HESI RN
HESI Medical Surgical Practice Exam
1. A client is scheduled to have an arteriogram. During the arteriogram, the client reports having nausea, tingling, and dyspnea. The nurse's immediate action should be to:
- A. Administer epinephrine.
- B. Inform the physician.
- C. Administer oxygen.
- D. Inform the client that the procedure is almost over.
Correct answer: B
Rationale: The correct immediate action for the nurse to take in this situation is to inform the physician. The symptoms described - nausea, tingling, and dyspnea - indicate a potential allergic reaction to the contrast dye used in the arteriogram. It is crucial to notify the physician promptly so that further assessment and appropriate interventions can be initiated. Administering epinephrine without physician guidance can be dangerous as the physician needs to evaluate the severity of the reaction and determine the necessary treatment. Administering oxygen may be needed but should be done under the physician's direction. Informing the client that the procedure is almost over is not a priority when the client is experiencing symptoms of a possible allergic reaction.
2. A marathon runner comes into the clinic and states, 'I have not urinated very much in the last few days.' The nurse notes a heart rate of 110 beats/min and a blood pressure of 86/58 mm Hg. Which action by the nurse is the priority?
- A. Give the client a bottle of water immediately.
- B. Start an intravenous line for fluids.
- C. Teach the client to drink 2 to 3 liters of water daily.
- D. Perform an electrocardiogram.
Correct answer: A
Rationale: The priority action for the nurse is to give the client a bottle of water immediately. The athlete's symptoms of decreased urination, along with a heart rate of 110 beats/min and low blood pressure of 86/58 mm Hg, indicate mild dehydration. Rehydration should begin promptly to address the dehydration. Teaching the client to drink 2 to 3 liters of water daily is a good long-term strategy but not the immediate priority. Starting an intravenous line for fluids may be necessary if oral hydration is insufficient or if the degree of dehydration is severe. Performing an electrocardiogram is not indicated at this time as the priority is addressing the dehydration.
3. The client with chronic renal failure is being educated about the importance of a low-sodium diet. Which of the following statements by the client indicates a need for further teaching?
- A. I can eat canned vegetables as long as I rinse them first.
- B. I can use table salt sparingly.
- C. I can eat frozen dinners if they are labeled low-sodium.
- D. I can eat whatever I want as long as I avoid salty foods.
Correct answer: B
Rationale: The correct answer is B. Clients with chronic renal failure need to strictly limit their sodium intake. Advising the client to use table salt sparingly is incorrect as they should avoid table salt altogether to adhere to a low-sodium diet. Choice A is correct as rinsing canned vegetables can help reduce their sodium content. Choice C is correct as consuming frozen dinners labeled low-sodium can be a suitable option. Choice D is incorrect as it implies that avoiding only salty foods is sufficient, when in fact, overall sodium intake needs to be monitored closely.
4. Blood is drawn from a client with suspected uric acid calculi for a serum uric acid determination. Which value does the nurse recognize as a normal uric acid level?
- A. 1.7 mg/dL
- B. 5.8 mg/dL
- C. 8.9 mg/dL
- D. 12.8 mg/dL
Correct answer: B
Rationale: The normal range for uric acid is 4.5 to 8 mg/dL for males and 2.5 to 6.2 mg/dL for females. A uric acid level of 5.8 mg/dL falls within the normal range. Choices A, C, and D are outside the normal reference range, making them incorrect. Choice B is the correct answer as it aligns with the typical uric acid levels in the blood.
5. The healthcare provider is assessing the client's use of medications. Which of the following medications may cause a complication with the treatment plan of a client with diabetes?
- A. Aspirin
- B. Steroids
- C. Sulfonylureas
- D. Angiotensin-converting enzyme (ACE) inhibitors
Correct answer: B
Rationale: The correct answer is B: Steroids. Steroids can induce hyperglycemia, complicating diabetes management by raising blood sugar levels. Aspirin is not typically associated with causing complications in diabetic clients. Sulfonylureas are oral antidiabetic medications that can lower blood sugar levels and are commonly used in diabetes management, making them beneficial rather than harmful. Angiotensin-converting enzyme (ACE) inhibitors are medications often prescribed to manage hypertension in diabetic clients and do not typically interfere with diabetes treatment plans.
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