the home health nurse provides teaching about insulin self injection to a client who was recently diagnosed with diabetes mellitus when the client beg
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Nursing Elites

HESI RN

HESI Medical Surgical Exam

1. The home health nurse provides teaching about insulin self-injection to a client who was recently diagnosed with diabetes mellitus. When the client begins to perform a return demonstration of an insulin injection into the abdomen, which instruction should the nurse provide?

Correct answer: B

Rationale: Choosing to continue with the insulin injection is the correct instruction in this scenario because it allows the client to demonstrate proper technique and reinforces their learning. Selecting a different injection site (choice A) is not necessary if the client is injecting into the abdomen as it is a suitable site. Keeping the skin flat rather than bunched (choice C) is a good practice but is not the priority in this situation where the client is demonstrating the injection technique. Lying down flat for better skin exposure (choice D) is not required and may not be practical for the client during routine self-injections.

2. A middle-aged adult with a family history of CAD has the following: total cholesterol 198 (11 mmol/L); LDL cholesterol 120 (6.7 mmol/L); HDL cholesterol 58 (3.2 mmol/L); triglycerides 148 (8.2 mmol/L); blood sugar 102 (5.7 mmol/L); and C-reactive protein (CRP) 4.2. The health care provider prescribes a statin medication and aspirin. The client asks the nurse why these medications are needed. Which is the best response by the nurse?

Correct answer: C

Rationale: CRP is a marker of inflammation, which is elevated in cardiovascular disease. Statins and aspirin help lower CRP and reduce the risk of heart attacks and strokes.

3. A client has just returned to the nursing unit after computerized tomography (CT) with contrast medium. Which of the following actions should the nurse plan to take as part of routine after-care for this client?

Correct answer: B

Rationale: After CT scanning with contrast medium, the client does not require special restrictions or interventions. Encouraging fluid intake is important to help flush out the contrast dye and prevent dehydration. Administering a laxative (Choice A) is unnecessary and not indicated after CT with contrast. Maintaining the client on strict bed rest (Choice C) is not necessary unless specified by the healthcare provider. Holding all medications for at least 2 hours (Choice D) is not a standard practice after CT with contrast.

4. A client has just been scheduled for endoscopic retrograde cholangiopancreatography (ERCP). What should the nurse tell the client about the procedure? Select all that apply.

Correct answer: B

Rationale: The correct answer is that the ERCP procedure takes about 1 hour to complete. Informed consent is required before the procedure. Premedication for sedation may be necessary as sedation is commonly used during ERCP to keep the client comfortable. Food and fluids are withheld before the procedure to prevent aspiration and ensure a clear view during the procedure. Position changes may be necessary to facilitate the passage of the tube.

5. A client is starting urinary bladder training. Which statement should the nurse include in this client’s teaching?

Correct answer: B

Rationale: In urinary bladder training, the client should be taught to try to consciously hold their urine until the scheduled toileting time. This helps in training the bladder to hold urine for longer periods. Option A is incorrect because the goal is to consciously hold urine, not void immediately. Option C is incorrect as toileting at least every half hour may not promote bladder training. Option D is incorrect as increasing the toileting interval should be based on the client's comfort and progress, not just after being continent for a week.

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