HESI RN
RN Medical/Surgical NGN HESI 2023
1. A client is being prepared for a colonoscopy. Into which position does the nurse assist the client for the procedure?
- A. Left Sims' position
- B. Lithotomy position
- C. Knee-chest position
- D. Right Sims' position
Correct answer: A
Rationale: During a colonoscopy, the client is positioned in the left Sims' position. This position is chosen as it optimally utilizes the client’s anatomy to facilitate the introduction of the colonoscope. The lithotomy position (Choice B) is commonly used for gynecological exams, not colonoscopies. The knee-chest position (Choice C) is typically employed for rectal examinations or certain surgical procedures, not colonoscopies. The right Sims' position (Choice D) is a less common position for colonoscopy compared to the left Sims' position.
2. The nurse is providing teaching to a patient who will begin taking a cephalosporin to treat an infection. Which statement by the patient indicates a need for further teaching?
- A. I may stop taking the medication if my symptoms clear up.
- B. I should eat yogurt while taking this medication.
- C. I should stop taking the drug and call my provider if I develop a rash.
- D. I will not consume alcohol while taking this medication.
Correct answer: A
Rationale: Patients should take all of an antibiotic regimen even after symptoms clear to ensure complete treatment of the infection.
3. In a patient with pneumonia, what is the primary goal of treatment?
- A. Reducing inflammation.
- B. Eliminating the infection.
- C. Reducing pain.
- D. Preventing complications.
Correct answer: B
Rationale: The primary goal of treating pneumonia is to eliminate the infection. Antibiotics are commonly used to target the specific pathogen causing pneumonia. While reducing inflammation and preventing complications are important aspects of treatment, the key focus initially is on eradicating the infectious agent to improve the patient's condition and prevent further spread of the infection.
4. What most likely led to the 67-year-old woman who lives alone tripping on a rug in her home and fracturing her hip?
- A. Failing eyesight causing an unsafe environment.
- B. Renal osteodystrophy due to chronic renal failure.
- C. Osteoporosis due to hormonal changes.
- D. Cardiovascular changes leading to small strokes impairing mental acuity.
Correct answer: C
Rationale: The correct answer is C. Osteoporosis, caused by hormonal changes in later life, is the most likely predisposing factor for the fracture in the proximal end of her femur. Osteoporosis leads to reduced bone density, making bones more fragile and susceptible to fractures, especially in the elderly. Choices A, B, and D are less likely to directly lead to a hip fracture in this scenario. Failing eyesight (choice A) could contribute to the fall but is not the main predisposing factor for the fracture. Renal osteodystrophy (choice B) and cardiovascular changes (choice D) are less commonly associated with hip fractures compared to osteoporosis in elderly women.
5. A client with gastroesophageal reflux disease (GERD) has been experiencing severe reflux during sleep. Which recommendation by the nurse is most effective to assist the client?
- A. Losing weight.
- B. Decreasing caffeine intake.
- C. Avoiding large meals.
- D. Raising the head of the bed on blocks.
Correct answer: D
Rationale: The correct answer is to raise the head of the bed on blocks (reverse Trendelenburg position). This elevation helps reduce reflux by using gravity to keep stomach contents from flowing back into the esophagus during sleep. Losing weight (Choice A) could be beneficial in managing GERD, but it may not be as effective for immediate relief during sleep. Decreasing caffeine intake (Choice B) and avoiding large meals (Choice C) are also valuable recommendations to manage GERD; however, they may not specifically address the issue of reflux during sleep as directly and effectively as elevating the head of the bed.
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