HESI RN
Evolve HESI Medical Surgical Practice Exam
1. What should the nurse do before an echocardiogram for a client who has had a myocardial infarction?
- A. Ensuring no food or drink for 4 hours before the procedure
- B. Obtaining informed consent from the client
- C. Assessing for any history of iodine or shellfish allergies
- D. Informing the client about the painless nature and duration of the procedure
Correct answer: D
Rationale: The correct answer is to inform the client that the echocardiogram is a painless procedure that usually takes 30 to 60 minutes to complete. Echocardiography is a noninvasive, risk-free, and pain-free test that uses ultrasound to evaluate the heart's structure and motion. There is no need for special preparation before the procedure. Choices A, B, and C are incorrect because imposing nothing-by-mouth status, obtaining informed consent, and assessing for allergies to iodine or shellfish are not necessary steps before an echocardiogram.
2. What is the most important information for a nurse to obtain when an older female client expresses not deserving to eat due to lack of money?
- A. Client's thoughts about wanting to hurt herself
- B. Medication history for antipsychotic agents
- C. Availability of family members to provide meals
- D. Community resources to provide financial aid
Correct answer: A
Rationale: The correct answer is A: Client's thoughts about wanting to hurt herself. When a client expresses not deserving to eat due to lack of money, it raises concerns about her mental and emotional well-being. Assessing for suicidal ideation is crucial in this situation to ensure the client's immediate safety. Options B, C, and D are not the most critical information to obtain in this scenario. While medication history, family support, and community resources are important aspects of care, in this context, the client's mental health and risk of self-harm take precedence.
3. A 9-year-old received a short arm cast for a right radius. To relieve itching under the child's cast, which instructions should the nurse provide to the parents?
- A. Blow cool air from a hair dryer under the cast
- B. Twist the cast back and forth
- C. Shake powder into the cast
- D. Push a pencil under the cast edge
Correct answer: A
Rationale: The correct answer is A: 'Blow cool air from a hairdryer under the cast.' Blowing cool air can help relieve itching without damaging the cast or causing injury. Choice B, twisting the cast back and forth, can lead to discomfort, skin irritation, or even injury. Choice C, shaking powder into the cast, can create a mess, increase the risk of skin issues, and interfere with proper healing. Choice D, pushing a pencil under the cast edge, is dangerous as it can cause injury to the child's skin or the underlying tissues. Therefore, the safest and most effective option to relieve itching under the cast is to blow cool air from a hair dryer.
4. A child is recovering from an appendectomy. The parent asks when the child can resume normal activities. What is the best response by the nurse?
- A. The child can resume normal activities as soon as they feel up to it
- B. The child should avoid strenuous activities for at least 2 weeks
- C. The child can resume normal activities after the stitches are removed
- D. The child should avoid all physical activities for the next month
Correct answer: B
Rationale: After an appendectomy, it is important for the child to avoid strenuous activities for at least 2 weeks to allow for proper healing. Resuming normal activities too soon can put unnecessary strain on the healing process and increase the risk of complications.
5. A client with rheumatoid arthritis is prescribed methotrexate. Which instruction should the nurse include in the client's teaching plan?
- A. Avoid taking folic acid supplements.
- B. Report any signs of infection immediately.
- C. Take the medication with a full meal.
- D. Limit fluid intake while on this medication.
Correct answer: B
Rationale: The correct instruction for the nurse to include in the client's teaching plan when taking methotrexate is to report any signs of infection immediately. Methotrexate can suppress the immune system, making the client more susceptible to infections. It is important for the client to promptly report any signs of infection to receive timely medical intervention. Choice A is incorrect because folic acid supplements are often recommended to reduce side effects of methotrexate. Choice C is incorrect as methotrexate is usually taken on an empty stomach unless the client experiences gastrointestinal upset. Choice D is incorrect as there is no need to limit fluid intake while on methotrexate; in fact, maintaining adequate fluid intake is important to prevent complications such as kidney damage.