HESI RN
HESI Medical Surgical Specialty Exam
1. A patient taking trimethoprim-sulfamethoxazole (TMP-SMX) to treat a urinary tract infection complains of a sore throat. The nurse will contact the provider to request an order for which laboratory test(s)?
- A. Complete blood count with differential
- B. Throat culture
- C. Urinalysis
- D. Coagulation studies
Correct answer: A
Rationale: When a patient taking trimethoprim-sulfamethoxazole (TMP-SMX) for a urinary tract infection presents with a sore throat, the nurse should request a complete blood count with differential. TMP-SMX can cause life-threatening adverse effects such as agranulocytosis, a condition characterized by a low white blood cell count, which can manifest as a sore throat. Ordering a complete blood count with differential helps assess the patient's white blood cell count to detect any potential serious adverse effects. Throat culture (Choice B) is not indicated unless there are specific signs of a throat infection. Urinalysis (Choice C) is not relevant for assessing a sore throat. Coagulation studies (Choice D) are not typically indicated for a sore throat symptom.
2. A client who has undergone pleural biopsy is being monitored by a nurse. Which finding indicates a potential complication for the client?
- A. Warm, dry skin
- B. Mild pain at the biopsy site
- C. Complaints of shortness of breath
- D. Capillary refill time of less than 3 seconds
Correct answer: C
Rationale: Complaints of shortness of breath are a concerning finding post-pleural biopsy, as they may indicate a complication such as a pneumothorax or hemothorax. Shortness of breath can be a sign of respiratory distress that requires immediate attention. Warm, dry skin, mild pain at the biopsy site, and a capillary refill time of less than 3 seconds are not typically associated with immediate complications following a pleural biopsy. Warm, dry skin may be a normal finding, mild pain can be expected at the biopsy site, and a capillary refill time of less than 3 seconds is within normal limits.
3. Which of the following is the most appropriate diet for a client during the acute phase of myocardial infarction?
- A. Liquids as desired.
- B. Small, easily digested meals.
- C. Three regular meals per day.
- D. Nothing by mouth.
Correct answer: B
Rationale: During the acute phase of myocardial infarction, it is recommended to provide small, easily digested meals for the client. This type of diet is better tolerated as it reduces the workload on the heart, allowing for easier digestion and absorption of nutrients. Choice A, 'Liquids as desired,' may not provide adequate nutrition and may not be well-balanced. Choice C, 'Three regular meals per day,' may be too heavy for the client's weakened condition. Choice D, 'Nothing by mouth,' is not appropriate as the client still requires essential nutrients for recovery.
4. 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.
5. During an interview with a client planning elective surgery, the client asks the nurse, 'What is the advantage of having a preferred provider organization insurance plan?' Which response is best for the nurse to provide?
- A. Neither plan allows the selection of healthcare providers or hospitals.
- B. There are fewer healthcare providers to choose from than in an HMO plan.
- C. An individual may select healthcare providers from outside of the PPO network.
- D. An individual can become a member of a PPO without belonging to a group.
Correct answer: C
Rationale: The best response for the nurse to provide is option C, as it highlights a key advantage of a preferred provider organization (PPO) insurance plan. By stating that an individual may select healthcare providers from outside of the PPO network, the nurse emphasizes the flexibility and freedom of choice that PPO plans offer. This feature allows individuals to seek care from providers who are not part of the PPO network, albeit at a higher cost. Option A is incorrect because both PPO and HMO plans allow the selection of healthcare providers, although with different restrictions. Option B is incorrect as PPO plans typically offer a larger selection of healthcare providers compared to HMO plans. Option D is incorrect as membership in a PPO usually requires affiliation with a group, such as through employment or membership in an organization.
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