HESI RN
HESI RN Medical Surgical Practice Exam
1. A client who is anxious about an impending surgery is at risk for respiratory alkalosis. For which signs and symptoms of respiratory alkalosis does the nurse assess this client?
- A. Disorientation and dyspnea
- B. Drowsiness, headache, and tachypnea
- C. Tachypnea, dizziness, and paresthesias
- D. Dysrhythmias and decreased respiratory rate and depth
Correct answer: C
Rationale: The correct answer is C: Tachypnea, dizziness, and paresthesias. When a client is anxious, they may hyperventilate, leading to respiratory alkalosis. Tachypnea (rapid breathing) is a common sign of respiratory alkalosis. Dizziness and paresthesias (tingling or numbness in the extremities) are also typical symptoms. Choices A, B, and D are incorrect. Disorientation and dyspnea (Choice A) are not specific signs of respiratory alkalosis. Drowsiness, headache, and tachypnea (Choice B) may be more indicative of other conditions. Dysrhythmias and decreased respiratory rate and depth (Choice D) are not consistent with the expected signs of respiratory alkalosis.
2. The healthcare provider caring for a patient who will receive penicillin to treat an infection asks the patient about previous drug reactions. The patient reports having had a rash when taking amoxicillin (Amoxil). The healthcare provider will contact the provider to
- A. discuss giving a smaller dose of penicillin.
- B. discuss using erythromycin (E-mycin) instead of penicillin.
- C. request an order for diphenhydramine (Benadryl).
- D. suggest that the patient receive cefuroxime (Ceftin).
Correct answer: B
Rationale: When a patient reports a previous rash with amoxicillin, which is a type of penicillin, there is a concern for a penicillin allergy. In such cases, using an alternative antibiotic like erythromycin, which is not a penicillin, is the appropriate approach to avoid potential cross-reactivity and allergic reactions. Giving smaller doses of penicillin does not address the underlying allergy issue and can still lead to severe hypersensitivity reactions. Diphenhydramine (Benadryl) is used to manage allergic reactions but should not be the first choice in changing the antibiotic. While some patients allergic to penicillins may also be allergic to cephalosporins like cefuroxime, it is not the best immediate alternative in this scenario.
3. When working with a large population of African-American clients at a community health center, which priority assessment should a nurse include?
- A. Measure height and weight.
- B. Assess blood pressure.
- C. Observe for any signs of abuse.
- D. Ask about medications.
Correct answer: B
Rationale: Assessing blood pressure is the priority assessment when working with a population of African-American clients due to the high prevalence of hypertension in this group. African Americans have a higher risk of hypertension, which can lead to complications like end-stage renal disease. Monitoring blood pressure allows for the early detection and management of hypertension. While measuring height and weight, observing for signs of abuse, and asking about medications are important assessments, assessing blood pressure is crucial in this context to address the specific health needs of African-American clients.
4. The nurse is caring for a patient who is ordered to receive PO trimethoprim-sulfamethoxazole (TMP-SMX) 160/800 QID to treat a urinary tract infection caused by E. coli. The nurse will contact the provider to clarify the correct
- A. dose.
- B. drug.
- C. frequency.
- D. route.
Correct answer: C
Rationale: The correct answer is 'frequency.' Trimethoprim-sulfamethoxazole (TMP-SMX) is typically prescribed to be taken twice daily, not four times a day (QID). The dose, drug, and route are already specified in the order, so the nurse should contact the provider to clarify the frequency of administration to ensure optimal treatment for the urinary tract infection caused by E. coli. Choosing 'dose' is incorrect because the dose of 160/800 is already provided in the order. 'Drug' is incorrect because the medication Trimethoprim-sulfamethoxazole (TMP-SMX) is explicitly stated in the prescription. 'Route' is incorrect as PO (by mouth) is also clearly indicated in the prescription.
5. After teaching a client with nephrotic syndrome and a normal glomerular filtration rate, the nurse assesses the client’s understanding. Which statement made by the client indicates a correct understanding of the nutritional therapy for this condition?
- A. I must decrease my intake of fat.
- B. I will increase my intake of protein.
- C. A decreased intake of carbohydrates will be required.
- D. An increased intake of vitamin C is necessary.
Correct answer: B
Rationale: In nephrotic syndrome, there is significant renal loss of protein leading to hypoalbuminemia and edema formation. If glomerular filtration is normal or near normal, increased protein loss should be matched by an increased intake of protein. Therefore, the correct statement indicating a correct understanding of the nutritional therapy for this condition is increasing protein intake. Decreasing fat, decreasing carbohydrates, or increasing vitamin C intake is not necessary for addressing the underlying issues associated with nephrotic syndrome.
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