HESI RN
HESI Medical Surgical Practice Exam
1. A client with type 1 diabetes mellitus who jogs daily is being taught by a nurse about the preferred sites for insulin absorption. What is the most appropriate site for this client?
- A. Arms
- B. Legs
- C. Abdomen
- D. Iliac crest
Correct answer: C
Rationale: The abdomen is the most appropriate site for insulin absorption in a client who jogs. When a client is involved in physical activity like jogging, the abdomen is preferred as it provides more consistent absorption compared to the arms or legs, which can have altered absorption rates due to increased blood flow during exercise. The iliac crest is not a common site for insulin injections and may not provide optimal absorption rates compared to the abdomen.
2. The client is planning care for a client who is receiving hemodialysis. Which of the following interventions should be included in the plan of care?
- A. Administer anticoagulants to prevent clot formation.
- B. Monitor the client for signs of infection.
- C. Provide the client with a high-protein diet.
- D. Encourage the client to drink at least 2 liters of fluid daily.
Correct answer: B
Rationale: Monitoring for signs of infection is crucial in clients receiving hemodialysis because they are at an increased risk of infection due to the invasive nature of the procedure. Administering anticoagulants is not typically a part of the routine care for clients undergoing hemodialysis unless specifically prescribed. While a high-protein diet may be beneficial for some clients, it is not a specific intervention related to hemodialysis. Encouraging fluid intake must be individualized based on the client's fluid status and should not be a generalized recommendation for all clients receiving hemodialysis.
3. 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.
4. A client with cirrhosis develops increasing pedal edema and ascites. What dietary modification is most important for the nurse to teach this client?
- A. Avoid high carbohydrate foods.
- B. Decrease intake of fat-soluble vitamins.
- C. Decrease caloric intake.
- D. Restrict salt and fluid intake.
Correct answer: D
Rationale: The correct answer is to restrict salt and fluid intake. In clients with cirrhosis presenting with pedal edema and ascites, excessive fluid retention occurs, necessitating the restriction of salt and fluid to alleviate these symptoms. Choice A, avoiding high carbohydrate foods, is not the priority in this situation. Decreasing intake of fat-soluble vitamins (Choice B) is not specifically indicated for managing edema and ascites in cirrhosis. While maintaining an appropriate caloric intake is important, decreasing caloric intake (Choice C) is not the primary focus when addressing fluid retention in cirrhosis.
5. The client with chronic kidney disease (CKD) is being taught about the necessary sodium restriction in the diet to prevent edema and hypertension. Which statement by the client indicates more teaching is needed?
- A. I am thrilled that I can continue to eat fast food.
- B. I will cut out bacon with my eggs every morning.
- C. My cooking style will change by not adding salt.
- D. I will probably lose weight by cutting out potato chips.
Correct answer: A
Rationale: Choice A, 'I am thrilled that I can continue to eat fast food,' indicates a lack of understanding as fast food is typically high in sodium, which is detrimental for individuals with CKD. The client should be advised to avoid fast food due to its high sodium content. Choices B, C, and D demonstrate a good understanding of the need for sodium restriction in the diet to prevent complications associated with CKD. Cutting out bacon, avoiding salt in cooking, and eliminating high-sodium snacks like potato chips are all positive steps towards managing CKD.
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