HESI RN
HESI Medical Surgical Practice Quiz
1. A patient’s serum osmolality is 305 mOsm/kg. Which term describes this patient’s body fluid osmolality?
- A. Iso-osmolar
- B. Hypo-osmolar
- C. Hyperosmolar
- D. Isotonic
Correct answer: C
Rationale: The correct term to describe a patient with a serum osmolality of 305 mOsm/kg is 'hyperosmolar.' Normal osmolality ranges from 280 to 300 mOsm/kg. A patient with an osmolality above this range is considered hyperosmolar. Choice A ('Iso-osmolar') implies an equal osmolality, which is not the case in this scenario. Choice B ('Hypo-osmolar') suggests a lower osmolality, which is incorrect based on the provided serum osmolality value. Choice D ('Isotonic') refers to a solution having the same osmolality as another solution, not describing the specific scenario of this patient being above the normal range.
2. A client without a history of respiratory disease has a pulse oximeter in place after surgery. The nurse monitors the pulse oximeter readings to ensure that oxygen saturation remains above:
- A. 85%
- B. 89%
- C. 95%
- D. 100%
Correct answer: C
Rationale: Pulse oximetry is a noninvasive method of continuously monitoring the oxygen saturation of hemoglobin (SaO2). In the absence of underlying respiratory disease, the expected oxygen saturation level is at least 95%. Oxygen saturation levels below 95% may indicate hypoxemia, which can compromise tissue perfusion and oxygen delivery to vital organs. Therefore, maintaining oxygen saturation above 95% is crucial to ensure adequate oxygenation post-surgery. Choices A, B, and D are incorrect as they represent oxygen saturation levels that are below the expected value for a client without a history of respiratory disease, which should be at least 95%.
3. What information will the nurse provide when counseling a patient starting a sulfonamide drug for a urinary tract infection?
- A. Drink several quarts of water daily.
- B. If stomach upset occurs, avoid taking antacids.
- C. Limit sun exposure to avoid skin reactions.
- D. Report any sore throat promptly.
Correct answer: A
Rationale: The correct answer is A: Drink several quarts of water daily. This advice aims to prevent crystalluria, a potential side effect of sulfonamide drugs. Option B is incorrect because antacids should not be taken with sulfonamides as they can decrease drug absorption. Option C is incorrect as sulfonamides can increase sensitivity to sunlight, not requiring sun exposure limitations but sun protection measures. Option D is incorrect because a sore throat could indicate a more serious adverse effect and should be promptly reported for evaluation.
4. A healthcare professional is reviewing the results of renal function testing in a client with renal calculi. Which finding indicates to the healthcare professional that the client’s blood urea nitrogen (BUN) level is within the normal range?
- A. 2 mg/dL
- B. 18 mg/dL
- C. 25 mg/dL
- D. 35 mg/dL
Correct answer: B
Rationale: The normal BUN ranges from 5 to 20 mg/dL. A BUN level of 18 mg/dL falls within this normal range. Values of 25 and 35 mg/dL are elevated, suggesting potential renal insufficiency. Choice A (2 mg/dL) is abnormally low and not indicative of a normal BUN level.
5. Which clients are at risk for kidney problems? (Select all that apply.)
- A. Clients taking synthetic creatine supplements
- B. Clients taking metformin for diabetes mellitus
- C. Clients taking high-dose nonsteroidal anti-inflammatory drugs (NSAIDs) for chronic back pain
- D. Clients taking prenatal vitamins and using albuterol nebulizers
Correct answer: A
Rationale: Clients who take synthetic creatine supplements, metformin, and high-dose or long-term NSAIDs are at risk for kidney dysfunction. Synthetic creatine supplements can cause kidney damage, metformin may rarely cause lactic acidosis leading to renal impairment, and high-dose NSAIDs can lead to acute kidney injury. Prenatal vitamins and albuterol nebulizers are not known to significantly impact kidney function, thus do not pose a risk for kidney problems.
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