HESI RN
HESI Medical Surgical Exam
1. A client is scheduled for an arteriogram. The nurse should explain to the client that the arteriogram will confirm the diagnosis of occlusive arterial disease by:
- A. Showing the location of the obstruction and the collateral circulation.
- B. Scanning the affected extremity and identifying the areas of volume changes.
- C. Using ultrasound to estimate the velocity changes in the blood vessels.
- D. Determining how long the client can walk.
Correct answer: A
Rationale: The correct answer is A: Showing the location of the obstruction and the collateral circulation. An arteriogram is a diagnostic procedure that involves injecting a contrast agent to visualize the blood vessels and identify the location of any obstructions. This helps confirm the diagnosis of occlusive arterial disease by showing where the blockage is located and how collateral circulation is compensating for the reduced blood flow. Choices B, C, and D are incorrect because scanning the extremity, estimating velocity changes with ultrasound, or determining walking distance are not the primary purposes of an arteriogram in diagnosing occlusive arterial disease.
2. 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.
3. A client with early breast cancer receives the results of a breast biopsy and asks the nurse to explain the meaning of staging and the type of receptors found on the cancer cells. Which explanation should the nurse provide?
- A. Lymph node involvement is not significant.
- B. Small tumors are aggressive and indicate poor prognosis.
- C. The tumor's estrogen receptor guides treatment options.
- D. Stage I indicates metastasis.
Correct answer: C
Rationale: Treatment decisions and prediction of prognosis are related to the tumor's receptor status, such as estrogen and progesterone receptor status which commonly are well-differentiated, have a lower chance of recurrence, and are receptive to hormonal therapy. Tumor staging designates tumor size and spread of breast cancer cells into axillary lymph nodes, which is one of the most important prognostic factors in early-stage breast cancer.
4. A young adult client, admitted to the Emergency Department following a motor vehicle collision, is transfused with 4 units of PRBCs (packed red blood cells). The client's pretransfusion hematocrit is 17%. Which hematocrit value should the nurse expect the client to have after all the PRBCs have been transfused?
- A. 0.19
- B. 0.09
- C. 0.39
- D. 0.29
Correct answer: D
Rationale: The expected increase in hematocrit after transfusion is approximately 3% per unit of PRBCs. Since the client received 4 units, the expected increase would be 4 x 3% = 12%. Therefore, adding this to the pretransfusion hematocrit of 17% would result in an expected post-transfusion hematocrit of 29%. Choice A (0.19) is incorrect as it doesn't consider the incremental increase per unit of PRBCs. Choices B (0.09) and C (0.39) are also incorrect as they do not align with the expected increase in hematocrit following the transfusion of 4 units of PRBCs.
5. A 20-year-old female client calls the nurse to report a lump she found in her breast. Which response is the best for the nurse to provide?
- A. Check it again in one month, and if it is still there schedule an appointment.
- B. Most lumps are benign, but it is always best to come in for an examination.
- C. Try not to worry too much about it, because usually, most lumps are benign.
- D. If you are in your menstrual period it is not a good time to check for lumps.
Correct answer: B
Rationale: The nurse advising the client to come in provides the best response because it addresses the client's anxiety most effectively and encourages prompt and immediate action for a potential problem.
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