HESI RN
Evolve HESI Medical Surgical Practice Exam
1. A client with autosomal dominant polycystic kidney disease (ADPKD) asks, “Will my children develop this disease?†How should the nurse respond?
- A. No genetic link is known, so your children are not at increased risk.
- B. Your sons will develop this disease because it has a sex-linked gene.
- C. Only if both you and your spouse are carriers of this disease.
- D. Each of your children has a 50% risk of having ADPKD.
Correct answer: D
Rationale: Children whose parent has the autosomal dominant form of PKD have a 50% chance of inheriting the gene that causes the disease. ADPKD is transmitted as an autosomal dominant trait and therefore is not gender-specific. Both parents do not need to have this disorder. Choice A is incorrect because ADPKD has a known genetic link and a definitive mode of inheritance. Choice B is incorrect as ADPKD is not sex-linked but autosomal dominant. Choice C is incorrect because ADPKD follows an autosomal dominant inheritance pattern and does not require both parents to be carriers for the child to inherit the disease.
2. A client with polycystic kidney disease (PKD is being assessed by a nurse. Which assessment finding should prompt the nurse to immediately contact the healthcare provider?
- A. Flank pain
- B. Periorbital edema
- C. Bloody and cloudy urine
- D. Enlarged abdomen
Correct answer: B
Rationale: Periorbital edema would not typically be associated with polycystic kidney disease (PKD) and could indicate other underlying issues that require immediate attention. Flank pain and an enlarged abdomen are common findings in PKD due to kidney enlargement and displacement of other organs. Bloody or cloudy urine can result from cyst rupture or infection, which are expected in PKD. Therefore, periorbital edema is the most alarming finding in this scenario and warrants prompt notification of the healthcare provider.
3. The nurse is providing discharge instructions to a client who is receiving prednisone 5 mg PO daily for a rash due to contact with poison ivy. Which symptoms should the nurse tell the client to report to the healthcare provider?
- A. Rapid weight gain
- B. Abdominal striae
- C. Moon faces
- D. Gastric irritation
Correct answer: A
Rationale: Rapid weight gain can indicate fluid retention, which is a serious side effect of prednisone and should be reported.
4. A client who has undergone abdominal surgery calls the nurse and reports that she just felt 'something give way' in the abdominal incision. The nurse checks the incision and notes the presence of wound dehiscence. The nurse immediately:
- A. Contacts the physician
- B. Documents the findings
- C. Places the client in a supine position with the legs flat
- D. Covers the abdominal wound with a sterile dressing moistened with sterile saline solution
Correct answer: D
Rationale: In the scenario described, the presence of wound dehiscence indicates a separation of the layers of the surgical incision. The immediate priority for the nurse is to cover the abdominal wound with a sterile dressing moistened with sterile saline solution. This helps to protect the wound from contamination and promotes a moist environment conducive to healing. Contacting the physician (Choice A) is important, but the initial action should be to address the wound. Documenting the findings (Choice B) is necessary but not the immediate priority. Placing the client in a supine position with the legs flat (Choice C) is not indicated in this situation as wound dehiscence requires wound care intervention.
5. Which of the following is a common cause of chronic liver disease?
- A. Alcohol abuse.
- B. Hepatitis C infection.
- C. Obesity.
- D. Smoking.
Correct answer: B
Rationale: Hepatitis C infection is a common cause of chronic liver disease due to its long-term effects on the liver. Hepatitis C can lead to liver inflammation, fibrosis, cirrhosis, and even liver cancer. Alcohol abuse can also cause liver damage, but hepatitis C infection is specifically known for its chronic impact on liver health. Obesity and smoking, while detrimental to overall health, are not typically direct causes of chronic liver disease like hepatitis C infection.
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