HESI RN
Evolve HESI Medical Surgical Practice Exam
1. A young female client prescribed amoxicillin (Amoxil) for a urinary tract infection is being taught by a nurse. Which statement should the nurse include in this client’s teaching?
- A. Use a second form of birth control while taking this medication.
- B. You will experience increased menstrual bleeding while on this medication.
- C. You may experience an irregular heartbeat while on this medication.
- D. Watch for blood in your urine while taking this drug.
Correct answer: A
Rationale: The correct statement for the nurse to include in the teaching is to advise the client to use a second form of birth control while taking amoxicillin. Penicillin, like amoxicillin, may reduce the effectiveness of estrogen-containing contraceptives, making it important to use additional contraceptive measures. The incorrect choices are B, C, and D. Increased menstrual bleeding, irregular heartbeat, or blood in the urine are not common side effects associated with amoxicillin use for a urinary tract infection.
2. A nurse checks the residual volume from a client’s nasogastric tube feeding before administering an intermittent tube feeding and finds 35 mL of gastric contents. What should the nurse do before administering the prescribed 100 mL of formula to the client?
- A. Pour the residual volume into the nasogastric tube through a syringe with the plunger removed
- B. Discard the residual volume properly and record it as output on the client’s fluid balance record
- C. Dilute the residual volume with water and inject it into the nasogastric tube, applying pressure on the plunger
- D. Mix the residual volume with the formula and pour it into the nasogastric tube, using a syringe without a plunger
Correct answer: A
Rationale: After checking the residual feeding contents, the nurse should pour the residual volume back into the stomach by removing the syringe bulb or plunger and then pouring the gastric contents, using the syringe, into the nasogastric tube. This helps ensure that the residual volume is reintroduced into the client's gastrointestinal tract. Option B is incorrect because discarding the residual volume without reinstilling it into the stomach can lead to inaccurate medication administration and potential electrolyte imbalances. Option C is incorrect as diluting the residual volume with water and injecting it under pressure can cause aspiration or discomfort for the client. Option D is incorrect because mixing the residual volume with the formula can alter the prescribed dosage and consistency, potentially affecting the client's nutritional intake and causing complications.
3. An older client with long-term type 2 diabetes Mellitus (DM) is seen in the clinic for a routine health assessment. Which assessment would the nurse complete to determine if a patient with type 2 diabetes Mellitus (DM) is experiencing long-term complications?
- A. Signs of respiratory tract infection
- B. Sensation in feet and legs
- C. Skin condition of lower extremities
- D. Serum creatinine and blood urea nitrogen (BUN)
Correct answer: B
Rationale: Assessing sensation in the feet and legs is crucial for detecting diabetic neuropathy, a common long-term complication of diabetes. While signs of respiratory tract infection, skin condition of lower extremities, and serum creatinine and blood urea nitrogen levels are important assessments in diabetic care, they are not specific for detecting long-term complications like neuropathy.
4. A client who is postmenopausal and has had two episodes of bacterial urethritis in the last 6 months asks, “I never have urinary tract infections. Why is this happening now?” How should the nurse respond?
- A. Your immune system becomes less effective as you age.
- B. Low estrogen levels can make the tissue more susceptible to infection.
- C. You should be more careful with your personal hygiene in this area.
- D. It is likely that you have an untreated sexually transmitted disease.
Correct answer: B
Rationale: Low estrogen levels in postmenopausal women decrease moisture and secretions in the perineal area, causing tissue changes that predispose them to infection, including urethritis. This is a common reason for urethritis in postmenopausal women. While immune function does decrease with aging and sexually transmitted diseases can cause urethritis, the most likely reason in this case is the low estrogen levels. Personal hygiene practices are usually not a significant factor in the development of urethritis.
5. A client with a family history of polycystic kidney disease (PKD is being assessed by a nurse. For which clinical manifestations should the nurse assess? (Select all that apply.)
- A. Nocturia
- B. Flank pain
- C. Increased abdominal girth
- D. B & C
Correct answer: D
Rationale: Clients with PKD commonly present with flank pain and increased abdominal girth due to abdominal distention caused by cysts. Bloody urine is also a common symptom due to tissue damage from PKD. Nocturia and dysuria are not typical manifestations of PKD. Constipation is not directly associated with PKD. Therefore, the correct choices are flank pain and increased abdominal girth, making option D the correct answer.
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