HESI RN
HESI Medical Surgical Practice Exam
1. A male client expresses concern about how a hypophysectomy will affect his sexual function. Which of the following statements provides the most accurate information about the physiologic effects of hypophysectomy?
- A. Removing the source of excess hormone should restore the client's libido, erectile function, and fertility.
- B. Potency will be restored, but the client will remain infertile.
- C. Fertility will be restored, but impotence and decreased libido will persist.
- D. Exogenous hormones will be needed to restore erectile function after the adenoma is removed.
Correct answer: A
Rationale: Choice A is the most accurate statement regarding the physiologic effects of hypophysectomy on sexual function. The client's sexual problems are directly related to excessive hormone levels. Removing the source of excess hormone secretion through hypophysectomy should allow the client to return to a normal physiologic pattern, which includes restoring libido, erectile function, and fertility. Choices B, C, and D are incorrect. Choice B incorrectly states that the client will remain infertile, which is not necessarily true after a hypophysectomy. Choice C inaccurately suggests that fertility will be restored while impotence and decreased libido will persist, which is not aligned with the expected outcomes of hypophysectomy. Choice D is incorrect because exogenous hormones are typically not needed to restore erectile function after the adenoma is removed; rather, the removal of the source of excessive hormone secretion should address the sexual function concerns.
2. A client with cardiovascular disease is scheduled to receive a daily dose of furosemide (Lasix). Which potassium level would cause the nurse to contact the physician before administering the dose?
- A. 3.0 mEq/L
- B. 3.8 mEq/L
- C. 4.2 mEq/L
- D. 5.1 mEq/L
Correct answer: A
Rationale: The normal serum potassium level in adults ranges from 3.5 to 5.1 mEq/L. A potassium level of 3.0 mEq/L is low, indicating hypokalemia and necessitating physician notification before administering furosemide, a loop diuretic that can further lower potassium levels. Potassium levels of 3.8 and 4.2 mEq/L are within the normal range, while a level of 5.1 mEq/L is high (hyperkalemia), but the critical value in this case is the low potassium level that requires immediate attention to prevent potential complications.
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. Which of the following is a primary intervention for a patient with sepsis?
- A. Administering antibiotics
- B. Administering IV fluids
- C. Administering antipyretics
- D. Monitoring blood cultures
Correct answer: D
Rationale: Monitoring blood cultures is a primary intervention for a patient with sepsis because it helps identify the causative organism, which is crucial in guiding appropriate antibiotic therapy. Administering antibiotics (Choice A) is important in treating sepsis but is considered a secondary intervention. Administering IV fluids (Choice B) is also crucial for sepsis management to restore perfusion and hemodynamic stability. Administering antipyretics (Choice C) may help reduce fever, but it is not a primary intervention for managing sepsis.
5. A client recovering from a urologic procedure is being assessed by a nurse. Which assessment finding indicates an obstruction of urine flow?
- A. Severe pain
- B. Overflow incontinence
- C. Hypotension
- D. Blood-tinged urine
Correct answer: B
Rationale: The correct answer is 'B: Overflow incontinence.' The most common manifestation of urethral stricture after a urologic procedure is obstruction of urine flow. This obstruction can lead to overflow incontinence, which is the involuntary loss of urine when the bladder is distended. Severe pain is not typically associated with an obstruction of urine flow. Hypotension is unrelated to this issue. Blood-tinged urine is not a direct indication of an obstruction of urine flow but may indicate other conditions like trauma or infection.
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