HESI RN
HESI Medical Surgical Exam
1. A client receives a prescription for 1 liter of lactated Ringer's intravenously to be infused over 6 hours. How many mL/hr should the nurse program the infusion pump to deliver? (Enter numerical value only. If rounding is needed, round to the nearest whole number.)
- A. 167 mL/hr
- B. 200 mL/hr
- C. 83 mL/hr
- D. 111 mL/hr
Correct answer: A
Rationale: The correct infusion rate is 167 mL/hr. This is calculated by dividing the total volume (1000 mL) by the total time (6 hours), resulting in 166.67 mL/hr, which should be rounded to the nearest whole number as 167 mL/hr. This calculation ensures a steady infusion rate over the specified time frame. Choices B, C, and D are incorrect as they do not accurately reflect the correct calculation based on the volume and time provided in the prescription.
2. A nurse is assessing the status of a client with diabetes mellitus. The nurse concludes that the client is exhibiting adequate diabetic control if the serum level of glycosylated hemoglobin A1C (HbA1C) is less than:
- A. 7%
- B. 9%
- C. 10%
- D. 15%
Correct answer: A
Rationale: The correct answer is A: 7%. Glycosylated hemoglobin A1C (HbA1C) level of 7.0% or less is considered indicative of adequate diabetic control. This level reflects good long-term blood sugar management. Choices B, C, and D are incorrect because an HbA1C level above 7% indicates poor diabetic control and an increased risk of complications associated with diabetes, such as cardiovascular disease, neuropathy, and retinopathy.
3. An adult client who received partial thickness burns on 40% of the body in a house fire is admitted to the inpatient burn unit. Which fluid should the nurse prepare to administer during the client's burn recovery?
- A. 5% dextrose in water
- B. 5% dextrose in 0.25 normal saline
- C. Total parenteral nutrition
- D. Lactated Ringer's
Correct answer: D
Rationale: During the burn recovery phase, the nurse should prepare to administer Lactated Ringer's solution. Lactated Ringer's is the preferred fluid choice for burn patients as it helps replace lost fluids and electrolytes, maintain perfusion, and support organ function. Option A, 5% dextrose in water, is not the appropriate choice for fluid resuscitation in burn patients. Option B, 5% dextrose in 0.25 normal saline, does not provide the necessary electrolytes needed for burn recovery. Option C, Total parenteral nutrition, may be considered later in the treatment but is not the initial fluid of choice for burn recovery.
4. A client with elevated levels of antidiuretic hormone (ADH) triggers the release of this hormone due to which disorder?
- A. Pneumonia
- B. Dehydration
- C. Renal failure
- D. Edema
Correct answer: B
Rationale: Antidiuretic hormone (ADH) increases tubular permeability to water, causing more water absorption into the capillaries. ADH is released in response to a rising extracellular fluid osmolarity, such as in dehydration. Pneumonia, renal failure, and edema do not typically lead to the release of ADH. Pneumonia is an inflammatory lung condition, renal failure affects kidney function, and edema is the accumulation of excess fluid in the tissues, none of which directly stimulate the release of ADH.
5. A nurse teaches a client who is recovering from a nephrectomy secondary to kidney trauma. Which statement should the nurse include in this client’s teaching?
- A. Since you only have one kidney, a salt and fluid restriction is required.
- B. Your therapy will include hemodialysis while you recover.
- C. Medication will be prescribed to control your high blood pressure.
- D. You need to avoid participating in contact sports like football.
Correct answer: D
Rationale: Clients with one kidney need to avoid contact sports because the kidneys are easily injured. The client will not be required to restrict salt and fluids, end up on dialysis, or have new hypertension because of the nephrectomy.
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