Medical Surgical HESI

HESI LPN

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

A. Agranulocytosis
B. Hypoglycemia
C. Bradycardia
D. Hypercalcemia

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. Which nursing intervention is most important for the nurse to implement when caring for an older client who is legally blind?

A. Keep the room well-lit at all times.
B. Speak to the client each time the nurse enters the room.
C. Ensure the client wears glasses at all times.
D. Provide written instructions in large print.

Correct answer: B

Rationale: The correct answer is to speak to the client each time the nurse enters the room. This intervention is crucial for orienting and reassuring the client, promoting safety, and facilitating communication. Keeping the room well-lit (Choice A) can be helpful but is not as essential as direct verbal communication. Ensuring the client wears glasses (Choice C) may not be feasible or necessary for someone who is legally blind. Providing written instructions in large print (Choice D) is not effective for a client with visual impairments.

3. Which dietary modification is most appropriate for a client with nephrotic syndrome?

A. High protein, low sodium
B. Low protein, high sodium
C. High protein, high potassium
D. Low protein, low sodium

Correct answer: D

Rationale: The most appropriate dietary modification for a client with nephrotic syndrome is a low protein, low sodium diet. This diet helps reduce the workload on the kidneys and manage edema, which are common issues in nephrotic syndrome. Choice A, high protein, low sodium, is not recommended because excessive protein intake can further strain the kidneys. Choice B, low protein, high sodium, is inappropriate as high sodium can worsen fluid retention and hypertension. Choice C, high protein, high potassium, is not ideal as high potassium levels can be problematic for individuals with kidney issues.

4. Which statement correctly explains the etiology of Down syndrome?

A. There is an extra chromosome on the 21st pair.
B. There is a missing chromosome on the 21st pair.
C. There are two pairs of the 21st chromosome.
D. The 21st chromosome pair is missing.

Correct answer: A

Rationale: The correct answer is A: 'There is an extra chromosome on the 21st pair.' Down syndrome is caused by the presence of an extra copy of chromosome 21, known as trisomy 21. This additional genetic material leads to the characteristics associated with Down syndrome. Choices B, C, and D are incorrect because Down syndrome is not due to a missing chromosome or having two pairs of the 21st chromosome; it results from the presence of an extra chromosome on the 21st pair.

5. Which individual has the highest risk for developing skin cancer?

A. A 16-year-old dark-skinned female who tans in tanning beds once a week.
B. A 65-year-old fair-skinned male who is a construction worker
C. A 25-year-old dark-skinned male whose mother had skin cancer.
D. A 70-year-old fair-skinned female who works as a secretary.

Correct answer: B

Rationale: The correct answer is B, a 65-year-old fair-skinned male who is a construction worker. Fair-skinned individuals are at higher risk of developing skin cancer due to prolonged sun exposure. Construction workers are often exposed to the sun for long periods, further increasing the risk. Choices A, C, and D are less likely to develop skin cancer compared to choice B due to factors such as age, frequency of tanning bed use, and occupation.