HESI RN
Evolve HESI Medical Surgical Practice Exam Quizlet
1. What is the primary action of insulin in the body?
- A. To lower blood pressure.
- B. To promote the absorption of glucose into cells.
- C. To increase blood glucose levels.
- D. To decrease blood glucose levels.
Correct answer: B
Rationale: The correct answer is B: To promote the absorption of glucose into cells. Insulin facilitates the uptake of glucose by cells, thereby decreasing blood glucose levels. Choice A is incorrect as insulin does not directly affect blood pressure. Choice C is inaccurate as insulin works to lower, not increase, blood glucose levels. Choice D is incorrect because insulin's primary role is to lower, not increase, blood glucose levels by promoting glucose uptake into cells.
2. The client with chronic renal failure is being educated about the importance of a low-sodium diet. Which of the following statements by the client indicates a need for further teaching?
- A. I can eat canned vegetables as long as I rinse them first.
- B. I can use table salt sparingly.
- C. I can eat frozen dinners if they are labeled low-sodium.
- D. I can eat whatever I want as long as I avoid salty foods.
Correct answer: B
Rationale: The correct answer is B. Clients with chronic renal failure need to strictly limit their sodium intake. Advising the client to use table salt sparingly is incorrect as they should avoid table salt altogether to adhere to a low-sodium diet. Choice A is correct as rinsing canned vegetables can help reduce their sodium content. Choice C is correct as consuming frozen dinners labeled low-sodium can be a suitable option. Choice D is incorrect as it implies that avoiding only salty foods is sufficient, when in fact, overall sodium intake needs to be monitored closely.
3. In a patient with cirrhosis, which of the following lab results is most concerning?
- A. Elevated liver enzymes.
- B. Low albumin levels.
- C. Elevated bilirubin levels.
- D. Low platelet count.
Correct answer: D
Rationale: In a patient with cirrhosis, a low platelet count is the most concerning lab result. Thrombocytopenia, or low platelet count, is common in cirrhosis due to impaired platelet production in the liver. It significantly increases the risk of bleeding and can lead to serious complications such as hemorrhage. Elevated liver enzymes (Choice A) are expected in cirrhosis but may not directly indicate the severity of the disease. Low albumin levels (Choice B) are common in cirrhosis and can contribute to fluid retention but do not pose an immediate risk of bleeding. Elevated bilirubin levels (Choice C) are also expected in cirrhosis and typically indicate impaired liver function but do not directly increase the risk of bleeding as much as a low platelet count.
4. A client tells the clinic nurse about experiencing burning on urination, and assessment reveals that the client had sexual intercourse four days ago with a person who was casually met. Which action should the nurse implement?
- A. Observe the perineal area for a chancroid-like lesion
- B. Obtain a specimen of urethral drainage for culture
- C. Assess for perineal itching, erythema, and excoriation
- D. Identify all sexual partners in the last four days
Correct answer: B
Rationale: Obtaining a urethral drainage specimen for culture is crucial in diagnosing a potential sexually transmitted infection (STI) in this client. While assessing for perineal symptoms like itching, erythema, and excoriation (Choice C) may provide additional information, obtaining a culture is more definitive. Observing for a chancroid-like lesion (Choice A) is not as pertinent as obtaining a culture for a broader diagnostic approach. Identifying all sexual partners in the last four days (Choice D) is important for contact tracing but obtaining a specimen for culture takes priority in this scenario.
5. The nurse is monitoring a client with chronic renal failure who is receiving hemodialysis. The nurse should report which of the following findings immediately?
- A. Clear dialysate outflow.
- B. Weight gain of 2 lbs (0.9 kg) since the last treatment.
- C. Blood pressure of 130/80 mm Hg.
- D. Pulse rate of 72 bpm.
Correct answer: B
Rationale: The correct answer is B. Weight gain of 2 lbs (0.9 kg) since the last treatment is concerning in a client undergoing hemodialysis with chronic renal failure as it may indicate fluid overload. This finding requires immediate reporting and intervention to prevent complications such as fluid retention, pulmonary edema, or exacerbation of heart failure. Choices A, C, and D are not findings that require immediate attention in this context. Clear dialysate outflow is a normal finding during hemodialysis, a blood pressure of 130/80 mm Hg is within a normal range for many clients, and a pulse rate of 72 bpm is also within the expected range for most individuals.
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