HESI RN
HESI Medical Surgical Specialty Exam
1. The nurse is providing discharge teaching for a patient who will receive oral levofloxacin (Levaquin) to treat pneumonia. The patient takes an oral hypoglycemic medication and uses over-the-counter (OTC) antacids to treat occasional heartburn. The patient reports frequent arthritis pain and takes acetaminophen when needed. Which statement by the nurse is correct when teaching this patient?
- A. You may take antacids with levofloxacin to decrease gastrointestinal upset.
- B. You may take nonsteroidal anti-inflammatory medications (NSAIDs) for arthritis pain.
- C. You should monitor your serum glucose more closely while taking levofloxacin.
- D. You should take levofloxacin on an empty stomach to improve absorption.
Correct answer: C
Rationale: Levofloxacin may increase the effects of oral hypoglycemic medications, so patients taking these should be advised to monitor their serum glucose levels closely.
2. A client is starting urinary bladder training. Which statement should the nurse include in this client’s teaching?
- A. Use the toilet when you first feel the urge, rather than at specific intervals.
- B. Try to consciously hold your urine until the scheduled toileting time.
- C. Initially try to use the toilet at least every half hour for the first 24 hours.
- D. The toileting interval can be increased once you have been continent for a week.
Correct answer: B
Rationale: In urinary bladder training, the client should be taught to try to consciously hold their urine until the scheduled toileting time. This helps in training the bladder to hold urine for longer periods. Option A is incorrect because the goal is to consciously hold urine, not void immediately. Option C is incorrect as toileting at least every half hour may not promote bladder training. Option D is incorrect as increasing the toileting interval should be based on the client's comfort and progress, not just after being continent for a week.
3. An adult female client has undergone a routine health screening in the clinic. Which of the following values indicates to the nurse who receives the report of the client’s laboratory work that the client’s hematocrit is normal?
- A. 10%
- B. 22%
- C. 30%
- D. 43%
Correct answer: D
Rationale: The normal hematocrit for an adult female client ranges from 35% to 47%. A hematocrit value of 43% falls within this normal range, indicating normal levels of red blood cells. Choices A, B, and C are low hematocrit values and are considered below the normal range for adult females, signifying potential anemia or other health issues.
4. A client has just returned to the nursing unit after bronchoscopy. To which intervention should the nurse give priority?
- A. Assessing the client for the return of the gag reflex
- B. Administering pain medication
- C. Encouraging copious fluid intake
- D. Ambulating the client
Correct answer: A
Rationale: After bronchoscopy, the priority intervention for the nurse is to assess the client for the return of the gag reflex. This assessment is crucial to ensure the client's safety and prevent aspiration. Keeping the client on nothing-by-mouth status until the gag reflex returns is essential. Administering pain medication, encouraging fluid intake, and ambulating the client are important interventions but assessing the gag reflex takes precedence due to the risk of aspiration post-bronchoscopy.
5. A nursing assistant is measuring the blood pressure (BP) of a hypertensive client while a nurse observes. Which action on the part of the assistant would interfere with accurate measurement and prompt the nurse to intervene? Select all that apply.
- A. Measuring the BP after the client has sat quietly for 5 minutes
- B. Having the client sit with the arm bared and supported at heart level
- C. Using a cuff with a rubber bladder that encircles less than 80% of the limb
- D. Measuring the BP after the client reports that he just drank a cup of coffee
Correct answer: C
Rationale: To ensure accurate blood pressure (BP) measurement, the cuff used should have a rubber bladder that encircles at least 80% of the limb being measured. This ensures proper compression and accurate readings. Choices A and B are correct practices as it is recommended to measure BP after the client has sat quietly for 5 minutes and to have the client sit with the arm bared and supported at heart level. Choice D is also a correct reason for intervention as the client should not have consumed caffeine or smoked tobacco within 30 minutes before BP measurement, as it can affect the accuracy of the reading.
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