HESI RN
HESI Medical Surgical Practice Exam
1. A client with chronic renal failure is receiving erythropoietin therapy. The nurse should assess the client for which of the following side effects?
- A. Hypotension.
- B. Hypertension.
- C. Hyperglycemia.
- D. Hypercalcemia.
Correct answer: B
Rationale: The correct answer is B: Hypertension. Erythropoietin therapy can lead to an increase in blood pressure, making hypertension a common side effect that the nurse should closely monitor. Hypotension (choice A) is not typically associated with erythropoietin therapy. Hyperglycemia (choice C) and hypercalcemia (choice D) are not commonly linked to erythropoietin therapy in clients with chronic renal failure, making them incorrect choices.
2. What discharge instruction is most important for a client after a kidney transplant?
- A. Weigh weekly.
- B. Report symptoms of secondary Candidiasis.
- C. Use daily reminders to take immunosuppressants.
- D. Stop cigarette smoking.
Correct answer: C
Rationale: After a kidney transplant, it is crucial for the client to adhere to the prescribed immunosuppressive therapy to prevent organ rejection. The client must take medications like corticosteroids and azathioprine (Imuran) regularly for the rest of their life. Using daily reminders is essential to ensure compliance with the medication regimen, as missing doses can increase the risk of organ rejection. Weighing weekly, reporting symptoms of secondary Candidiasis, and stopping cigarette smoking are important aspects of post-transplant care but may not be as critical as ensuring proper intake of immunosuppressants to prevent rejection.
3. The nurse is caring for a client who is scheduled for hemodialysis. Which of the following laboratory values should the nurse monitor closely before, during, and after the procedure?
- A. Hemoglobin level.
- B. Blood urea nitrogen (BUN) level.
- C. Creatinine level.
- D. Serum potassium level.
Correct answer: D
Rationale: The correct answer is D: Serum potassium level. Before, during, and after hemodialysis, monitoring the serum potassium level is crucial to prevent hyperkalemia, a potentially life-threatening complication. Hemodialysis is done to remove waste products and excess electrolytes like potassium from the blood. Monitoring other laboratory values like hemoglobin, BUN, and creatinine is important in assessing kidney function and anemia, but serum potassium level requires close monitoring during hemodialysis due to the risk of rapid shifts that can lead to cardiac arrhythmias.
4. In a patient with diabetes mellitus, which of the following is a sign of hypoglycemia?
- A. Polydipsia.
- B. Polyuria.
- C. Sweating.
- D. Dry skin.
Correct answer: C
Rationale: Sweating is a common sign of hypoglycemia in diabetic patients. When blood sugar levels drop too low, the body releases stress hormones like adrenaline, which can cause sweating as a response to the perceived danger. Polydipsia (excessive thirst) and polyuria (excessive urination) are actually more commonly associated with hyperglycemia, not hypoglycemia. Dry skin is not typically a sign of hypoglycemia.
5. 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.
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