HESI RN
Evolve HESI Medical Surgical Practice Exam
1. A healthcare professional has a prescription to collect a 24-hour urine specimen from a client. Which of the following measures should the healthcare professional take during this procedure?
- A. Keeping the specimen chilled
- B. Saving the first urine specimen collected at the start time
- C. Discarding the last voided specimen at the end of the collection time
- D. Asking the client to void, discarding the specimen, and noting the start time
Correct answer: D
Rationale: The correct answer is asking the client to void, discarding the specimen, and noting the start time. During a 24-hour urine collection, the first voided urine is discarded to ensure the test starts with an empty bladder. The specimen should be kept chilled, not at room temperature, to prevent bacterial growth. The last voided specimen is not discarded because it contributes to the total volume collected, so choice C is incorrect. Discarding the specimen and noting the start time is essential for accurate results in a timed quantitative determination like a 24-hour urine collection.
2. A loading dose of terbutaline (Brethine) 250 mcg IV is prescribed for a client in preterm labor. Brethine 20 mg is added to 1,000 mL of D5W. How many milliliters of the solution should the nurse administer?
- A. 45
- B. 15 mL
- C. 4
- D. 13
Correct answer: D
Rationale: To calculate the amount of terbutaline to administer, first convert the dose to the same unit. 250 mcg = 0.25 mg. Next, set up a proportion: 20 mg is to 1000 mL as 0.25 mg is to X mL. Cross multiply and solve for X: 20 × X = 0.25 × 1000. X = (0.25 × 1000) / 20 = 12.5 mL. Therefore, the nurse should administer 13 mL of the solution. Choice A is incorrect as it does not reflect the correct calculation. Choice B is incorrect as it does not consider the accurate conversion and calculation. Choice C is incorrect as it is not the result of the correct proportion calculation.
3. A client who is receiving digoxin (Lanoxin) daily has a serum potassium level of 3.0 mEq/L and is complaining of anorexia. A healthcare provider prescribes a digoxin level to rule out digoxin toxicity. A nurse checks the results, knowing that which of the following is the therapeutic serum level (range) for digoxin?
- A. 3 to 5 ng/mL
- B. 0.5 to 2 ng/mL
- C. 1.2 to 2.8 ng/mL
- D. 3.5 to 5.5 ng/mL
Correct answer: B
Rationale: The therapeutic serum level for digoxin ranges from 0.5 to 2 ng/mL. This range is considered optimal for therapeutic effects while minimizing the risk of toxicity. Levels above 2 ng/mL may lead to digoxin toxicity, which can manifest as anorexia among other symptoms. Therefore, the nurse should be vigilant in monitoring the digoxin levels to ensure the client's safety and therapeutic effectiveness of the medication.
4. A client with pneumonia is receiving oxygen via nasal cannula at 2 L/min. What assessment finding indicates the need for further intervention?
- A. The client reports feeling short of breath.
- B. The client's oxygen saturation is 92%.
- C. The client's respiratory rate is 20 breaths per minute.
- D. The client is unable to complete sentences without pausing.
Correct answer: D
Rationale: The correct answer is D because the inability to complete sentences without pausing indicates respiratory distress and the need for immediate intervention. This finding suggests an increased work of breathing and inadequate oxygenation. Choices A, B, and C are not as urgent as choice D. Feeling short of breath (choice A) is expected in pneumonia but does not necessarily indicate the need for immediate intervention. An oxygen saturation of 92% (choice B) is slightly below the normal range but may not require immediate intervention. A respiratory rate of 20 breaths per minute (choice C) is within the normal range and does not signify an urgent need for intervention.
5. When planning a community health fair to promote mental health awareness, which activity should be included to best engage participants?
- A. free mental health screenings
- B. lectures on mental health topics
- C. distribution of mental health resources
- D. interactive workshops on stress management
Correct answer: A
Rationale: The best activity to engage participants in a community health fair promoting mental health awareness is to offer free mental health screenings. This activity not only attracts participants but also provides them with immediate, valuable information about their mental health status. Free screenings can help raise awareness, encourage early detection of mental health issues, and prompt participants to seek further assistance if needed. Lectures, while informative, may not be as engaging or impactful as the personalized feedback individuals receive from screenings. Distributing resources is helpful, but active engagement through screenings is more effective in promoting awareness and encouraging action. Interactive workshops on stress management are beneficial but might not provide the same level of individualized insight into mental health as screenings do.