HESI RN
HESI RN Medical Surgical Practice Exam
1. A patient is being treated for shock after a motor vehicle accident. The provider orders 6% dextran 75 to be given intravenously. The nurse should expect which outcome as the result of this infusion?
- A. Decreased urine output
- B. Improved blood oxygenation
- C. Increased interstitial fluid
- D. Stabilization of heart rate and blood pressure
Correct answer: D
Rationale: 6% Dextran 75 is a high molecular-weight colloidal solution used to treat shock from burns or trauma. Colloids like 6% dextran 75 are plasma expanders that help increase blood volume, leading to improved heart rate and blood pressure stabilization. The infusion of plasma expanders does not typically decrease urine output. It primarily aims to stabilize circulation rather than affect blood oxygenation or increase interstitial fluid levels.
2. A nurse reviews a client’s urinalysis report. Which finding does the nurse recognize as abnormal?
- A. pH of 6.0
- B. An absence of protein
- C. The presence of ketones
- D. Specific gravity of 1.018
Correct answer: C
Rationale: The correct answer is C. The presence of ketones in the urine is abnormal. Ketones in the urine may indicate a state of ketosis, which is commonly seen in uncontrolled diabetes, fasting, or a low-carbohydrate diet. A normal pH range of urine is 4.5 to 7.8, making a pH of 6.0 within the normal range. An absence of protein is a normal finding in urine, as proteinuria (presence of protein) is abnormal. A specific gravity of 1.018 falls within the normal range of 1.016 to 1.022. Therefore, the presence of ketones is the abnormal finding in this scenario.
3. The nurse is caring for a newly admitted patient who will receive digoxin to treat a cardiac dysrhythmia. The patient takes hydrochlorothiazide (HydroDIURIL) and reports regular use of over-the-counter laxatives. Before administering the first dose of digoxin, the nurse will review the patient’s electrolytes with careful attention to the levels of which electrolytes?
- A. Calcium and magnesium
- B. Sodium and calcium
- C. Potassium and chloride
- D. Potassium and magnesium
Correct answer: D
Rationale: Before administering digoxin, the nurse must review the patient's electrolyte levels, focusing on potassium and magnesium. Hypomagnesemia, similar to hypokalemia, can enhance the action of digitalis and lead to digitalis toxicity. Laxatives and diuretics, like hydrochlorothiazide, can deplete both potassium and magnesium. Therefore, monitoring these electrolytes is crucial to prevent potential adverse effects associated with digoxin therapy. Choice A (Calcium and magnesium) is incorrect because calcium levels are not specifically mentioned as crucial for digoxin therapy. Choice B (Sodium and calcium) is incorrect as sodium is not typically monitored in relation to digoxin therapy. Choice C (Potassium and chloride) is incorrect because although potassium is vital, chloride is not typically associated with digoxin therapy.
4. A client's urinalysis results show a urine osmolality of 1200 mOsm/L. What action should the nurse take?
- A. Encourage the client to drink more fluids.
- B. Contact the provider and recommend a low-sodium diet.
- C. Prepare to administer an intravenous diuretic.
- D. Obtain a suction device and implement seizure precautions.
Correct answer: A
Rationale: The correct action for the nurse to take when the client has a urine osmolality of 1200 mOsm/L, indicating dehydration, is to encourage the client to drink more fluids. Dehydration can lead to elevated urine osmolality, and increasing fluid intake can help rehydrate the client. A low-sodium diet is not the priority in this scenario as it would not directly address the dehydration indicated by the high urine osmolality. Administering an intravenous diuretic would further concentrate the urine, exacerbating the dehydration. Obtaining a suction device and implementing seizure precautions are not indicated based on the client's urine osmolality results and would not address the underlying issue of dehydration.
5. A female patient will receive doxycycline to treat a sexually transmitted infection (STI). What information will the nurse include when teaching this patient about this medication?
- A. Nausea and vomiting are uncommon adverse effects.
- B. The drug may cause possible teratogenic effects.
- C. Increase intake of dairy products with each dose of this medication.
- D. Use a backup method of contraception if taking oral contraceptives.
Correct answer: D
Rationale: The correct answer is D. The desired action of oral contraceptives can be reduced when taken with tetracyclines like doxycycline. Therefore, patients on oral contraceptives should be advised to use a backup contraception method while taking doxycycline. Choice A is incorrect because nausea and vomiting are common adverse effects of doxycycline. Choice B is incorrect because doxycycline is not known for causing teratogenic effects. Choice C is incorrect because dairy products can interfere with the absorption of doxycycline, so they should be avoided when taking this medication.
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