HESI RN
HESI RN Medical Surgical Practice Exam
1. When a patient starts taking amoxicillin, which foods should the nurse instruct the patient to avoid?
- A. Green leafy vegetables
- B. Beef and other red meat
- C. Coffee, tea, and colas
- D. Acidic fruits and juices
Correct answer: D
Rationale: The correct answer is D: Acidic fruits and juices. Amoxicillin can be irritating to the stomach, so avoiding acidic fruits and juices is recommended to reduce stomach discomfort or potential interactions. Green leafy vegetables (Choice A), beef and other red meat (Choice B), and coffee, tea, and colas (Choice C) are not typically contraindicated with amoxicillin. It is important to focus on acidic foods and beverages to promote comfort and effectiveness of the medication.
2. The client with chronic renal failure is being taught about fluid restrictions by the nurse. Which statement by the client indicates a need for further teaching?
- A. I can drink as much water as I want, as long as I limit my salt intake.
- B. I should limit my fluid intake to prevent fluid overload.
- C. I can skip dialysis sessions if I feel tired.
- D. I can eat whatever I want, as long as I take my medications.
Correct answer: C
Rationale: Choice C is the correct answer because clients with chronic renal failure should not skip dialysis sessions. Skipping dialysis can lead to serious complications and worsen the client's condition. It is crucial for clients to understand the importance of adhering to their dialysis schedule for optimal management of chronic renal failure. Choices A, B, and D are incorrect because they demonstrate understanding of fluid restrictions, the need to limit fluid intake to prevent overload, and the importance of medication compliance, respectively. These statements show appropriate knowledge and do not indicate a need for further teaching.
3. A nursing student is suctioning a client through a tracheostomy tube while a nurse observes. Which action by the student would prompt the nurse to intervene and demonstrate the correct procedure? Select all that apply.
- A. Setting the suction pressure to 60 mm Hg
- B. Applying suction throughout the procedure
- C. Assessing breath sounds before suctioning
- D. Placing the client in a supine position before the procedure
Correct answer: A
Rationale: The correct suction pressure for an adult client with a tracheostomy tube is typically between 80 to 120 mm Hg. Suction should be applied intermittently during catheter withdrawal to avoid damaging the airway. Assessing breath sounds before suctioning is important to ensure the procedure is necessary. Placing the client in a supine position before suctioning can compromise their airway; instead, the head of the bed should be elevated to facilitate proper drainage and reduce the risk of aspiration. Therefore, setting the suction pressure to 60 mm Hg is incorrect and would prompt the nurse to intervene and correct the procedure.
4. A client presents with a fungal urinary tract infection (UTI). Which assessments should the nurse complete? (Select all that apply.)
- A. Palpate the kidneys and bladder.
- B. Assess the medical history and current medical problems.
- C. Perform a bladder scan to assess post-void residual.
- D. Inquire about recent travel to foreign countries.
Correct answer: B
Rationale: When assessing a client with a fungal UTI, the nurse should prioritize gathering information related to the medical history and current medical problems. Clients who are severely immunocompromised or have conditions like diabetes mellitus are more susceptible to fungal UTIs. Assessing the medical history helps identify risk factors and potential causes of the infection. While physical examinations like palpating the kidneys and bladder and performing a bladder scan may be necessary, they should follow the initial assessment of medical history. Inquiring about recent travel to foreign countries is less relevant in the context of a fungal UTI, as the focus should be on immediate medical factors predisposing the client to the infection.
5. What most likely led to the 67-year-old woman who lives alone tripping on a rug in her home and fracturing her hip?
- A. Failing eyesight causing an unsafe environment.
- B. Renal osteodystrophy due to chronic renal failure.
- C. Osteoporosis due to hormonal changes.
- D. Cardiovascular changes leading to small strokes impairing mental acuity.
Correct answer: C
Rationale: The correct answer is C. Osteoporosis, caused by hormonal changes in later life, is the most likely predisposing factor for the fracture in the proximal end of her femur. Osteoporosis leads to reduced bone density, making bones more fragile and susceptible to fractures, especially in the elderly. Choices A, B, and D are less likely to directly lead to a hip fracture in this scenario. Failing eyesight (choice A) could contribute to the fall but is not the main predisposing factor for the fracture. Renal osteodystrophy (choice B) and cardiovascular changes (choice D) are less commonly associated with hip fractures compared to osteoporosis in elderly women.
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