HESI RN
HESI Medical Surgical Test Bank
1. A client with diabetes is taking insulin lispro (Humalog) injections. The nurse should advise the client to eat:
- A. Within 10 to 15 minutes after the injection.
- B. 1 hour after the injection.
- C. At any time, because timing of meals with lispro injections is unnecessary.
- D. 2 hours before the injection.
Correct answer: A
Rationale: The correct answer is to eat within 10 to 15 minutes after the injection. Insulin lispro, also known as Humalog, is a rapid-acting insulin that starts working very quickly. Eating shortly after the injection helps match the food intake with the insulin action, reducing the risk of hypoglycemia. Choice B is incorrect because waiting 1 hour after the injection may lead to a mismatch between insulin activity and food intake. Choice C is incorrect as timing meals with lispro injections is essential to optimize glycemic control. Choice D is incorrect as eating 2 hours before the injection is not in alignment with the rapid action of insulin lispro and may lead to fluctuations in blood sugar levels.
2. A client has pyelonephritis and expresses embarrassment about discussing symptoms. How should the nurse respond?
- A. Assure the client that their symptoms will be kept confidential.
- B. Acknowledge the client's discomfort and avoid discussing elimination topics.
- C. Encourage the use of familiar language and assure the client they can take their time.
- D. Offer the client a nurse of the same gender to provide care.
Correct answer: C
Rationale: When a client expresses embarrassment or discomfort in discussing symptoms related to sensitive topics like elimination and the genitourinary area, the nurse should respond by encouraging the client to use words they are comfortable with. This helps the client feel more at ease and opens up communication. Offering a nurse of the same gender may not address the client's discomfort with discussing symptoms. Assuring confidentiality is important, but it should not be promised in a way that may not be fulfilled. Avoiding the topic of elimination entirely does not address the client's feelings or promote effective communication.
3. What is included in the Quality of Care in reproductive health?
- A. Ensuring accessible services, privacy, confidentiality, and continuity of care.
- B. Providing reproductive health services only in urban areas.
- C. Ensuring that all women deliver in a hospital setting.
- D. Ensuring that reproductive health services are only provided by doctors.
Correct answer: A
Rationale: The correct answer is A. Quality of care in reproductive health encompasses ensuring accessible services, privacy, confidentiality, and continuity of care. These elements are crucial in providing comprehensive and effective reproductive health services. Choices B, C, and D are incorrect because they do not adequately address the holistic approach required for quality reproductive health care. Providing services only in urban areas limits accessibility, mandating hospital deliveries may not be suitable for all women, and restricting services to doctors only disregards the importance of a multi-disciplinary approach in reproductive health care.
4. In a client with moderate, persistent, chronic neuropathic pain due to diabetic neuropathy who takes gabapentin (Neurontin) and ibuprofen (Motrin, Advil) daily, if Step 2 of the World Health Organization (WHO) pain relief ladder is prescribed, which drug protocol should be implemented?
- A. Continue gabapentin.
- B. Discontinue ibuprofen.
- C. Add aspirin to the protocol.
- D. Add oral methadone to the protocol.
Correct answer: A
Rationale: In the presence of moderate, persistent, chronic neuropathic pain, the WHO pain relief ladder recommends continuing gabapentin, as it is effective for managing both anxiety and pain. Ibuprofen, a nonsteroidal anti-inflammatory drug, is not the mainstay for neuropathic pain relief according to the ladder and can be discontinued if needed. Aspirin is not typically added to the protocol for neuropathic pain management at this step. Methadone is reserved for severe pain and is not the standard choice at Step 2 of the WHO pain relief ladder for neuropathic pain.
5. The nurse is assessing a client with chronic kidney disease (CKD) who is receiving erythropoietin therapy. Which laboratory value should the nurse monitor closely?
- A. Serum potassium level
- B. Hemoglobin level
- C. White blood cell count
- D. Serum calcium level
Correct answer: A
Rationale: In a client with chronic kidney disease (CKD) receiving erythropoietin therapy, the nurse should closely monitor the serum potassium level. Erythropoietin therapy can increase red blood cell production, leading to a higher demand for potassium. Monitoring potassium levels is crucial to prevent hyperkalemia, a potential risk associated with this therapy. Hemoglobin level (Choice B) is important to assess the effectiveness of erythropoietin therapy, but monitoring potassium levels takes precedence due to the risk of hyperkalemia. White blood cell count (Choice C) and serum calcium level (Choice D) are not directly affected by erythropoietin therapy in the context of chronic kidney disease.