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Nursing Elites

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Medical Surgical HESI

1. A client with hyperthyroidism is prescribed methimazole. Which adverse effect should the nurse monitor for?

Correct answer: A

Rationale: The correct answer is Agranulocytosis. Methimazole, used to treat hyperthyroidism, can lead to agranulocytosis, a severe decrease in white blood cells. This condition increases the risk of infections and requires immediate medical attention. Hypoglycemia (choice B) is not a common adverse effect of methimazole. Bradycardia (choice C) is unlikely as methimazole tends to have minimal effects on heart rate. Hypercalcemia (choice D) is not associated with methimazole use.

2. A healthcare worker with no known exposure to tuberculosis has received a Mantoux tuberculosis skin test. The nurse's assessment of the test after 62 hours indicates 5mm of erythema without induration. Which is the best initial nursing action?

Correct answer: D

Rationale: A Mantoux tuberculosis skin test without induration is considered negative. In this case, with 5mm of erythema and no induration, the result is negative, indicating no current infection. The best initial nursing action is to document these negative results in the healthcare worker's medical record. Reviewing the history for possible exposure to TB is unnecessary as the test result is negative. Instructing the healthcare worker to return for a repeat test or referring for INH therapy is not warranted when the test is negative.

3. A client with chronic kidney disease is advised to follow a low-phosphorus diet. Which food should the client avoid?

Correct answer: A

Rationale: Correct Answer: Milk. Milk is high in phosphorus and should be avoided in a low-phosphorus diet for clients with chronic kidney disease. Choice B (Apples), C (Carrots), and D (Rice) are not significant sources of phosphorus and can be included in moderation in a low-phosphorus diet. Apples and carrots are generally considered healthy choices for most individuals, while rice is a staple food that is low in phosphorus and can be part of a renal diet.

4. A middle-aged man who has a 35-year smoking history presents to the emergency department confused and short of breath. Before starting oxygen, these baseline arterial blood gases (ABGs) are obtained: pH=7.25, pCO2=50 mmHg, HCO3=30 mEq/L. These findings indicate to the nurse that the client is experiencing which acid-base imbalance?

Correct answer: B

Rationale: The ABG results show a low pH (acidosis) and increased pCO2, indicating respiratory acidosis. In respiratory acidosis, the lungs cannot remove enough CO2, leading to its accumulation in the blood. This often occurs in conditions like COPD and is consistent with the patient's smoking history. Metabolic acidosis (choice A) is characterized by low pH and low HCO3 levels. Metabolic alkalosis (choice C) is marked by high pH and high HCO3 levels. Respiratory alkalosis (choice D) presents with high pH and low pCO2.

5. Parents of a 6-month-old child, who has just been diagnosed with iron deficiency anemia, ask why it was not diagnosed earlier. What would be the best response by the nurse?

Correct answer: B

Rationale: The best response by the nurse would be choice B: 'This happens when the maternal stores of iron are depleted at about 6 months.' Iron deficiency anemia becomes apparent at about 6 months of age in a full-term infant when the maternal stores of iron are depleted. Choice A is incorrect because it questions the diagnosis provided by the healthcare provider. Choice C is incorrect because iron deficiency anemia in infants is primarily due to insufficient iron intake rather than blood loss. Choice D is incorrect as iron deficiency anemia typically develops gradually due to inadequate iron intake.

Similar Questions

Parents of a 6-month-old child, who has just been diagnosed with iron deficiency anemia, ask why it was not diagnosed earlier. What would be the best response by the nurse?
Laboratory findings indicate that a client’s serum potassium level is 2.5 mEq/L. What action should the nurse take?
During the admission interview, an older client answers some questions inappropriately. The nurse notes that a hearing aid is in one ear. Which intervention is most helpful in assisting the client to hear the nurse’s question?
An older adult woman with a long history of COPD is admitted with progressive shortness of breath and a persistent cough, is anxious, and is complaining of dry mouth. Which intervention should the nurse implement?
After a CT scan with intravenous contrast medium, a client returns to the room complaining of shortness of breath and itching. Which intervention should the nurse implement?
The nurse is caring for a client with acute pancreatitis. Which laboratory result is most indicative of this condition?
ATI TEAS 7 Exam Overview

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