HESI RN
HESI Medical Surgical Exam
1. The client has been receiving peritoneal dialysis. The nurse should assess the client for which of the following complications that is most likely to occur?
- A. Electrolyte imbalance
- B. Peritonitis
- C. Infection
- D. Hyperglycemia
Correct answer: B
Rationale: Peritonitis is the most likely complication to occur in clients receiving peritoneal dialysis due to the risk of infection. Peritonitis is a serious inflammation of the peritoneum lining the abdominal cavity, commonly caused by infection. While electrolyte imbalance and hyperglycemia are possible complications in some cases, peritonitis poses a more immediate and severe threat to the client's health. Infection is a general term that can encompass peritonitis but is not as specific as directly identifying peritonitis as the primary concern in this scenario.
2. The nurse is providing teaching to a patient who will begin taking a cephalosporin to treat an infection. Which statement by the patient indicates a need for further teaching?
- A. I may stop taking the medication if my symptoms clear up.
- B. I should eat yogurt while taking this medication.
- C. I should stop taking the drug and call my provider if I develop a rash.
- D. I will not consume alcohol while taking this medication.
Correct answer: A
Rationale: Patients should take all of an antibiotic regimen even after symptoms clear to ensure complete treatment of the infection.
3. A client in the emergency department is severely dehydrated and is prescribed 3 L of intravenous fluid over 6 hours. At what rate (mL/hr) should the nurse set the intravenous pump to infuse the fluids? (Record your answer using a whole number.)
- A. 500 mL/hr
- B. 400 mL/hr
- C. 550 mL/hr
- D. 600 mL/hr
Correct answer: A
Rationale: To calculate the rate of the intravenous pump, divide the total volume of fluid (3 L = 3000 mL) by the total time in hours (6 hours), which equals 500 mL/hr. The correct answer is A. Choice B (400 mL/hr) is incorrect as it would result in a slower infusion rate. Choice C (550 mL/hr) and Choice D (600 mL/hr) are incorrect as they would result in a faster infusion rate, exceeding the prescribed amount of fluid to be infused over 6 hours.
4. The nurse is teaching the main principles of hemodialysis to a client with chronic kidney disease. Which statement by the client indicates a need for further teaching by the nurse?
- A. My sodium level changes due to the movement from the blood into the dialysate.
- B. Dialysis works by the movement of wastes from higher to lower concentration.
- C. Extra fluid can be pulled from the blood by osmosis.
- D. The dialysate is similar to blood but without any toxins.
Correct answer: B
Rationale: The correct answer is B because dialysis works by the movement of solutes from an area of higher concentration to an area of lower concentration, which is known as diffusion. The other statements are accurate: A correctly describes the movement of sodium during hemodialysis, C explains the removal of excess fluid by osmosis, and D highlights the purpose of the dialysate in removing toxins from the blood.
5. The nurse is providing discharge teaching for a patient who will receive oral levofloxacin (Levaquin) to treat pneumonia. The patient takes an oral hypoglycemic medication and uses over-the-counter (OTC) antacids to treat occasional heartburn. The patient reports frequent arthritis pain and takes acetaminophen when needed. Which statement by the nurse is correct when teaching this patient?
- A. You may take antacids with levofloxacin to decrease gastrointestinal upset.
- B. You may take nonsteroidal anti-inflammatory medications (NSAIDs) for arthritis pain.
- C. You should monitor your serum glucose more closely while taking levofloxacin.
- D. You should take levofloxacin on an empty stomach to improve absorption.
Correct answer: C
Rationale: Levofloxacin may increase the effects of oral hypoglycemic medications, so patients taking these should be advised to monitor their serum glucose levels closely.
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