HESI RN
HESI Medical Surgical Test Bank
1. A client who is experiencing respiratory distress is admitted with respiratory acidosis. Which pathophysiological process supports the client's respiratory acidosis?
- A. Carbon dioxide is converted in the kidneys for elimination.
- B. Blood oxygen levels are stimulating the respiratory rate.
- C. Hyperventilation is eliminating carbon dioxide rapidly.
- D. High levels of carbon dioxide have accumulated in the blood.
Correct answer: D
Rationale: The correct answer is D. High levels of carbon dioxide in the blood are indicative of respiratory acidosis, often due to inadequate ventilation. In respiratory acidosis, there is retention of carbon dioxide (hypercapnia) leading to an increase in carbonic acid levels in the blood, resulting in an acidic pH. Option A is incorrect because carbon dioxide elimination primarily occurs through the lungs, not the kidneys. Option B is incorrect because blood oxygen levels primarily affect the respiratory rate to regulate oxygen levels, not carbon dioxide levels. Option C is incorrect because hyperventilation would lead to a decrease, not an increase, in carbon dioxide levels.
2. Which of the following is the best indicator of long-term glycemic control in a patient with diabetes?
- A. Fasting blood glucose levels.
- B. Postprandial blood glucose levels.
- C. Hemoglobin A1c.
- D. Random blood glucose levels.
Correct answer: C
Rationale: The correct answer is C, Hemoglobin A1c. Hemoglobin A1c measures the average blood glucose level over the past 2-3 months, providing a reliable indicator of long-term glycemic control. Fasting blood glucose levels (choice A) only offer a snapshot of the current glucose level and can fluctuate throughout the day. Postprandial blood glucose levels (choice B) reflect glucose levels after meals but do not give a comprehensive view of long-term control. Random blood glucose levels (choice D) are taken at any time and lack the consistency needed to assess long-term glycemic control effectively. Therefore, Hemoglobin A1c is the superior choice for monitoring and managing diabetes over an extended period.
3. The nurse is obtaining a health history from a new client who has a history of kidney stones. Which statement by the client indicates an increased risk for renal calculi?
- A. Eats a vegetarian diet with cheese 2 to 3 times a day
- B. Experiences additional stress since adopting a child
- C. Jogs more frequently than usual daily routine
- D. Drinks several bottles of carbonated water daily
Correct answer: D
Rationale: The correct answer is D. Drinking several bottles of carbonated water daily may contribute to renal calculi formation due to the high mineral content. Carbonated drinks can increase the risk of kidney stones due to their high levels of phosphoric acid and caffeine, which can lead to the formation of crystals in the urine. Choices A, B, and C are less likely to directly contribute to an increased risk of renal calculi compared to the excessive consumption of carbonated water.
4. The client with chronic renal failure is receiving instruction on dietary restrictions. Which of the following food items should the client be instructed to avoid?
- A. Bananas.
- B. Apples.
- C. Rice.
- D. Potatoes.
Correct answer: A
Rationale: The correct answer is A: Bananas. Bananas are high in potassium, and individuals with chronic renal failure are often advised to limit potassium intake to prevent hyperkalemia. Apples, rice, and potatoes are lower in potassium and can be included in moderation in the diet of clients with chronic renal failure.
5. What is the most common symptom of gastroesophageal reflux disease (GERD)?
- A. Heartburn.
- B. Nausea.
- C. Abdominal pain.
- D. Vomiting.
Correct answer: A
Rationale: The correct answer is A: Heartburn. Heartburn is the most common symptom of GERD as it occurs due to the reflux of stomach acid into the esophagus. This leads to a burning sensation in the chest that can worsen after eating, lying down, or bending over. Choice B, Nausea, is not typically the most common symptom of GERD, although it can occur in some cases. Choice C, Abdominal pain, is not a primary symptom of GERD and is more commonly associated with other gastrointestinal conditions. Choice D, Vomiting, is also not the most common symptom of GERD, although it can occur in severe cases or as a result of complications.
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