HESI RN
HESI Medical Surgical Assignment Exam
1. A client recovering from surgery has a large abdominal wound. Which of the following foods, high in vitamin C, should the nurse encourage the client to eat to promote wound healing?
- A. Steak
- B. Veal
- C. Cheese
- D. Oranges
Correct answer: D
Rationale: Oranges are a rich source of vitamin C, which is essential for wound healing due to its role in collagen synthesis. Citrus fruits like oranges, as well as other fruits and vegetables such as strawberries, kiwi, bell peppers, and broccoli, are high in vitamin C. Meats like steak and veal are not significant sources of vitamin C; they are primarily sources of protein. Cheese is not a good source of vitamin C but does provide calcium and protein.
2. A young female client prescribed amoxicillin (Amoxil) for a urinary tract infection is being taught by a nurse. Which statement should the nurse include in this client’s teaching?
- A. Use a second form of birth control while taking this medication.
- B. You will experience increased menstrual bleeding while on this medication.
- C. You may experience an irregular heartbeat while on this medication.
- D. Watch for blood in your urine while taking this drug.
Correct answer: A
Rationale: The correct statement for the nurse to include in the teaching is to advise the client to use a second form of birth control while taking amoxicillin. Penicillin, like amoxicillin, may reduce the effectiveness of estrogen-containing contraceptives, making it important to use additional contraceptive measures. The incorrect choices are B, C, and D. Increased menstrual bleeding, irregular heartbeat, or blood in the urine are not common side effects associated with amoxicillin use for a urinary tract infection.
3. A client with type 1 diabetes mellitus has a blood glucose level of 620 mg/dL. After the nurse calls the physician to report the finding and monitors the client closely for:
- A. Metabolic acidosis
- B. Metabolic alkalosis
- C. Respiratory acidosis
- D. Respiratory alkalosis
Correct answer: A
Rationale: In the scenario described, a client with a blood glucose level of 620 mg/dL and type 1 diabetes mellitus is at risk of developing metabolic acidosis. In type 1 diabetes, the lack of sufficient circulating insulin leads to an increase in blood glucose levels. As the body cells utilize all available glucose, the breakdown of fats for energy results in the production of ketones, leading to metabolic acidosis. Metabolic alkalosis, respiratory acidosis, and respiratory alkalosis are not typically associated with uncontrolled type 1 diabetes. Metabolic alkalosis is more commonly linked to conditions such as vomiting or excessive diuretic use, while respiratory acidosis and respiratory alkalosis are related to respiratory system imbalances in carbon dioxide levels.
4. The client has been managing angina episodes with nitroglycerin. Which of the following indicates the drug is effective?
- A. Decreased chest pain.
- B. Increased blood pressure.
- C. Decreased blood pressure.
- D. Decreased heart rate.
Correct answer: A
Rationale: The correct answer is A: Decreased chest pain. Nitroglycerin is a vasodilator that works by decreasing myocardial oxygen consumption, which helps to reduce chest pain caused by angina. Therefore, a reduction in chest pain is a positive indicator of the drug's effectiveness. Choices B, C, and D are incorrect because nitroglycerin does not typically increase blood pressure or heart rate; instead, it often causes a decrease in blood pressure due to vasodilation and may cause a reflex tachycardia (increased heart rate) as a compensatory response to lowered blood pressure.
5. A client has had a pulmonary artery catheter inserted. In performing hemodynamic monitoring with the catheter, the nurse will wedge the catheter to gain information about which of the following?
- A. Cardiac output.
- B. Right atrial blood flow.
- C. Left end-diastolic pressure.
- D. Cardiac index.
Correct answer: C
Rationale: The correct answer is C: Left end-diastolic pressure. Wedging the pulmonary artery catheter allows the nurse to obtain the pulmonary artery wedge pressure, which reflects the left end-diastolic pressure. This pressure is essential in assessing left ventricular function and diagnosing conditions like heart failure. Choices A, B, and D are incorrect because wedging the catheter does not directly provide information about cardiac output, right atrial blood flow, or cardiac index.
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