HESI RN
HESI Medical Surgical Specialty Exam
1. A client who is postmenopausal and has had two episodes of bacterial urethritis in the last 6 months asks, “I never have urinary tract infections. Why is this happening now?” How should the nurse respond?
- A. Your immune system becomes less effective as you age.
- B. Low estrogen levels can make the tissue more susceptible to infection.
- C. You should be more careful with your personal hygiene in this area.
- D. It is likely that you have an untreated sexually transmitted disease.
Correct answer: B
Rationale: Low estrogen levels in postmenopausal women decrease moisture and secretions in the perineal area, causing tissue changes that predispose them to infection, including urethritis. This is a common reason for urethritis in postmenopausal women. While immune function does decrease with aging and sexually transmitted diseases can cause urethritis, the most likely reason in this case is the low estrogen levels. Personal hygiene practices are usually not a significant factor in the development of urethritis.
2. The client who experiences angina has been advised to follow a low-cholesterol diet. Which of the following meals would be best?
- A. Hamburger, salad, and milkshake.
- B. Baked liver, green beans, and coffee.
- C. Spaghetti with tomato sauce, salad, and coffee.
- D. Fried chicken, green beans, and skim milk.
Correct answer: C
Rationale: The best meal option for a client with angina following a low-cholesterol diet is spaghetti with tomato sauce, salad, and coffee. This meal is lower in cholesterol content compared to the other options provided. Hamburger with salad and milkshake, baked liver with green beans and coffee, and fried chicken with green beans and skim milk are higher in cholesterol and may not be suitable for an individual with angina who needs to adhere to a low-cholesterol diet.
3. Which of the following is a common cause of acute kidney injury?
- A. Hypertension
- B. Dehydration
- C. Infection
- D. Hypotension
Correct answer: C
Rationale: Infection is a common cause of acute kidney injury because when the body fights an infection, it activates the immune response, leading to inflammation. This inflammatory response can affect the kidneys and impair their function. While hypertension (choice A) is a risk factor for chronic kidney disease, it is not a direct cause of acute kidney injury. Dehydration (choice B) can lead to prerenal acute kidney injury due to decreased blood flow to the kidneys, but infection is a more common cause of acute kidney injury. Hypotension (choice D) can contribute to prerenal acute kidney injury, but it is not a direct cause like infection.
4. A client is experiencing diarrhea. For which acid-base disorder should the nurse assess the client?
- A. Metabolic acidosis
- B. Metabolic alkalosis
- C. Respiratory acidosis
- D. Respiratory alkalosis
Correct answer: A
Rationale: When a client experiences diarrhea, the loss of bicarbonate-rich fluids from the body leads to a decrease in the bicarbonate levels in the blood, resulting in metabolic acidosis. Metabolic alkalosis (choice B) is characterized by an increase in bicarbonate levels, which is not typically associated with diarrhea. Respiratory acidosis (choice C) is caused by retention of carbon dioxide, while respiratory alkalosis (choice D) results from excessive exhalation of carbon dioxide, neither of which are directly related to diarrhea. Therefore, the correct answer is metabolic acidosis (choice A) in the context of diarrhea.
5. The client with chronic renal failure is being educated on dietary restrictions. Which of the following foods should the client avoid?
- A. Bananas.
- B. Oranges.
- C. Rice.
- D. Apples.
Correct answer: A
Rationale: The correct answer is A: Bananas. Bananas are high in potassium, and clients with chronic renal failure are often advised to follow a low-potassium diet to prevent hyperkalemia. Oranges and apples are also high in potassium and should be avoided by clients with renal issues. Rice, on the other hand, is low in potassium and is generally considered safe for individuals with chronic renal failure to consume in moderation.
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