HESI RN
RN Medical/Surgical NGN HESI 2023
1. A client who is scheduled for cardiac catheterization to rule out coronary occlusion should be informed by the nurse that:
- A. The procedure is performed in a darkened room in the radiology department
- B. It is necessary to lie quietly on a hard x-ray table for about 4 hours
- C. The room is bright and well lit, and it is best to keep the eyes closed
- D. The client may have feelings of warmth or flushing during the procedure
Correct answer: D
Rationale: Before cardiac catheterization, the nurse should inform the client that the procedure is performed in a darkened room in the radiology department, not the operating room. The client should expect to lie still on an x-ray table for the duration of the procedure, not necessarily for about 4 hours. Keeping the eyes closed is not necessary as the room is usually dimly lit. The client may experience sensations of warmth or flushing during the procedure due to catheter passage and dye injection, making choice D the correct answer.
2. A client has just returned to the nursing unit after computerized tomography (CT) with contrast medium. Which of the following actions should the nurse plan to take as part of routine after-care for this client?
- A. Administering a laxative
- B. Encouraging fluid intake
- C. Maintaining the client on strict bed rest
- D. Holding all medications for at least 2 hours
Correct answer: B
Rationale: After CT scanning with contrast medium, the client does not require special restrictions or interventions. Encouraging fluid intake is important to help flush out the contrast dye and prevent dehydration. Administering a laxative (Choice A) is unnecessary and not indicated after CT with contrast. Maintaining the client on strict bed rest (Choice C) is not necessary unless specified by the healthcare provider. Holding all medications for at least 2 hours (Choice D) is not a standard practice after CT with contrast.
3. During a routine clinic visit, a nurse is assessing a 48-year-old client with a history of smoking. The client, who exercises regularly, reports calf pain during exercise that disappears at rest. Which of the following findings requires further evaluation?
- A. Heart rate of 57 bpm.
- B. SpO2 of 94% on room air.
- C. Blood pressure of 134/82.
- D. Ankle-brachial index of 0.65.
Correct answer: D
Rationale: An Ankle-Brachial Index of 0.65 suggests moderate arterial vascular disease in a client experiencing intermittent claudication, indicating compromised blood flow to the lower extremities during exercise. This finding requires further evaluation to assess the severity of arterial insufficiency and determine appropriate interventions. Choice A (Heart rate of 57 bpm) is within the normal range for an adult at rest and indicates good cardiovascular fitness. Choice B (SpO2 of 94% on room air) is slightly lower than the normal range but is generally acceptable in a healthy individual. Choice C (Blood pressure of 134/82) falls within the normal range and does not raise immediate concerns in this context.
4. The nurse is obtaining the admission history for a client with suspected peptic ulcer disease (PUD). Which subjective data reported by the client supports this diagnosis?
- A. Frequent use of chewable and liquid antacids for indigestion
- B. Severe abdominal cramps and diarrhea after eating spicy foods
- C. Upper mid-abdominal gnawing and burning pain
- D. Marked weight loss and appetite over the last 3 to 4 months
Correct answer: C
Rationale: The correct answer is C: 'Upper mid-abdominal gnawing and burning pain.' This symptom is a classic presentation of peptic ulcer disease. Antacids (choice A) may provide relief but do not confirm the diagnosis. Severe abdominal cramps and diarrhea (choice B) are more suggestive of other conditions like irritable bowel syndrome. Weight loss and appetite changes (choice D) are non-specific and could be related to various health issues.
5. Prior to a percutaneous kidney biopsy, which actions should a nurse take? (Select all that apply.)
- A. Keep the client NPO for 4 to 6 hours.
- B. Obtain coagulation study results.
- C. Maintain strict bedrest in a supine position.
- D. A & B
Correct answer: D
Rationale: Prior to a percutaneous kidney biopsy, the nurse should ensure that the client is kept NPO for 4 to 6 hours to prevent aspiration during the procedure. Obtaining coagulation study results is crucial to assess the risk of bleeding during and after the biopsy. Strict bedrest in a supine position is not necessary before the procedure. It is important to note that blood pressure medications should be carefully managed, but it is not a pre-procedure action. Keeping the client on bedrest or assessing for blood in the urine are interventions that are more relevant post-procedure to monitor for complications.
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