HESI RN
Evolve HESI Medical Surgical Practice Exam Quizlet
1. A client with chronic renal failure is receiving sodium polystyrene sulfonate (Kayexalate). The nurse should monitor the client for which of the following?
- A. Hyponatremia.
- B. Hypokalemia.
- C. Hyperkalemia.
- D. Hypocalcemia.
Correct answer: C
Rationale: Correct Answer: The correct answer is C, 'Hyperkalemia.' Sodium polystyrene sulfonate (Kayexalate) is a medication used to treat high potassium levels (hyperkalemia) by exchanging sodium ions for potassium ions in the intestines, leading to potassium removal from the body. Therefore, the nurse should monitor the client for changes in potassium levels to assess the effectiveness of the medication and prevent potential complications related to hyperkalemia. Choice A, 'Hyponatremia,' is incorrect as Kayexalate does not primarily affect sodium levels. Choice B, 'Hypokalemia,' is incorrect as Kayexalate is used to treat high potassium levels, not low. Choice D, 'Hypocalcemia,' is incorrect as Kayexalate does not directly impact calcium levels.
2. A nurse is preparing to administer NPH insulin to a client with DM. The nurse notes that the NPH insulin vial is cloudy. The nurse should:
- A. Obtain a new vial of NPH insulin.
- B. Draw up the cloudy insulin as ordered.
- C. Shake the vial vigorously before drawing up the insulin.
- D. Warm the insulin to room temperature before administration.
Correct answer: B
Rationale: The correct answer is to draw up the cloudy insulin as ordered. NPH insulin is inherently cloudy due to its suspension of insulin crystals. Shaking the vial vigorously can lead to denaturation of the insulin molecules, altering its efficacy. Warming NPH insulin is not necessary as it can cause breakdown of insulin molecules. The nurse should gently roll the vial between hands to mix it before drawing it up to ensure an even distribution of insulin in the suspension.
3. During a well baby visit, the parents explain that a soft bulge appears in the groin of their 4-month-old son when he cries or strains during stooling. The infant is scheduled for surgical repair of the inguinal hernia in two weeks. What should the parent be instructed to do if the hernia becomes incarcerated prior to the surgery?
- A. Use a rectal thermometer to strain during stooling.
- B. Gently manipulate the hernia for reduction.
- C. Offer oral electrolyte fluids for comfort.
- D. Give acetaminophen or aspirin for crying.
Correct answer: B
Rationale: In the case of an incarcerated inguinal hernia, gentle manipulation can sometimes help in reducing it before surgery. This action should be taken cautiously and immediately followed by seeking medical attention. It is important to note that attempting reduction should be done by a healthcare professional, and parents should be advised to seek urgent medical care if the hernia becomes incarcerated. Using a rectal thermometer to strain during stooling (Choice A) is not the correct approach for an incarcerated hernia and can worsen the condition. Offering oral electrolyte fluids for comfort (Choice C) or giving acetaminophen or aspirin for crying (Choice D) are not appropriate interventions for an incarcerated hernia and may delay necessary medical treatment.
4. The healthcare provider is evaluating diet teaching for a client who has nontropical sprue (celiac disease). Choosing which food indicates that the teaching has been effective?
- A. Creamed corn.
- B. Pancakes.
- C. Rye crackers.
- D. Cooked oatmeal.
Correct answer: A
Rationale: Creamed corn is a gluten-free food, making it a suitable option for clients with celiac disease. This choice indicates effective diet teaching as it aligns with the dietary restrictions necessary for managing the condition. Pancakes, rye crackers, and cooked oatmeal contain gluten, which is harmful to individuals with celiac disease. Therefore, they are not suitable choices and would not indicate effective teaching for a client with this condition.
5. When bathing an uncircumcised boy older than 3 years, which action should the nurse take?
- A. Remind the child to clean his genital area.
- B. Defer perineal care due to the child's age.
- C. Retract the foreskin gently to cleanse the penis.
- D. Inquire about the reason for the child not being circumcised.
Correct answer: C
Rationale: The correct action when bathing an uncircumcised boy older than 3 years is to gently retract the foreskin to cleanse the penis. This is important to ensure proper hygiene and prevent the accumulation of bacteria that can lead to infections. It is not advisable to defer perineal care because of the child's age, as hygiene is crucial at any age. Asking the parents about the circumcision status may not be relevant during routine perineal care. Reminding the child to clean his genital area is not as effective as directly cleaning the area during bathing.