HESI RN
HESI Medical Surgical Specialty Exam
1. A client is starting urinary bladder training. Which statement should the nurse include in this client’s teaching?
- A. Use the toilet when you first feel the urge, rather than at specific intervals.
- B. Try to consciously hold your urine until the scheduled toileting time.
- C. Initially try to use the toilet at least every half hour for the first 24 hours.
- D. The toileting interval can be increased once you have been continent for a week.
Correct answer: B
Rationale: In urinary bladder training, the client should be taught to try to consciously hold their urine until the scheduled toileting time. This helps in training the bladder to hold urine for longer periods. Option A is incorrect because the goal is to consciously hold urine, not void immediately. Option C is incorrect as toileting at least every half hour may not promote bladder training. Option D is incorrect as increasing the toileting interval should be based on the client's comfort and progress, not just after being continent for a week.
2. During the menstrual cycle, which hormone maintains the corpus luteum?
- A. Luteinizing hormone
- B. Follicle-stimulating hormone
- C. Progesterone
- D. Relaxin
Correct answer: A
Rationale: During the menstrual cycle, luteinizing hormone maintains the corpus luteum. The correct answer is A. Luteinizing hormone stimulates the corpus luteum to produce progesterone. Choice B, Follicle-stimulating hormone, is involved in stimulating the growth of follicles in the ovaries. Choice C, Progesterone, is produced by the corpus luteum and plays a role in preparing the endometrium for implantation. Choice D, Relaxin, is involved in processes such as softening the cervix and ligaments during pregnancy, but it is not responsible for maintaining the corpus luteum.
3. An elderly client seems confused and reports the onset of nausea, dysuria, and urgency with incontinence. Which action should the nurse implement?
- A. Auscultate for renal bruits
- B. Obtain a clean catch mid-stream specimen
- C. Use a dipstick to measure for urinary ketones
- D. Begin to strain the client's urine
Correct answer: B
Rationale: This elderly client is presenting symptoms consistent with a urinary tract infection (UTI), such as confusion, nausea, dysuria, urgency, and incontinence. The best course of action for the nurse is to obtain a clean catch mid-stream specimen. This specimen will help identify the causative agent of the UTI, allowing for targeted treatment with an appropriate anti-infective agent. Auscultating for renal bruits (Choice A) is not indicated in this scenario as the client's symptoms point towards a UTI rather than a renal issue. Using a dipstick to measure for urinary ketones (Choice C) is not relevant in the context of UTI symptoms. Beginning to strain the client's urine (Choice D) would not address the need to identify the causative agent for targeted treatment.
4. The client with DM is being taught about foot care. The nurse instructs the client to:
- A. Avoid hot water when bathing the feet.
- B. Apply a moisturizing lotion to the feet, especially between the toes.
- C. Use a heating pad to warm the feet if they feel cold.
- D. Go barefoot at home to allow the feet to air out.
Correct answer: A
Rationale: The correct answer is to avoid hot water when bathing the feet. This instruction is crucial because clients with diabetes may have decreased sensation in their feet, which can put them at risk of burns from hot water. Choice B is incorrect because applying moisturizing lotion between the toes can increase moisture and promote fungal growth. Choice C is incorrect because using a heating pad can also lead to burns due to decreased sensation. Choice D is incorrect as going barefoot can increase the risk of injury and infections in clients with diabetes.
5. Which information is a priority for the client to reinforce after intravenous pyelography?
- A. Eat a light diet for the rest of the day
- B. Rest for the next 24 hours as the preparation and test are tiring.
- C. During waking hours, drink at least 1 8-ounce glass of fluid every hour for the next 2 days
- D. Measure urine output for the next day and immediately notify the healthcare provider if it decreases.
Correct answer: D
Rationale: After intravenous pyelography, monitoring urine output is crucial to assess kidney function and detect any early signs of complications. Decreased urine output could indicate a problem with kidney function or potential complications from the procedure. While rest and hydration are important, the priority lies in monitoring urine output for any abnormalities. Eating a light diet may be recommended, but it is not the priority post-procedure instruction.