HESI RN
Evolve HESI Medical Surgical Practice Exam
1. The nurse is caring for a 70-kg patient who is receiving gentamicin (Garamycin) 85 mg 4 times daily. The patient reports experiencing ringing in the ears. The nurse will contact the provider to discuss
- A. decreasing the dose to 50 mg QID.
- B. giving the dose 3 times daily.
- C. obtaining a serum drug level.
- D. ordering a hearing test.
Correct answer: C
Rationale: When a patient receiving gentamicin (Garamycin) reports experiencing ringing in the ears, it is crucial to consider the possibility of ototoxicity. Ototoxicity is a known adverse effect of aminoglycosides. The appropriate action for the nurse in this situation is to contact the provider to discuss obtaining a serum drug level. This is important to assess the drug concentration in the patient's blood, which can help determine if the ringing in the ears is related to the medication. Decreasing the dose or changing the dosing frequency without assessing the serum drug level may not address the underlying issue and could potentially lead to suboptimal treatment. Ordering a hearing test may be necessary at a later stage if the serum drug level indicates a concern. Therefore, option C, obtaining a serum drug level, is the most appropriate action to take in this scenario.
2. The client with hyperparathyroidism is being taught about dietary management. Which of the following foods should the client avoid?
- A. Bananas
- B. Spinach
- C. Milk
- D. Processed meats
Correct answer: C
Rationale: Clients with hyperparathyroidism should avoid high-calcium foods like milk because they already have elevated calcium levels. Bananas and spinach are not high in calcium and can be included in the diet. Processed meats are not specifically contraindicated in hyperparathyroidism, so they are not the correct answer.
3. A client who is receiving chemotherapy asks the nurse, 'Why is so much of my hair falling out each day?' Which response by the nurse best explains the reason for alopecia?
- A. 'Chemotherapy affects the cells of the body that grow rapidly, both normal and malignant.'
- B. 'Alopecia is a common side effect you will experience during long-term steroid therapy.'
- C. 'Your hair will grow back completely after your course of chemotherapy is completed.'
- D. 'The chemotherapy causes permanent alterations in your hair follicles that lead to hair loss.'
Correct answer: A
Rationale: The correct answer is A: 'Chemotherapy affects the cells of the body that grow rapidly, both normal and malignant.' Chemotherapy targets rapidly dividing cells, which include not only cancer cells but also healthy cells like those in hair follicles. This leads to alopecia (hair loss) as a common side effect. Choice B is incorrect as alopecia is primarily associated with chemotherapy and not long-term steroid therapy. Choice C is incorrect because while hair may grow back after chemotherapy, it may not always be to the same extent or thickness. Choice D is incorrect as chemotherapy-induced hair loss is often temporary and reversible, not permanent alterations in hair follicles.
4. The bilayer of the cellular membrane consists of phospholipids with all except which of the following scattered throughout?
- A. Nucleic acids
- B. Cholesterol
- C. Proteins
- D. Glycoproteins
Correct answer: A
Rationale: The cellular membrane is composed of a phospholipid bilayer with cholesterol, proteins, and glycoproteins distributed throughout. Nucleic acids are not found within the cellular membrane. Cholesterol helps maintain membrane fluidity, while proteins and glycoproteins play important roles in cell signaling, transport, and structural support.
5. A client with a history of hypertension is prescribed a beta-blocker. Which client statement indicates that further teaching is needed?
- A. ‘I will take my medication in the morning before breakfast.’
- B. ‘I should avoid eating foods high in potassium.’
- C. ‘I should change positions slowly to avoid dizziness.’
- D. ‘I should avoid abrupt discontinuation of the medication.’
Correct answer: B
Rationale: The correct answer is B: ‘I should avoid eating foods high in potassium.’ This statement indicates a misunderstanding as beta-blockers do not typically affect potassium levels. The other choices (A, C, and D) are all appropriate statements for a client prescribed a beta-blocker. Choice A shows understanding of the timing of medication administration, choice C addresses orthostatic hypotension concerns, and choice D highlights the importance of not abruptly stopping the medication to prevent adverse effects.