HESI RN
HESI Medical Surgical Test Bank
1. A client with diabetes begins to cry and says, 'I just cannot stand the thought of having to give myself a shot every day.' Which of the following would be the best response by the nurse?
- A. If you do not give yourself your insulin shots, you will die.
- B. We can teach your daughter to give the shots so you will not have to do it.
- C. I can arrange to have a home care nurse give you the shots every day.
- D. What is it about giving yourself the insulin shots that bothers you?
Correct answer: D
Rationale: The correct response is option D because it is an open-ended question that allows the client to express their feelings and concerns. This approach facilitates a therapeutic communication process by encouraging the client to verbalize their thoughts, emotions, and fears related to giving themselves insulin shots. Option A is incorrect as it uses a fear-inducing statement that may not be helpful in addressing the client's emotional needs. Option B assumes involvement of a family member without exploring the client's feelings further. Option C offers a solution without addressing the client's underlying concerns and emotions, potentially overlooking essential aspects of client-centered care.
2. A nurse has a prescription to discontinue a client’s nasogastric tube. The nurse auscultates the client’s bowel sounds, positions the client properly, and flushes the tube with 15 mL of air to clear secretions. The nurse then instructs the client to take a deep breath and:
- A. Exhale during tube removal
- B. Bear down during tube removal
- C. Hold the breath during tube removal
- D. Breathe normally during tube removal
Correct answer: C
Rationale: The correct answer is to instruct the client to hold their breath during tube removal. This is because the airway may be temporarily obstructed during the removal process. By holding their breath, the client can help prevent aspiration or discomfort during the removal of the nasogastric tube. Choices A, B, and D are incorrect because exhaling, bearing down, or breathing normally during tube removal may not provide the necessary protection against aspiration or discomfort that holding the breath does.
3. What is the most common cause of coronary artery disease?
- A. Atherosclerosis.
- B. Hyperlipidemia.
- C. Diabetes.
- D. Smoking.
Correct answer: A
Rationale: The correct answer is Atherosclerosis. It is the primary cause of coronary artery disease, as it involves the buildup of plaque in the arteries, restricting blood flow to the heart. Hyperlipidemia (choice B) contributes to atherosclerosis by increasing cholesterol levels in the blood but is not the direct cause of coronary artery disease. Diabetes (choice C) can accelerate atherosclerosis due to high blood sugar levels, but it is not the most common cause. Smoking (choice D) is a significant risk factor for developing coronary artery disease but is not the primary cause.
4. The client who has a history of Parkinson's disease for the past 5 years is being assessed by the nurse. What symptoms would this client most likely exhibit?
- A. Loss of short-term memory, facial tics, and grimaces, and constant writhing movements.
- B. Shuffling gait, masklike facial expression, and tremors of the head.
- C. Extreme muscular weakness, easy fatigability, and ptosis.
- D. Numbness of the extremities, loss of balance, and visual disturbances.
Correct answer: B
Rationale: Parkinson's Disease, a common neurologic progressive disorder in older clients, is characterized by symptoms such as shuffling gait, masklike facial expression, and tremors of the head and hands. Choice A is incorrect as symptoms like loss of short-term memory, facial tics, and constant writhing movements are not typically associated with Parkinson's disease. Choice C is incorrect as extreme muscular weakness, easy fatigability, and ptosis are more indicative of other conditions like myasthenia gravis. Choice D is incorrect as numbness of the extremities, loss of balance, and visual disturbances are not classic symptoms of Parkinson's disease.
5. A client who has had two episodes of bacterial cystitis in the last 6 months is being assessed by a nurse. Which questions should the nurse ask? (Select all that apply.)
- A. How much water do you drink every day?
- B. Do you take estrogen replacement therapy?
- C. Does anyone in your family have a history of cystitis?
- D. All of the Above
Correct answer: D
Rationale: The correct answers are all of the above (D). Asking about fluid intake (choice A) is important as it can affect the risk of cystitis. Estrogen levels (choice B) can also impact the likelihood of recurrent cystitis. Family history (choice C) is relevant as certain genetic factors can predispose individuals to cystitis. Cranberry juice, not grapefruit or orange juice, has been found to reduce the risk of bacterial cystitis by increasing the acidic pH. Therefore, choices A, B, and C are all pertinent questions to ask during the assessment of a client with recurrent bacterial cystitis.
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