HESI RN
Evolve HESI Medical Surgical Practice Exam Quizlet
1. The client has been managing angina episodes with nitroglycerin. Which of the following indicates the drug is effective?
- A. Decreased chest pain.
- B. Increased blood pressure.
- C. Decreased blood pressure.
- D. Decreased heart rate.
Correct answer: A
Rationale: The correct answer is A: Decreased chest pain. Nitroglycerin is a vasodilator that works by decreasing myocardial oxygen consumption, which helps to reduce chest pain caused by angina. Therefore, a reduction in chest pain is a positive indicator of the drug's effectiveness. Choices B, C, and D are incorrect because nitroglycerin does not typically increase blood pressure or heart rate; instead, it often causes a decrease in blood pressure due to vasodilation and may cause a reflex tachycardia (increased heart rate) as a compensatory response to lowered blood pressure.
2. A client arrived to the medical-surgical unit 4 hours after a transurethral resection of the prostate (TURP). A triple-lumen catheter for continuous bladder irrigation with normal saline is infusing, and the nurse observes dark, pink-tinged outflow with blood clots in the tubing and collection bag. Which action should the nurse take?
- A. Monitoring catheter drainage
- B. Decreasing the flow rate
- C. Irrigating the catheter manually
- D. Discontinuing infusing the solution
Correct answer: C
Rationale: In this scenario, the nurse should choose option C - irrigating the catheter manually. This action can help clear the clots from the catheter and ensure proper bladder drainage. Monitoring catheter drainage (option A) alone may not address the issue of clots obstructing the flow. Decreasing the flow rate (option B) could potentially worsen clot formation. Discontinuing the infusing solution (option D) without addressing the clots first may lead to inadequate irrigation and increase the risk of complications.
3. Which of the following is a priority intervention for a patient with heart failure?
- A. Administering diuretics.
- B. Administering oxygen.
- C. Administering beta-blockers.
- D. Administering vasodilators.
Correct answer: B
Rationale: Administering oxygen is a priority intervention in heart failure because it helps improve oxygenation, alleviate hypoxemia, and reduce the workload on the heart. Oxygen therapy is crucial in managing acute heart failure exacerbations. While diuretics (Choice A) are commonly used in heart failure to reduce fluid overload, administering oxygen takes precedence due to its immediate impact on oxygen delivery. Beta-blockers (Choice C) and vasodilators (Choice D) are also important in heart failure management, but in the acute setting, ensuring adequate oxygen supply is the priority.
4. A client with gouty arthritis reports tenderness and swelling of the right ankle and great toe. The nurse observes the area of inflammation extends above the ankle. The client receives prescriptions for colchicine and indomethacin. Which instruction should the nurse include in the discharge teaching?
- A. Eat high-protein foods to achieve ideal body weight
- B. Drink at least 8 cups (1920mL) of water per day
- C. Use an electric heating pad when pain is at its worst
- D. Encourage active range of motion to prevent stiffness
Correct answer: B
Rationale: The correct answer is to instruct the client to drink at least 8 cups (1920mL) of water per day. Adequate hydration helps to prevent the formation of uric acid crystals, which can exacerbate gout symptoms. Choice A is incorrect because while maintaining a healthy weight is important, it doesn't directly address gout management. Choice C is incorrect because using an electric heating pad can worsen inflammation. Choice D is incorrect because active range of motion may exacerbate pain and inflammation in the affected joints.
5. Which instruction should be included in the discharge teaching plan for a client who underwent cataract extraction today?
- A. Use a metal eye shield on the operative eye during the day.
- B. Administer eye ointment before applying eye drops.
- C. Sexual activities may be resumed after returning home.
- D. Light housekeeping is safe to do, but avoid heavy lifting.
Correct answer: D
Rationale: The correct instruction to include in the discharge teaching plan for a client who underwent cataract extraction is to advise them that light housekeeping is safe to do, but they should avoid heavy lifting. Heavy lifting can strain the surgical site and potentially lead to complications. Choice A is incorrect as a metal eye shield is usually recommended during sleep, not during the day. Choice B is incorrect because eye ointment should typically be administered after applying eye drops to prevent dilution of the medication. Choice C is incorrect as sexual activities should usually be avoided for a specific period post-surgery as advised by the healthcare provider.
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