HESI RN
HESI Medical Surgical Practice Exam Quizlet
1. A client who is receiving chemotherapy asks the nurse, 'Why is so much of my hair falling out each day?' Which response by the nurse best explains the reason for alopecia?
- A. 'Chemotherapy affects the cells of the body that grow rapidly, both normal and malignant.'
- B. 'Alopecia is a common side effect you will experience during long-term steroid therapy.'
- C. 'Your hair will grow back completely after your course of chemotherapy is completed.'
- D. 'The chemotherapy causes permanent alterations in your hair follicles that lead to hair loss.'
Correct answer: A
Rationale: The correct answer is A: 'Chemotherapy affects the cells of the body that grow rapidly, both normal and malignant.' Chemotherapy targets rapidly dividing cells, which include not only cancer cells but also healthy cells like those in hair follicles. This leads to alopecia (hair loss) as a common side effect. Choice B is incorrect as alopecia is primarily associated with chemotherapy and not long-term steroid therapy. Choice C is incorrect because while hair may grow back after chemotherapy, it may not always be to the same extent or thickness. Choice D is incorrect as chemotherapy-induced hair loss is often temporary and reversible, not permanent alterations in hair follicles.
2. 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.
3. To help minimize the risk of postoperative respiratory complications after a hypophysectomy, during preoperative teaching, the nurse should instruct the client how to:
- A. Use incentive spirometry.
- B. Turn in bed.
- C. Take deep breaths.
- D. Cough.
Correct answer: C
Rationale: The correct answer is to instruct the client on how to take deep breaths. Deep breathing exercises are essential in preventing postoperative respiratory complications like atelectasis by promoting lung expansion. Using incentive spirometry is a more specific and advanced method of promoting deep breathing and lung expansion, making it a better choice than just turning in bed. While turning in bed may help with overall comfort and positioning, it is not as directly related to respiratory complications as deep breathing exercises. Coughing, although important for clearing secretions, is not as effective in preventing atelectasis as deep breathing exercises.
4. The nurse is caring for a patient who will receive 10% calcium gluconate to treat a serum potassium level of 5.9 mEq/L. The nurse performs a drug history prior to beginning the infusion. Which drug taken by the patient would cause concern?
- A. Digitalis
- B. Hydrochlorothiazide
- C. Hydrocortisone
- D. Vitamin D
Correct answer: A
Rationale: Calcium gluconate is administered to treat hyperkalemia by reducing myocardial irritability. When given to a patient taking digitalis, it can lead to digitalis toxicity. Digitalis and calcium gluconate both affect cardiac function, and their concomitant use can potentiate adverse effects. Hydrochlorothiazide, Hydrocortisone, and Vitamin D may impact potassium levels, but they do not interact with calcium gluconate in a way that would cause concern for toxicity.
5. A 57-year-old male client is scheduled to have a stress-thallium test the following morning and is NPO after midnight. At 0130, he is agitated because he cannot eat and is demanding food. Which response is best for the nurse to provide to this client?
- A. I'm sorry sir, you have a prescription for nothing by mouth from midnight tonight.
- B. I will let you have one cracker, but that is all you can have for the rest of tonight.
- C. What did the healthcare provider tell you about the test you are having tomorrow?
- D. The test you are having tomorrow requires that you have nothing by mouth tonight.
Correct answer: D
Rationale: Being direct and explaining to the client that the test requires him to be NPO, is the most therapeutic statement because the nurse is responding to the client's question and providing him the reason why.
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