HESI RN
HESI Medical Surgical Assignment Exam
1. A 70-kg adult with chronic renal failure is on a 40-g protein diet. The client has a reduced glomerular filtration rate and is not undergoing dialysis. Which result would give the nurse the most concern?
- A. Albumin level of 2.5 g/dL
- B. Phosphorus level of 5 mg/dL
- C. Sodium level of 135 mmol/L
- D. Potassium level of 5.5 mmol/L
Correct answer: A
Rationale: In chronic renal failure, a protein-restricted diet is crucial to prevent the buildup of waste products. A low albumin level (<3.5 g/dL) indicates inadequate protein intake, raising concern as it may lead to malnutrition and tissue breakdown. Phosphorus, sodium, and potassium levels are not directly impacted by protein intake. Phosphorus levels may elevate in renal failure, but at 5 mg/dL, it is within normal range. Sodium and potassium levels are also within normal limits and not influenced by protein restriction.
2. The nurse is preparing to begin a medication regimen for a patient who will receive intravenous ampicillin and gentamicin. Which is an important nursing action?
- A. Administer each antibiotic to infuse over 15 to 20 minutes.
- B. Order serum peak and trough levels of ampicillin.
- C. Prepare the schedule so that the drugs are given at the same time.
- D. Set up separate tubing sets for each drug labeled with the drug name and date.
Correct answer: D
Rationale: When administering intravenous aminoglycosides like gentamicin with penicillins such as ampicillin, it is crucial to avoid mixing them in the same container. Separate tubing sets labeled with the drug name and date should be used to prevent interactions between the medications. Administering each antibiotic over 15 to 20 minutes (Choice A) may not be appropriate for all medications and does not address the issue of compatibility. Ordering serum peak and trough levels of ampicillin (Choice B) is important for monitoring drug levels but does not directly address the administration process. Preparing a schedule to give drugs simultaneously (Choice C) may increase the risk of drug interactions and is not recommended when administering incompatible medications.
3. After teaching a client with early polycystic kidney disease (PKD) about nutritional therapy, the nurse assesses the client’s understanding. Which statement made by the client indicates a correct understanding of the teaching?
- A. I will take a laxative every night before going to bed.
- B. I must increase my intake of dietary fiber and fluids.
- C. I shall only use salt when I am cooking my own food.
- D. I’ll eat white bread to minimize gastrointestinal gas.
Correct answer: B
Rationale: Choice B is the correct answer. Clients with PKD often experience constipation, which can be managed by increasing their intake of dietary fiber and fluids. This helps promote bowel regularity. Laxatives should be used cautiously and not as a routine solution. Choice A is incorrect as regular laxative use is not recommended. Choice C is incorrect as a low-salt diet is typically advised for clients with PKD, not just limiting salt while cooking. Choice D is incorrect as white bread is low in fiber and not beneficial for managing constipation, which is common in PKD.
4. The nurse is providing teaching to a patient who will begin taking a cephalosporin to treat an infection. Which statement by the patient indicates a need for further teaching?
- A. I may stop taking the medication if my symptoms clear up.
- B. I should eat yogurt while taking this medication.
- C. I should stop taking the drug and call my provider if I develop a rash.
- D. I will not consume alcohol while taking this medication.
Correct answer: A
Rationale: Patients should take all of an antibiotic regimen even after symptoms clear to ensure complete treatment of the infection.
5. A nurse cares for a client with urinary incontinence. The client states, “I am so embarrassed. My bladder leaks like a young child’s bladder.” How should the nurse respond?
- A. I understand how you feel. I would be mortified.
- B. Incontinence pads will minimize leaks in public.
- C. I can teach you strategies to help control your incontinence.
- D. More women experience incontinence than you might think.
Correct answer: C
Rationale: The nurse should accept and acknowledge the client’s concerns, and assist the client to learn techniques that will allow control of urinary incontinence. The nurse should not diminish the client’s concerns with the use of pads or stating statistics about the occurrence of incontinence.
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