HESI RN
HESI Medical Surgical Practice Quiz
1. The patient is receiving acetazolamide (Diamox) for metabolic alkalosis and fluid overload. After taking the medication, the patient complains of right-sided flank pain. The nurse suspects that the patient has developed which condition?
- A. Gout
- B. Hemolytic anemia
- C. Metabolic acidosis
- D. Renal calculi
Correct answer: D
Rationale: The correct answer is D: Renal calculi. Acetazolamide, a carbonic anhydrase inhibitor, can lead to electrolyte imbalances and the formation of renal calculi. Right-sided flank pain is a classic symptom of renal calculi. Choices A, B, and C are incorrect. Gout is not typically associated with acetazolamide use. Hemolytic anemia and metabolic acidosis are not commonly linked to acetazolamide-induced side effects. Therefore, the patient's symptoms align more closely with the development of renal calculi.
2. During nasotracheal suctioning, which of the following observations should be cause for concern to the nurse? Select all that apply.
- A. The client becomes cyanotic.
- B. Secretions are bloody.
- C. The client gags during the procedure.
- D. Clear to opaque secretions are removed.
Correct answer: C
Rationale: During nasotracheal suctioning, the client gagging during the procedure is a cause for concern as it can indicate discomfort or potential airway obstruction. Cyanosis, bloody secretions, or the removal of clear to opaque secretions are expected observations that the nurse should monitor for, but gagging indicates a need for immediate intervention to ensure the safety and comfort of the client. Cyanosis and bloody secretions can signify oxygenation issues and potential complications, while the removal of secretions is the goal of the suctioning procedure.
3. A nurse assesses clients on the medical-surgical unit. Which client is at greatest risk for bladder cancer?
- A. A 25-year-old female with a history of sexually transmitted diseases
- B. A 42-year-old male who has worked in a lumber yard for 10 years
- C. A 55-year-old female who has had numerous episodes of bacterial cystitis
- D. An 86-year-old male with a 50–pack-year cigarette smoking history
Correct answer: D
Rationale: The correct answer is D. The greatest risk factor for bladder cancer is a long history of tobacco use, which is reflected in an 86-year-old male with a 50–pack-year cigarette smoking history. Smoking is a well-established risk factor for developing bladder cancer. Choices A, B, and C are not directly linked to an increased risk of bladder cancer. While sexually transmitted diseases, certain occupational exposures, and recurrent urinary tract infections may pose other health risks, they are not specifically associated with an elevated risk of bladder cancer.
4. After pericardiocentesis for cardiac tamponade, for which signs should the nurse assess the client to determine if tamponade is recurring?
- A. Decreasing pulse
- B. Rising blood pressure
- C. Distant muffled heart sounds
- D. Falling central venous pressure (CVP)
Correct answer: C
Rationale: After pericardiocentesis for cardiac tamponade, the nurse should assess for distant muffled heart sounds that were noted before the procedure. If these sounds return, it could indicate recurring pericardial effusion and potential tamponade. Therefore, the correct answer is the return of distant muffled heart sounds (Option C). Decreasing pulse (Option A) and falling central venous pressure (Option D) are not specific signs of recurring tamponade. Rising blood pressure (Option B) is also not a typical sign of tamponade recurrence; in fact, hypotension is more commonly associated with tamponade.
5. A client who has undergone pleural biopsy is being monitored by a nurse. Which finding indicates a potential complication for the client?
- A. Warm, dry skin
- B. Mild pain at the biopsy site
- C. Complaints of shortness of breath
- D. Capillary refill time of less than 3 seconds
Correct answer: C
Rationale: Complaints of shortness of breath are a concerning finding post-pleural biopsy, as they may indicate a complication such as a pneumothorax or hemothorax. Shortness of breath can be a sign of respiratory distress that requires immediate attention. Warm, dry skin, mild pain at the biopsy site, and a capillary refill time of less than 3 seconds are not typically associated with immediate complications following a pleural biopsy. Warm, dry skin may be a normal finding, mild pain can be expected at the biopsy site, and a capillary refill time of less than 3 seconds is within normal limits.
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