HESI RN
Evolve HESI Medical Surgical Practice Exam
1. The patient has a heart rate of 98 beats per minute and a blood pressure of 82/58 mm Hg, is lethargic, complaining of muscle weakness, and has had gastroenteritis for several days. Based on these findings, which sodium value would the nurse expect?
- A. 126 mEq/L
- B. 140 mEq/L
- C. 145 mEq/L
- D. 158 mEq/L
Correct answer: A
Rationale: The patient's presentation of tachycardia, hypotension, lethargy, muscle weakness, and gastroenteritis suggests hyponatremia. Hyponatremia is characterized by a serum sodium level below the normal range of 135-145 mEq/L. A serum sodium level of 126 mEq/L falls significantly below this range, indicating hyponatremia. Choice B (140 mEq/L) and Choice C (145 mEq/L) are within the normal range for serum sodium levels and would not explain the patient's symptoms. Choice D (158 mEq/L) is above the normal range and would indicate hypernatremia, which is not consistent with the patient's presentation.
2. The nurse assesses a client’s wound. What type of wound requires immediate intervention by the nurse?
- A. Laceration
- B. Abrasion
- C. Contusion
- D. Ulceration
Correct answer: A
Rationale: Lacerations, especially deep ones, are prone to bacterial contamination and may require immediate intervention to prevent infection. Abrasions, contusions, and ulcerations are not as likely to lead to immediate serious complications like infections as lacerations.
3. A client with chronic obstructive pulmonary disease (COPD) is admitted with an exacerbation. Which clinical finding requires immediate intervention?
- A. Oxygen saturation of 90%
- B. Respiratory rate of 24 breaths per minute
- C. Use of accessory muscles
- D. Inspiratory crackles
Correct answer: C
Rationale: The correct answer is C. The use of accessory muscles in a client with COPD indicates increased work of breathing and may signal respiratory failure, requiring immediate intervention. This finding suggests that the patient is struggling to breathe effectively. Oxygen saturation of 90% is low but not critically low, while a respiratory rate of 24 breaths per minute is slightly elevated but not as concerning as the increased work of breathing indicated by the use of accessory muscles. Inspiratory crackles may be present in COPD due to underlying conditions like pneumonia but do not require immediate intervention as the use of accessory muscles does.
4. Before initiating a client with tuberculosis on anti-tuberculosis therapy with isoniazid (INH), a nurse ensures that which of the following baseline study has been completed?
- A. Electrolyte levels
- B. Coagulation times
- C. Liver enzyme levels
- D. Serum creatinine level
Correct answer: C
Rationale: Before starting INH therapy for tuberculosis, it is essential to assess liver enzyme levels as INH can cause hepatotoxicity. Monitoring liver enzyme levels before and during the initial 3 months of therapy is crucial to detect any liver damage early and prevent further complications. Choice A, electrolyte levels, are not directly impacted by INH therapy. Choice B, coagulation times, are not routinely monitored before starting INH therapy. Choice D, serum creatinine level, is not specifically required as a baseline study before initiating INH therapy for tuberculosis.
5. How many autosomes does a human primary spermatocyte have?
- A. 34
- B. 44
- C. 54
- D. 33
Correct answer: B
Rationale: A human primary spermatocyte has 44 autosomes. Autosomes are chromosomes that are not involved in determining an individual's sex. In humans, there are a total of 46 chromosomes in a somatic cell, with 22 pairs of autosomes and one pair of sex chromosomes. Therefore, the correct answer is 44 autosomes, making choice B the correct answer. Choices A, C, and D are incorrect as they do not represent the accurate number of autosomes in a human primary spermatocyte.