HESI RN
Evolve HESI Medical Surgical Practice Exam Quizlet
1. The nurse is caring for a client who is scheduled for hemodialysis. Which of the following laboratory values should the nurse monitor closely before, during, and after the procedure?
- A. Hemoglobin level.
- B. Blood urea nitrogen (BUN) level.
- C. Creatinine level.
- D. Serum potassium level.
Correct answer: D
Rationale: The correct answer is D: Serum potassium level. Before, during, and after hemodialysis, monitoring the serum potassium level is crucial to prevent hyperkalemia, a potentially life-threatening complication. Hemodialysis is done to remove waste products and excess electrolytes like potassium from the blood. Monitoring other laboratory values like hemoglobin, BUN, and creatinine is important in assessing kidney function and anemia, but serum potassium level requires close monitoring during hemodialysis due to the risk of rapid shifts that can lead to cardiac arrhythmias.
2. The nurse obtains a heart rate of 92 and a blood pressure of 110/76 before administering a scheduled dose of verapamil (Calan) for a client with atrial flutter. Which action should the nurse implement?
- A. Administer the dose as prescribed.
- B. Hold the medication.
- C. Call the healthcare provider.
- D. Repeat the vital signs in 30 minutes.
Correct answer: A
Rationale: The correct action is to administer the dose as prescribed. Verapamil slows sinoatrial nodal automaticity and delays atrioventricular nodal conduction, which helps in slowing the ventricular rate. The heart rate of 92 and blood pressure of 110/76 are within an acceptable range for administering verapamil in a client with atrial flutter. Holding the medication, calling the healthcare provider, or repeating the vital signs in 30 minutes are not necessary based on the vital signs obtained and the action of verapamil in this scenario.
3. A nurse is reinforcing dietary teaching with a client who has iron deficiency anemia. The nurse should explain that which of the following food sources contains iron that is most easily absorbed by the body?
- A. Spinach
- B. Dried apricots
- C. Chicken
- D. Lentils
Correct answer: C
Rationale: The correct answer is C, 'Chicken.' Heme iron from animal sources, such as chicken, is more easily absorbed by the body compared to non-heme iron from plant sources like spinach, dried apricots, and lentils. While plant-based iron sources are beneficial, they are not as readily absorbed by the body as heme iron from animal products.
4. Which of the following actions could be considered a breach of patient confidentiality?
- A. Discussing patient information with other healthcare providers in a private setting.
- B. Sharing patient information with family members without the patient's consent.
- C. Discussing patient information in public areas where others may overhear.
- D. Sharing patient information in a private, secure setting with other healthcare providers involved in the patient's care.
Correct answer: C
Rationale: Discussing patient information in public areas where others may overhear is considered a breach of patient confidentiality because it compromises the privacy and confidentiality of the patient's health information. Choices A and D are not breaches of confidentiality as discussing patient information with other healthcare providers in a private setting or in a private, secure setting with those involved in the patient's care is appropriate. Choice B is also incorrect as sharing patient information with family members without the patient's consent could potentially be a breach of privacy but is not the best answer in this context.
5. A client with a history of chronic kidney disease (CKD) is admitted with hyperkalemia. Which intervention should the nurse implement first?
- A. Administer intravenous calcium gluconate.
- B. Administer intravenous insulin and glucose.
- C. Administer intravenous sodium bicarbonate.
- D. Administer a loop diuretic as prescribed.
Correct answer: B
Rationale: The correct answer is B: Administer intravenous insulin and glucose. In the presence of hyperkalemia, the priority intervention is to shift potassium back into the cells to lower serum levels. Insulin, in combination with glucose, helps drive potassium intracellularly. Administering calcium gluconate (choice A) is used to stabilize myocardial cell membranes but does not address the underlying cause of hyperkalemia. Administering sodium bicarbonate (choice C) is not the initial treatment for hyperkalemia. Loop diuretics (choice D) may be used later to enhance potassium excretion but are not the primary intervention for acute hyperkalemia.