HESI RN
Evolve HESI Medical Surgical Practice Exam Quizlet
1. The client who experiences angina has been advised to follow a low-cholesterol diet. Which of the following meals would be best?
- A. Hamburger, salad, and milkshake.
- B. Baked liver, green beans, and coffee.
- C. Spaghetti with tomato sauce, salad, and coffee.
- D. Fried chicken, green beans, and skim milk.
Correct answer: C
Rationale: The best meal option for a client with angina following a low-cholesterol diet is spaghetti with tomato sauce, salad, and coffee. This meal is lower in cholesterol content compared to the other options provided. Hamburger with salad and milkshake, baked liver with green beans and coffee, and fried chicken with green beans and skim milk are higher in cholesterol and may not be suitable for an individual with angina who needs to adhere to a low-cholesterol diet.
2. A client with a history of peptic ulcer disease is admitted with severe abdominal pain. Which assessment finding requires immediate intervention?
- A. Epigastric tenderness.
- B. Bowel sounds are hypoactive.
- C. The client reports sudden, severe abdominal pain.
- D. Bowel sounds are hyperactive.
Correct answer: C
Rationale: The correct answer is C. Sudden, severe abdominal pain can indicate a perforated ulcer, which is a medical emergency requiring immediate intervention. Epigastric tenderness (choice A) may be expected in a client with peptic ulcer disease but does not necessarily require immediate intervention. Hypoactive bowel sounds (choice B) are concerning but not as urgent as sudden, severe abdominal pain. Hyperactive bowel sounds (choice D) are more indicative of conditions like gastroenteritis rather than a perforated ulcer, making it a less critical finding compared to sudden, severe abdominal pain.
3. To reduce the risk of pulmonary complications for a client with ALS, which intervention should the nurse implement?
- A. Perform chest physiotherapy
- B. Teach the client breathing exercises
- C. Initiate passive range of motion exercises
- D. Establish a regular bladder routine
Correct answer: A
Rationale: Performing chest physiotherapy is the most appropriate intervention to reduce the risk of pulmonary complications in clients with ALS. Chest physiotherapy helps mobilize and clear respiratory secretions, improving lung function and reducing the risk of complications such as pneumonia. Teaching breathing exercises (Choice B) may be beneficial for some clients, but chest physiotherapy is more specifically targeted at managing pulmonary issues in ALS. Initiating passive range of motion exercises (Choice C) and establishing a regular bladder routine (Choice D) are important interventions in ALS care but are not directly related to reducing the risk of pulmonary complications.
4. A client with pneumococcal pneumonia had been started on antibiotics 16 hours ago. During the nurse's initial evening rounds, the nurse notices a foul smell in the room. The client makes all of these statements during their conversation. Which statement would alert the nurse to a complication?
- A. I have a sharp pain in my chest when I take a breath.
- B. I have been coughing up foul-tasting, brown, thick sputum.
- C. I have been sweating all day.
- D. I feel hot off and on.
Correct answer: B
Rationale: Coughing up foul-tasting, brown, thick sputum suggests a possible abscess or secondary infection, requiring attention. Choice A may indicate pleurisy, but the focus should be on the sputum. Choice C may be non-specific and could be related to the infection or fever. Choice D is non-specific and may be expected during an infection.
5. A client with rheumatoid arthritis has just been prescribed methotrexate. What teaching should the nurse include?
- A. Take the medication on an empty stomach.
- B. Report any signs of infection, such as a sore throat.
- C. Take folic acid supplements to prevent anemia.
- D. Use sunscreen to prevent photosensitivity.
Correct answer: D
Rationale: The correct answer is D: 'Use sunscreen to prevent photosensitivity.' Methotrexate increases photosensitivity, so clients should be advised to use sunscreen to protect their skin from sun exposure. Choice A is incorrect because methotrexate is usually taken with food to reduce gastrointestinal side effects. Choice B may be important but is not specific to methotrexate therapy. Choice C is also important, but the primary reason for folic acid supplementation with methotrexate is to reduce the risk of certain side effects like anemia rather than preventing anemia itself.