HESI RN
HESI RN Medical Surgical Practice Exam
1. After teaching a client with bacterial cystitis who is prescribed phenazopyridine (Pyridium), the nurse assesses the client’s understanding. Which statement made by the client indicates a correct understanding of the teaching?
- A. I will not take this drug with food or milk.
- B. If I suspect pregnancy, I will discontinue the drug.
- C. An orange color in my urine should not alarm me.
- D. I will consume two glasses of cranberry juice daily.
Correct answer: C
Rationale: The correct answer is C. Phenazopyridine commonly discolors urine to a deep reddish orange, which can be mistaken for blood. It is important for the client to understand that this color change is an expected side effect and should not be a cause for alarm. Additionally, the urine can stain clothing. There are no dietary restrictions or precautions related to food or milk intake while taking phenazopyridine. Stopping the medication if suspecting pregnancy is not necessary as phenazopyridine is safe to use during pregnancy. Drinking cranberry juice is not directly related to the use of phenazopyridine and is not a specific instruction given for managing bacterial cystitis.
2. During an annual physical at the corporate clinic, a male employee expresses to the RN that his high-stress job is causing trouble in his personal life. He mentions getting so angry while driving to and from work that he has considered 'getting even' with other drivers. How should the RN respond?
- A. “Anger is contagious and could lead to major confrontations.”
- B. “Try not to let your anger cause you to act impulsively.”
- C. “Expressing your anger to a stranger could lead to an unsafe situation.”
- D. “It seems like there are many situations that make you feel angry.”
Correct answer: B
Rationale: The correct response for the RN is to advise the employee not to act impulsively when feeling angry. This approach helps the individual learn to manage anger in a constructive manner, reducing the likelihood of potential conflicts. Choice A is incorrect because although acknowledging that anger can escalate into confrontations is valid, it does not provide immediate guidance on managing the anger. Choice C focuses on the dangers of expressing anger to strangers but does not address the core issue of managing anger. Choice D simply acknowledges the employee's feelings without providing guidance on how to address the situation effectively.
3. A nurse starts classes for clients with type 2 diabetes. Which information would the nurse use as an outcome evaluation for the class?
- A. Parking convenience for attendees continues to be a major concern.
- B. Fasting blood glucose average readings were 20% lower by the end of classes.
- C. Discussion of food exchanges and calories was a well-attended class.
- D. Demonstrating the use of a blood glucose meter was an effective teaching strategy.
Correct answer: B
Rationale: A reduction in fasting blood glucose levels indicates the effectiveness of the diabetes management education provided. Monitoring blood glucose levels is a crucial aspect of diabetes management, and a decrease in average readings signifies improvement in managing blood sugar levels. Choices A, C, and D are not direct outcome evaluations related to the effectiveness of the education provided in managing diabetes. Parking convenience, attendance, and teaching strategies are not direct indicators of the impact on the clients' health outcomes.
4. The nurse is providing care for a client with a new tracheostomy. Which of these assessments is a priority?
- A. Checking the client's oxygen saturation level
- B. Monitoring the client's pain level
- C. Checking the tracheostomy site for signs of infection
- D. Monitoring the client's level of consciousness
Correct answer: C
Rationale: When caring for a client with a new tracheostomy, the priority assessment is checking the tracheostomy site for signs of infection. This is essential to detect early signs of complications such as infection, which can lead to serious issues. Monitoring oxygen saturation is important but not as critical as ensuring the tracheostomy site is free from infection. Pain assessment and level of consciousness are also important but secondary to assessing for signs of infection in this scenario.
5. A client with type 2 diabetes mellitus is being discharged after receiving initial treatment. What should the nurse emphasize as a crucial instruction?
- A. Take insulin as prescribed, even if you are not eating.
- B. Avoid all forms of physical exercise to prevent hypoglycemia.
- C. Monitor blood glucose levels regularly and report any changes.
- D. Stop taking oral antidiabetic medication if your blood glucose levels are normal.
Correct answer: C
Rationale: Monitoring blood glucose levels regularly is a critical aspect of managing type 2 diabetes mellitus. This allows the individual to track their blood sugar levels, understand the effectiveness of the treatment plan, and detect any fluctuations promptly. Option A is incorrect because insulin should be taken based on a prescribed schedule that correlates with meals to prevent hypoglycemia or hyperglycemia. Option B is incorrect as physical exercise is beneficial for managing diabetes but should be done cautiously with adjustments in insulin or food intake. Option D is incorrect because discontinuing oral antidiabetic medications without healthcare provider guidance can lead to uncontrolled blood glucose levels.