HESI RN
HESI Medical Surgical Practice Exam
1. Angiotensin-converting enzyme (ACE) inhibitors may be prescribed for the client with diabetes mellitus to reduce vascular changes and possibly prevent or delay the development of:
- A. Chronic obstructive pulmonary disease (COPD).
- B. Pancreatic cancer.
- C. Renal failure.
- D. Cerebrovascular accident.
Correct answer: C
Rationale: The correct answer is C: Renal failure. ACE inhibitors are commonly used in clients with diabetes mellitus to help reduce the progression of diabetic nephropathy by improving renal blood flow. This medication class can help prevent or delay the development of renal failure in these clients. Choices A, B, and D are incorrect because ACE inhibitors do not have a direct impact on preventing or delaying the development of chronic obstructive pulmonary disease, pancreatic cancer, or cerebrovascular accidents in clients with diabetes mellitus.
2. An older female client has normal saline infusing at 45 mL/hour. She complains of pain at the insertion site of the IV catheter. There is no redness or edema around the IV site. Which action should the nurse take?
- A. Determine which IV medications have recently been administered.
- B. Explain that without redness or edema, there is no need to re-start the IV.
- C. Consult with the healthcare provider about the best location to start a new IV.
- D. Convert the IV to a saline lock and continue to monitor the site.
Correct answer: D
Rationale: Converting the IV to a saline lock and continuing to monitor the site is the correct action in this scenario. When a client complains of pain at the IV insertion site without redness or edema, it may indicate phlebitis or irritation. Replacing the IV may not be necessary if there are no signs of infection or infiltration. Determining the IV medications administered or consulting with the healthcare provider to start a new IV are not immediate actions required for pain management at the insertion site. Therefore, the most appropriate intervention is to convert the IV to a saline lock and closely observe for any changes or complications.
3. A male client expresses concern about how a hypophysectomy will affect his sexual function. Which of the following statements provides the most accurate information about the physiologic effects of hypophysectomy?
- A. Removing the source of excess hormone should restore the client's libido, erectile function, and fertility.
- B. Potency will be restored, but the client will remain infertile.
- C. Fertility will be restored, but impotence and decreased libido will persist.
- D. Exogenous hormones will be needed to restore erectile function after the adenoma is removed.
Correct answer: A
Rationale: Choice A is the most accurate statement regarding the physiologic effects of hypophysectomy on sexual function. The client's sexual problems are directly related to excessive hormone levels. Removing the source of excess hormone secretion through hypophysectomy should allow the client to return to a normal physiologic pattern, which includes restoring libido, erectile function, and fertility. Choices B, C, and D are incorrect. Choice B incorrectly states that the client will remain infertile, which is not necessarily true after a hypophysectomy. Choice C inaccurately suggests that fertility will be restored while impotence and decreased libido will persist, which is not aligned with the expected outcomes of hypophysectomy. Choice D is incorrect because exogenous hormones are typically not needed to restore erectile function after the adenoma is removed; rather, the removal of the source of excessive hormone secretion should address the sexual function concerns.
4. A client with chronic renal failure is receiving erythropoietin therapy. The nurse should assess the client for which of the following side effects?
- A. Hypotension.
- B. Hypertension.
- C. Hyperglycemia.
- D. Hypercalcemia.
Correct answer: B
Rationale: The correct answer is B: Hypertension. Erythropoietin therapy can lead to an increase in blood pressure, making hypertension a common side effect that the nurse should closely monitor. Hypotension (choice A) is not typically associated with erythropoietin therapy. Hyperglycemia (choice C) and hypercalcemia (choice D) are not commonly linked to erythropoietin therapy in clients with chronic renal failure, making them incorrect choices.
5. In a patient with diabetes mellitus, which of the following is a sign of hypoglycemia?
- A. Polydipsia.
- B. Polyuria.
- C. Sweating.
- D. Dry skin.
Correct answer: C
Rationale: Sweating is a common sign of hypoglycemia in diabetic patients. When blood sugar levels drop too low, the body releases stress hormones like adrenaline, which can cause sweating as a response to the perceived danger. Polydipsia (excessive thirst) and polyuria (excessive urination) are actually more commonly associated with hyperglycemia, not hypoglycemia. Dry skin is not typically a sign of hypoglycemia.
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