HESI RN
HESI Medical Surgical Exam
1. The client with peripheral artery disease has been prescribed clopidogrel (Plavix). The nurse understands that more teaching is necessary when the client states which of the following?
- A. I should not be surprised if I bruise more easily or if my gums bleed a little when brushing my teeth.
- B. It is important to take this medicine with food to enhance its effectiveness and minimize stomach upset.
- C. I should stop taking Plavix if it makes me feel weak and dizzy.
- D. The doctor prescribed this medicine to make my platelets less likely to stick together and help prevent clots from forming.
Correct answer: C
Rationale: The correct answer is C. Weakness, dizziness, and headache are common adverse effects of Plavix and should be reported. It is essential to consult a physician before stopping Plavix as it plays a crucial role in preventing platelets from sticking together and forming clots. Choices A, B, and D are incorrect. Choice A is a common side effect of Plavix and does not indicate a need for further teaching. Choice B is incorrect because taking Plavix with or without food can affect its absorption and effectiveness. Choice D correctly explains the purpose of prescribing Plavix to prevent clot formation.
2. After a transsphenoidal hypophysectomy, the nurse should assess the client for:
- A. Cerebrospinal fluid (CSF) leak.
- B. Fluctuating blood glucose levels.
- C. Cushing's syndrome.
- D. Cardiac arrhythmias.
Correct answer: A
Rationale: Following a transsphenoidal hypophysectomy, assessing the client for a cerebrospinal fluid (CSF) leak is crucial due to the risk of this serious complication. A CSF leak can lead to infection and increased intracranial pressure, which must be promptly identified and managed to prevent further complications. Fluctuating blood glucose levels (Choice B) are not directly associated with a transsphenoidal hypophysectomy. Cushing's syndrome (Choice C) is a condition related to prolonged exposure to high levels of cortisol and is not a common immediate concern post-transsphenoidal hypophysectomy. Cardiac arrhythmias (Choice D) are not typically a direct complication of this surgical procedure, making it a less relevant concern compared to a CSF leak.
3. A client with type 1 diabetes mellitus has influenza. The nurse should instruct the client to:
- A. Increase the frequency of self-monitoring (blood glucose testing).
- B. Reduce food intake to alleviate nausea.
- C. Discontinue the insulin dose if unable to eat.
- D. Take the normal dose of insulin.
Correct answer: A
Rationale: During illness, individuals with type 1 diabetes mellitus may experience increased insulin requirements due to factors such as stress and the release of counterregulatory hormones. Increasing the frequency of self-monitoring, as stated in choice A, is crucial to closely monitor and adjust insulin doses as needed. Choice B, reducing food intake to alleviate nausea, is incorrect as it may lead to hypoglycemia and does not address the increased insulin needs during illness. Choice C, discontinuing the insulin dose if unable to eat, is dangerous as it can result in uncontrolled hyperglycemia. Choice D, taking the normal dose of insulin, may not be sufficient during illness when insulin requirements are likely elevated.
4. A client is hospitalized with heart failure (HF). Which intervention should the nurse implement to improve ventilation and reduce venous return?
- A. Perform passive range of motion exercises
- B. Place the client in high Fowler's position
- C. Administer oxygen via nasal cannula
- D. Increase the client's activity level
Correct answer: B
Rationale: In clients with heart failure, placing them in high Fowler's position is beneficial as it helps reduce venous return and improve ventilation. This position aids in decreasing the workload on the heart by promoting better lung expansion and oxygenation. Passive range of motion exercises (Choice A) are not directly related to improving ventilation or reducing venous return. Administering oxygen via nasal cannula (Choice C) may help with oxygenation but does not directly address reducing venous return. Increasing the client's activity level (Choice D) may worsen heart failure symptoms by increasing the workload on the heart.
5. The client has had a femoral-popliteal bypass surgery 6 hours ago. Which assessment provides the most accurate information about the client's postoperative status?
- A. Radial pulse.
- B. Femoral pulse.
- C. Apical pulse.
- D. Dorsalis pedis pulse.
Correct answer: D
Rationale: Assessing the dorsalis pedis pulse is crucial after a femoral-popliteal bypass surgery to determine adequate circulation distal to the surgical site. A strong dorsalis pedis pulse indicates sufficient blood flow to the foot, which is essential for monitoring postoperative status. The radial pulse (A) is not the most relevant assessment as it does not provide direct information on circulation in the lower extremities. The femoral pulse (B) may not accurately reflect circulation distal to the surgical site. The apical pulse (C) is used primarily to assess the heartbeat and cardiac function, not circulation in the lower extremities.
Similar Questions
Access More Features
HESI RN Basic
$69.99/ 30 days
- 50,000 Questions with answers
- All HESI courses Coverage
- 30 days access @ $69.99
HESI RN Premium
$149.99/ 90 days
- 50,000 Questions with answers
- All HESI courses Coverage
- 30 days access @ $149.99