HESI RN
HESI Medical Surgical Practice Exam Quizlet
1. An elderly client is admitted with a diagnosis of bacterial pneumonia. The nurse's assessment of the client will most likely reveal which sign/symptom?
- A. Leukocytosis and febrile.
- B. Polycythemia and crackles.
- C. Pharyngitis and sputum production.
- D. Confusion and tachycardia.
Correct answer: D
Rationale: The onset of pneumonia in the elderly may be signaled by general deterioration, confusion, increased heart rate or increased respiratory rate due to the decreased oxygen- carbon dioxide exchange at the alveoli, known as the V-Q mismatch.
2. The nurse is obtaining the admission history for a client with suspected peptic ulcer disease (PUD). Which subjective data reported by the client supports this diagnosis?
- A. Frequent use of chewable and liquid antacids for indigestion
- B. Severe abdominal cramps and diarrhea after eating spicy foods
- C. Upper mid-abdominal gnawing and burning pain
- D. Marked weight loss and appetite over the last 3 to 4 months
Correct answer: C
Rationale: The correct answer is C: 'Upper mid-abdominal gnawing and burning pain.' This symptom is a classic presentation of peptic ulcer disease. Antacids (choice A) may provide relief but do not confirm the diagnosis. Severe abdominal cramps and diarrhea (choice B) are more suggestive of other conditions like irritable bowel syndrome. Weight loss and appetite changes (choice D) are non-specific and could be related to various health issues.
3. Which of the following is a common cause of acute kidney injury?
- A. Hypertension
- B. Dehydration
- C. Infection
- D. Hypotension
Correct answer: C
Rationale: Infection is a common cause of acute kidney injury because when the body fights an infection, it activates the immune response, leading to inflammation. This inflammatory response can affect the kidneys and impair their function. While hypertension (choice A) is a risk factor for chronic kidney disease, it is not a direct cause of acute kidney injury. Dehydration (choice B) can lead to prerenal acute kidney injury due to decreased blood flow to the kidneys, but infection is a more common cause of acute kidney injury. Hypotension (choice D) can contribute to prerenal acute kidney injury, but it is not a direct cause like infection.
4. When preparing a client who has had a total laryngectomy for discharge, what instruction is most important for the nurse to include in the discharge teaching?
- A. Recommend that the client carry suction equipment at all times.
- B. Instruct the client to have writing materials with them at all times.
- C. Tell the client to carry a medic alert card stating that they are a total neck breather.
- D. Tell the client not to travel alone.
Correct answer: C
Rationale: The most crucial instruction for a client who has had a total laryngectomy is to carry a medic alert card stating that they are a total neck breather. This is important because if they experience a cardiac arrest, mouth-to-neck breathing may be required. Choice A about carrying suction equipment is not the most critical as the client may not always need it. Choice B is not as essential as having a medic alert card. Choice D is not directly related to the client's safety due to their laryngectomy.
5. 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.
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