HESI RN
Evolve HESI Medical Surgical Practice Exam
1. A client presents with a fungal urinary tract infection (UTI). Which assessments should the nurse complete? (Select all that apply.)
- A. Palpate the kidneys and bladder.
- B. Assess the medical history and current medical problems.
- C. Perform a bladder scan to assess post-void residual.
- D. Inquire about recent travel to foreign countries.
Correct answer: B
Rationale: When assessing a client with a fungal UTI, the nurse should prioritize gathering information related to the medical history and current medical problems. Clients who are severely immunocompromised or have conditions like diabetes mellitus are more susceptible to fungal UTIs. Assessing the medical history helps identify risk factors and potential causes of the infection. While physical examinations like palpating the kidneys and bladder and performing a bladder scan may be necessary, they should follow the initial assessment of medical history. Inquiring about recent travel to foreign countries is less relevant in the context of a fungal UTI, as the focus should be on immediate medical factors predisposing the client to the infection.
2. A patient who is taking trimethoprim-sulfamethoxazole (TMP-SMX) calls to report developing an all-over rash. What action should the nurse instruct the patient to perform?
- A. Increase fluid intake.
- B. Take diphenhydramine.
- C. Stop taking TMP-SMX immediately.
- D. Continue taking the medication.
Correct answer: C
Rationale: When a patient develops an all-over rash while taking trimethoprim-sulfamethoxazole (TMP-SMX), it may indicate a serious drug reaction. In this case, the patient should stop taking the medication immediately and notify their healthcare provider. Increasing fluid intake (Choice A) may be beneficial in some cases but is not the priority when a serious drug reaction is suspected. Taking diphenhydramine (Choice B) may help with itching but does not address the underlying issue of a potential drug reaction. Continuing the medication (Choice D) is not advisable when a serious adverse reaction such as a widespread rash occurs.
3. Which lab result would be most indicative of renal failure?
- A. Elevated creatinine levels.
- B. Low potassium levels.
- C. Low calcium levels.
- D. High sodium levels.
Correct answer: A
Rationale: The correct answer is A: Elevated creatinine levels. Creatinine is a waste product that is normally filtered by the kidneys. Elevated creatinine levels indicate impaired kidney function, which is commonly seen in renal failure. Choice B, low potassium levels, is not typically associated with renal failure. In fact, renal failure is more likely to cause high potassium levels due to the kidneys' inability to excrete potassium effectively. Choice C, low calcium levels, are not directly indicative of renal failure. Renal failure can lead to disturbances in calcium levels, but low calcium levels alone are not a specific marker for renal failure. Choice D, high sodium levels, are also not typically associated with renal failure. In renal failure, there may be disturbances in sodium levels, but high sodium levels alone are not a direct indicator of renal failure.
4. A client with a history of peptic ulcer disease (PUD) is admitted after vomiting bright red blood several times over the course of 2 hours. In reviewing the laboratory results, the nurse finds the client's hemoglobin is 12 g/dL (120g/L) and the hematocrit is 35% (0.35). Which action should the nurse prepare to take?
- A. Continue monitoring for blood loss
- B. Administer 1,000 mL (1L) of normal saline
- C. Transfuse 2 units of platelets
- D. Prepare the client for emergency surgery
Correct answer: D
Rationale: The correct answer is to prepare the client for emergency surgery. The client's presentation with bright red blood in vomitus suggests active bleeding, which is a medical emergency. With a hemoglobin of 12 g/dL and a hematocrit of 35%, the client is likely experiencing significant blood loss that may require surgical intervention to address the source of bleeding. Continuing to monitor for blood loss (Choice A) is not appropriate in this acute situation where immediate action is necessary. Administering normal saline (Choice B) may help with fluid resuscitation but does not address the underlying cause of bleeding. Transfusing platelets (Choice C) is not indicated in this scenario as platelets are involved in clot formation and are not the primary treatment for active bleeding in this context.
5. What is the primary action of insulin in the body?
- A. To lower blood pressure.
- B. To promote the absorption of glucose into cells.
- C. To increase blood glucose levels.
- D. To decrease blood glucose levels.
Correct answer: B
Rationale: The correct answer is B: To promote the absorption of glucose into cells. Insulin facilitates the uptake of glucose by cells, thereby decreasing blood glucose levels. Choice A is incorrect as insulin does not directly affect blood pressure. Choice C is inaccurate as insulin works to lower, not increase, blood glucose levels. Choice D is incorrect because insulin's primary role is to lower, not increase, blood glucose levels by promoting glucose uptake into cells.
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