HESI RN
Evolve HESI Medical Surgical Practice Exam Quizlet
1. Which of the following is a key symptom of appendicitis?
- A. Right lower quadrant pain.
- B. Left lower quadrant pain.
- C. Generalized abdominal pain.
- D. Rebound tenderness.
Correct answer: A
Rationale: Corrected Choice A: Right lower quadrant pain is a classic and key symptom of appendicitis. Pain in the right lower quadrant is typically the initial symptom and is a result of inflammation and irritation of the appendix. This pain can start around the umbilicus and then migrate to the right lower quadrant. It is important to note that appendicitis rarely presents with pain in the left lower quadrant or generalized abdominal pain. Rebound tenderness, indicated in Choice D, is a sign of peritoneal irritation and is associated with appendicitis, but it is not as characteristic as the right lower quadrant pain in the initial presentation of appendicitis.
2. Which of the following conditions is most commonly associated with a high risk of stroke?
- A. Hypertension.
- B. Diabetes.
- C. Obesity.
- D. Smoking.
Correct answer: A
Rationale: Hypertension is the correct answer. Hypertension, also known as high blood pressure, is a major risk factor for stroke because it puts increased pressure on blood vessels in the brain, making them more prone to damage and increasing the likelihood of a stroke. While diabetes, obesity, and smoking are also risk factors for stroke, hypertension is the most commonly associated condition with a high risk of stroke due to its direct impact on the blood vessels.
3. When assessing the lower extremities of a client with peripheral vascular disease (PVD), the nurse notes bilateral ankle edema. The edema is related to:
- A. Competent venous valves.
- B. Decreased blood volume.
- C. Increase in muscular activity.
- D. Increased venous pressure.
Correct answer: D
Rationale: The correct answer is 'Increased venous pressure.' In peripheral vascular disease (PVD), impaired blood flow leads to increased venous pressure in the lower extremities, causing fluid to leak out of the blood vessels and accumulate as edema. Choice A, 'Competent venous valves,' is incorrect because in PVD, the venous valves may be incompetent, contributing to venous pooling and edema. Choice B, 'Decreased blood volume,' is incorrect as PVD is associated with impaired blood flow rather than reduced blood volume. Choice C, 'Increase in muscular activity,' is incorrect as it does not directly relate to the development of edema in PVD.
4. The nurse is caring for a client who is scheduled for hemodialysis. Which of the following laboratory values should the nurse monitor closely before, during, and after the procedure?
- A. Hemoglobin level.
- B. Blood urea nitrogen (BUN) level.
- C. Creatinine level.
- D. Serum potassium level.
Correct answer: D
Rationale: The correct answer is D: Serum potassium level. Before, during, and after hemodialysis, monitoring the serum potassium level is crucial to prevent hyperkalemia, a potentially life-threatening complication. Hemodialysis is done to remove waste products and excess electrolytes like potassium from the blood. Monitoring other laboratory values like hemoglobin, BUN, and creatinine is important in assessing kidney function and anemia, but serum potassium level requires close monitoring during hemodialysis due to the risk of rapid shifts that can lead to cardiac arrhythmias.
5. After a client with peripheral vascular disease undergoes a right femoral-popliteal bypass graft, their blood pressure drops from 124/80 to 94/62. What should the nurse assess first?
- A. IV fluid infusion.
- B. Pedal pulses.
- C. Nasal cannula oxygen flow rate.
- D. Capillary refill time.
Correct answer: B
Rationale: Assessing pedal pulses is crucial in this situation as it helps determine the adequacy of perfusion to the lower extremity following a bypass graft. A decrease in blood pressure postoperatively could indicate decreased perfusion, making the assessment of pedal pulses a priority to ensure proper circulation. Checking IV fluid infusion, nasal cannula oxygen flow rate, or capillary refill time are not the immediate priorities in this scenario and would not provide direct information about perfusion to the affected extremity.
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