HESI RN
HESI RN Medical Surgical Practice Exam
1. A client with stress incontinence is being taught about pelvic muscle exercises. Which statements should be included by the nurse? (Select all that apply.)
- A. Starting and stopping the urine stream involves using pelvic muscles.
- B. Tighten pelvic muscles for a slow count of 10 and then relax for a slow count of 10.
- C. Pelvic muscle exercises can be performed in various positions: lying down, sitting up, and standing.
- D. A & B
Correct answer: D
Rationale: The correct statements to include when teaching a client with stress incontinence about pelvic muscle exercises are that starting and stopping the urine stream involve using pelvic muscles and that tightening pelvic muscles for a slow count of 10 and then relaxing for a slow count of 10 can help strengthen them. It is essential to highlight that pelvic muscle exercises can be performed in various positions, including lying down, sitting up, and standing. This variety in positions helps engage the muscles effectively. Performing these exercises 15 times in each position can aid in strengthening the pelvic floor muscles. Consistent exercise over several weeks typically leads to improved control over urine leakage. Choice C is incorrect because pelvic muscle exercises can be performed in different positions and are not limited to sitting upright with feet on the floor.
2. A client with hypothyroidism is prescribed levothyroxine. What is the most important teaching point for the nurse to provide?
- A. Take the medication with food to avoid stomach upset.
- B. Take the medication at the same time every day to maintain consistent thyroid levels.
- C. Expect increased sensitivity to cold as a side effect of the medication.
- D. Increase the dosage of levothyroxine if symptoms worsen.
Correct answer: B
Rationale: The correct answer is B. Levothyroxine should be taken at the same time every day to maintain stable thyroid hormone levels and ensure effective management of hypothyroidism. Consistent dosing is critical for preventing fluctuations in hormone levels. Choice A is incorrect because levothyroxine is usually recommended to be taken on an empty stomach for optimal absorption. Choice C is incorrect because increased sensitivity to cold is not a common side effect of levothyroxine. Choice D is incorrect because adjusting the dosage without healthcare provider guidance can be dangerous and should not be done independently.
3. During an excretory urogram, which observation made by the nurse indicates a complication?
- A. The client complains of a salty taste in the mouth when the dye is injected
- B. The client's entire body turns a bright red color
- C. The client states 'I have a feeling of getting warm.'
- D. The client gags and complains 'I am getting sick.'
Correct answer: B
Rationale: The correct answer is B because a whole-body bright red color indicates a severe reaction to the contrast dye and must be addressed immediately. Choices A, C, and D do not indicate a severe complication during an excretory urogram. Choice A is a common side effect of the dye, choice C could be a normal sensation due to the injection, and choice D may indicate nausea which is less severe compared to a whole-body red color reaction.
4. Complete abortion is characterized by:
- A. Os closed.
- B. Firm contracted uterus.
- C. Heavy bleeding.
- D. Heavy cramping.
Correct answer: A
Rationale: Complete abortion is characterized by a firm contracted uterus with a closed os. This closure of the os indicates that the products of conception have been completely expelled from the uterus. Choices B, C, and D are incorrect because a firm contracted uterus with a closed os is the hallmark sign of a complete abortion, not heavy bleeding, heavy cramping, or any other features.
5. When taking a health history, which information collected by the nurse correlates most directly to a diagnosis of chronic peripheral arterial insufficiency?
- A. Reports of leg cramping at rest
- B. Family history of heart disease
- C. Current use of beta-blockers
- D. History of intermittent claudication
Correct answer: D
Rationale: Corrected Rationale: Intermittent claudication, or pain in the legs while walking that is relieved by rest, is a classic symptom of peripheral arterial insufficiency. Other factors such as a family history or medication use may contribute to cardiovascular health, but claudication is the most specific indicator. Leg cramping at rest is more indicative of conditions like peripheral neuropathy or deep vein thrombosis. Family history of heart disease and current use of beta-blockers are relevant to overall cardiovascular health, but they are not as directly related to chronic peripheral arterial insufficiency as intermittent claudication.