HESI RN
HESI Medical Surgical Test Bank
1. The healthcare provider prescribes diagnostic tests for a client with pneumonia identified on a chest X-ray. Which diagnostic test should the nurse review for implementation to guide the most therapeutic treatment of pneumonia?
- A. Sputum culture and sensitivity
- B. Blood cultures
- C. Arterial blood gases (ABG)
- D. Computerized tomography (CT) of the chest
Correct answer: A
Rationale: Sputum culture and sensitivity is the most appropriate diagnostic test for pneumonia as it helps in identifying the causative organism, which is crucial for guiding the selection of the most effective antibiotic therapy. Blood cultures (choice B) are more useful in identifying systemic infections rather than pneumonia specifically. Arterial blood gases (ABG) (choice C) are helpful in assessing oxygenation but do not directly aid in identifying the causative organism. Computerized tomography (CT) of the chest (choice D) is useful for evaluating structural abnormalities in the lungs but is not the initial test of choice for diagnosing pneumonia.
2. Which of the following is a group of three RNA nucleotides?
- A. A stop codon
- B. A codon
- C. An anticodon
- D. tRNA
Correct answer: B
Rationale: The correct answer is B - A codon. A codon is a sequence of three RNA nucleotides that specifies a particular amino acid or a stop signal during protein synthesis. Choice A, a stop codon, is a sequence of three nucleotides that signals the termination of protein synthesis. Choice C, an anticodon, is a group of three nucleotides found in tRNA that pairs with the complementary codon in mRNA. Choice D, tRNA, stands for transfer RNA, which is a type of RNA that carries amino acids to the ribosome during protein synthesis.
3. A healthcare professional is reading a physician's progress notes in the client's record and reads that the physician has documented 'insensible fluid loss of approximately 800 mL daily.' The healthcare professional understands that this type of fluid loss can occur through:
- A. The skin
- B. Urinary output
- C. Wound drainage
- D. The gastrointestinal tract
Correct answer: A
Rationale: Insensible fluid loss refers to the fluid lost from the body that is not easily measured, such as through sweating and respiration. The skin is a major contributor to insensible fluid loss due to evaporation of water through the skin. Choice B, urinary output, represents measurable fluid loss through urine excretion. Choice C, wound drainage, is a measurable form of fluid loss that occurs externally from a wound. Choice D, the gastrointestinal tract, primarily involves fluid loss through feces and is also a measurable form of output. Therefore, the correct answer is 'A: The skin,' as it is the main route for insensible fluid loss.
4. Carbamazepine (Tegretol) is prescribed for a client with a diagnosis of psychomotor seizures. The nurse reviews the client's health history, knowing that this medication is contraindicated if which of the following disorders is present?
- A. Headaches
- B. Liver disease
- C. Hypothyroidism
- D. Diabetes mellitus
Correct answer: B
Rationale: Carbamazepine (Tegretol) is contraindicated in liver disease due to its potential to cause hepatic toxicity. Regular monitoring of liver function tests is necessary when using this medication to detect any signs of liver damage.
5. A client recovering from a stroke is demonstrating slurred speech. What action should the nurse take?
- A. Consult the healthcare provider to order speech therapy.
- B. Administer a dose of aspirin to prevent further neurological damage.
- C. Encourage the client to use communication aids, such as writing.
- D. Encourage the client to eat soft foods to avoid choking.
Correct answer: C
Rationale: The correct action for a client recovering from a stroke demonstrating slurred speech is to encourage the client to use communication aids, such as writing. This intervention can help the client effectively communicate while working on regaining speech abilities. Consulting the healthcare provider to order speech therapy (choice A) is a valid option, but immediate encouragement of using communication aids is beneficial. Administering aspirin (choice B) without healthcare provider orders is not recommended. Encouraging the client to eat soft foods (choice D) is important for preventing aspiration but doesn't directly address the communication issue.