client. Clients prescribed Atenolol for hypertension are at risk of developing dry eyes as a side effect of the medication. The UAP is assisting a client getting into the shower. The charge nurse answers a call from the cast clinic to immediately send the UAP's other assigned client to the clinic. Which action should the nurse take? a) Ask the UAP to find another team member to take the client to the clinic. b) Notify the delegating nurse of the current request from the cast clinic. c) Instruct the UAP to take the client to clinic after helping the other client taking a shower. d) While the client is showering the UAP should take the other client to cast clinic. b) Notify the delegating nurse of the current request from the cast clinic. Rationale The charge nurse should notify the delegating nurse of the situation. The third principle of delegation is "The person to whom the assignment was delegated cannot delegate that assignment to someone else... the delegating nurse needs to be notified and reassign the task..." During a literature review for a research study, the nurse discovers a separate study has already proved the proposed hypothesis to be true. Which action should the nurse take regarding the proposed research study? a) Discontinue the research. b) Revise the hypothesis of the current study so it is unique. c) Perform the current study as a replication study. d) Contact the authors of the original study for permission to continue. c) Perform the current study as a replication study. Rationale Because of inherent scientific error that may exist within all research studies, hypotheses require more than one test to support their accuracy. A critical weakness with nursing research is a lack of replication. Retesting a hypothesis that has been shown to be true strengthens the findings of the earlier study and supports the use of those findings to influence clinical practice. In assessing the scrotum of a male client, which finding would need to be reported to the healthcare provider? a) Asymmetric appearance. b) Taut appearance of skin surface. c) Deeper pigmentation of the underside. d) Presence of sebaceous cysts. b) Taut appearance of skin surface. Rationale The skin surface of the scrotum should appear coarse, rather than taut, which may indicate swelling or edema and should be reported to the healthcare provider. Which nursing intervention should the nurse implement when caring for a child with nephrotic syndrome? a) Take vital signs every 2 hours. b) Restrict the number of visitors. c) Reposition the client every 2 hours. d) Monitor fluid intake and urine output. d) Monitor fluid intake and urine output. Rationale Due to the pathophysiology of nephrotic syndrome, decreased colloidal osmotic pressure in the capillaries is decreased, resulting in overall body edema. Treatment usually includes infusion of 25% albumin and use of diuretics to help pull fluids out of the interstitial tissues back into the vascular system. Fluid intake and urine output should be carefully monitored to prevent hypervolemia and edema and monitor the efficacy of the medical interventions. A six-year-old client, who received a kidney transplant presents with signs including fever, decreased urine output, and tenderness over the transplanted organ. Laboratory results reveal an elevated serum creatinine level. This presentation is likely due to which cause? a) Immunosuppression medications. b) Obstructive uropathy. c) Transplant rejection. d) Nephrotic syndrome. c) Transplant rejection. Rationale Transplant rejection is caused by the recipient's immune system response to foreign tissue. Signs that may alert the nurse to rejection of a kidney transplant include fever, tenderness over the graft area, decreased urine output, and elevated serum creatinine.