HESI RN
HESI Medical Surgical Specialty Exam
1. A client in the postanesthesia care unit has an as-needed prescription for ondansetron (Zofran). Which of the following occurrences would prompt the nurse to administer this medication to the client?
- A. Paralytic ileus
- B. Incisional pain
- C. Urine retention
- D. Nausea and vomiting
Correct answer: D
Rationale: The correct answer is D: Nausea and vomiting. Ondansetron is an antiemetic used to manage postoperative nausea and vomiting, as well as nausea and vomiting related to chemotherapy. It is not indicated for treating paralytic ileus, incisional pain, or urine retention. Paralytic ileus is a condition of the gastrointestinal tract characterized by the paralysis of intestinal muscles, which would not be treated with ondansetron. Incisional pain is typically managed with analgesics, not antiemetics. Urine retention is a urinary issue that does not involve nausea and vomiting, making ondansetron an inappropriate choice for this condition.
2. A client who is scheduled for cardiac catheterization to rule out coronary occlusion should be informed by the nurse that:
- A. The procedure is performed in a darkened room in the radiology department
- B. It is necessary to lie quietly on a hard x-ray table for about 4 hours
- C. The room is bright and well lit, and it is best to keep the eyes closed
- D. The client may have feelings of warmth or flushing during the procedure
Correct answer: D
Rationale: Before cardiac catheterization, the nurse should inform the client that the procedure is performed in a darkened room in the radiology department, not the operating room. The client should expect to lie still on an x-ray table for the duration of the procedure, not necessarily for about 4 hours. Keeping the eyes closed is not necessary as the room is usually dimly lit. The client may experience sensations of warmth or flushing during the procedure due to catheter passage and dye injection, making choice D the correct answer.
3. What is the most suitable toy for a 3-year-old boy receiving weekly chemotherapy treatment?
- A. Bouncy ball
- B. Coloring book with crayons
- C. Duck that squeaks
- D. Remote-controlled car
Correct answer: B
Rationale: A coloring book with crayons is the best choice as it is safe, engaging, and can provide a distraction during treatment without posing any safety risks. Coloring activities can help keep the child occupied, promote creativity, and offer a calming and therapeutic outlet during chemotherapy sessions.
4. What is the most important assessment for a nurse to conduct on a child diagnosed with intussusception?
- A. Monitor for signs of infection.
- B. Measure abdominal girth and monitor for pain.
- C. Check for bowel movement and changes in stool.
- D. Assess hydration status and monitor urine output.
Correct answer: C
Rationale: The correct answer is C: 'Check for bowel movement and changes in stool.' Intussusception can cause obstruction in the bowel, leading to symptoms like abdominal pain, vomiting, and 'currant jelly' stools. Monitoring for changes in bowel movement, especially the passage of 'currant jelly' stools, is crucial for early detection of worsening conditions. Choices A, B, and D are important assessments in pediatric care but are not as specific or crucial as checking for changes in bowel movement in a child diagnosed with intussusception.
5. Which organelle has the ability to hydrolyze fats, nucleic acids, proteins, and sugars?
- A. Chloroplasts
- B. Mitochondria
- C. Lysosomes
- D. Ribosomes
Correct answer: C
Rationale: The correct answer is C, Lysosomes. Lysosomes contain hydrolytic enzymes that are capable of breaking down various biomolecules such as fats, nucleic acids, proteins, and sugars. This organelle acts as the 'digestive system' of the cell. Choices A, B, and D are incorrect because chloroplasts are involved in photosynthesis, mitochondria are responsible for energy production, and ribosomes are responsible for protein synthesis, not the hydrolysis of biomolecules.