HESI RN
HESI Medical Surgical Specialty Exam
1. A client with acute glomerulonephritis (GN) is being evaluated by a nurse. Which manifestation should the nurse recognize as a positive response to the prescribed treatment?
- A. The client has lost 11 pounds in the past 10 days.
- B. The client’s urine specific gravity is 1.048.
- C. No blood is observed in the client’s urine.
- D. The client’s blood pressure is 152/88 mm Hg.
Correct answer: A
Rationale: A weight loss of 11 pounds in the past 10 days indicates fluid loss, a positive response to treatment for acute glomerulonephritis. It signifies that the glomeruli are functioning adequately to filter excess fluid. A urine specific gravity of 1.048 is high, indicating concentrated urine, which is not a positive response in this context. Blood in the urine is not a typical finding in glomerulonephritis, so its absence is expected and does not indicate a positive response to treatment. A blood pressure of 152/88 mm Hg is elevated and may suggest kidney damage or fluid overload, which are not positive responses to treatment.
2. A client with a history of calcium phosphate urinary stones is being taught by a nurse. Which statements should the nurse include in this client’s dietary teaching? (Select all that apply.)
- A. Limit your intake of food high in animal protein.
- B. Read food labels to help minimize your sodium intake.
- C. A and B
- D. Reduce your intake of milk and other dairy products.
Correct answer: C
Rationale: For a client with a history of calcium phosphate urinary stones, it is essential to limit the intake of foods high in animal protein to prevent the formation of stones. Additionally, reducing sodium intake is crucial as high sodium levels can contribute to stone formation. Therefore, choices A and B are correct. Choice D, which suggests reducing intake of milk and other dairy products, is not specifically recommended for calcium phosphate stones. Clients with calcium phosphate stones should focus on limiting animal protein, sodium, and calcium intake. Choices A and B address these dietary modifications, making them the correct options for this client. Choices D, which is not directly related to calcium phosphate stones, is incorrect.
3. Which of the following is a sign of hypocalcemia?
- A. Hyperactive reflexes.
- B. Depressed reflexes.
- C. Muscle cramps.
- D. Seizures.
Correct answer: A
Rationale: Hyperactive reflexes are a classic sign of hypocalcemia. Hypocalcemia leads to increased neuromuscular excitability, resulting in hyperactive reflexes. Depressed reflexes (Choice B) are not typically associated with hypocalcemia. Muscle cramps (Choice C) can be seen in hypocalcemia due to muscle irritability but are not a specific sign. Seizures (Choice D) can occur in severe cases of hypocalcemia but are not as common as hyperactive reflexes.
4. Which food is most important to encourage a client with osteomalacia to include in a daily diet?
- A. Fortified milk and cereals
- B. Citrus fruits and juices
- C. Green leafy vegetables
- D. Red meats and eggs
Correct answer: A
Rationale: The correct answer is A: Fortified milk and cereals. Osteomalacia is a condition caused by a deficiency in vitamin D. Fortified milk and cereals are rich sources of vitamin D, which is essential for managing osteomalacia. Citrus fruits and juices (choice B) are high in vitamin C, but vitamin D is the primary concern for osteomalacia. Green leafy vegetables (choice C) are good sources of various nutrients but not the main focus for managing osteomalacia. Red meats and eggs (choice D) are good sources of protein and other nutrients but are not as critical as fortified milk and cereals for addressing vitamin D deficiency in osteomalacia.
5. The healthcare provider is assessing a client with chronic renal failure who is receiving hemodialysis. Which of the following findings would indicate that the client is experiencing a complication of the treatment?
- A. Clear dialysate outflow.
- B. Blood pressure of 150/90 mm Hg.
- C. Increased heart rate.
- D. Fatigue.
Correct answer: B
Rationale: A blood pressure of 150/90 mm Hg during hemodialysis may indicate fluid overload or an ineffective dialysis session, which can lead to complications such as heart failure or pulmonary edema. This finding should be reported promptly for further evaluation and intervention. Clear dialysate outflow is a normal and expected finding during hemodialysis, indicating proper filtration of waste products. Increased heart rate can be a normal compensatory response to hemodialysis due to fluid shifts and should be monitored but does not necessarily indicate a complication. Fatigue is a common symptom in clients with chronic renal failure undergoing hemodialysis and is not specific to complications of the treatment.
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