HESI RN
Evolve HESI Medical Surgical Practice Exam
1. The nurse is caring for several patients who are receiving antibiotics. Which order will the nurse question?
- A. Azithromycin (Zithromax) 500 mg IV in 500 mL of fluid
- B. Azithromycin (Zithromax) 500 mg PO once daily
- C. Erythromycin 300 mg IM QID
- D. Erythromycin 300 mg PO QID
Correct answer: C
Rationale: The nurse should question the order for Erythromycin 300 mg IM QID. Erythromycin and other macrolides should not be given intramuscularly because they cause painful tissue irritation. Options A and B are correct routes for Azithromycin, either intravenously or orally. Option D is a correct route for Erythromycin, which is orally.
2. A client is scheduled for an arteriogram. The nurse should explain to the client that the arteriogram will confirm the diagnosis of occlusive arterial disease by:
- A. Showing the location of the obstruction and the collateral circulation.
- B. Scanning the affected extremity and identifying the areas of volume changes.
- C. Using ultrasound to estimate the velocity changes in the blood vessels.
- D. Determining how long the client can walk.
Correct answer: A
Rationale: The correct answer is A: Showing the location of the obstruction and the collateral circulation. An arteriogram is a diagnostic procedure that involves injecting a contrast agent to visualize the blood vessels and identify the location of any obstructions. This helps confirm the diagnosis of occlusive arterial disease by showing where the blockage is located and how collateral circulation is compensating for the reduced blood flow. Choices B, C, and D are incorrect because scanning the extremity, estimating velocity changes with ultrasound, or determining walking distance are not the primary purposes of an arteriogram in diagnosing occlusive arterial disease.
3. A client is tested for HIV with the use of an enzyme-linked immunosorbent assay (ELISA), and the test result is positive. The nurse should tell the client that:
- A. HIV infection has been confirmed
- B. The client probably has an opportunistic infection
- C. The test will need to be confirmed with the use of a Western blot
- D. A positive test is a normal result and does not mean that the client is infected with HIV
Correct answer: C
Rationale: When an ELISA test for HIV is positive, it is essential to confirm the result with a Western blot. The Western blot is the confirmatory test for HIV. Choice A is incorrect because a positive ELISA test does not confirm HIV infection. Choice B is incorrect as it assumes a different diagnosis. Choice D is incorrect because a positive ELISA test does indicate potential HIV infection and requires confirmation.
4. The client with chronic renal failure is being taught about the importance of fluid restrictions. Which of the following statements by the client indicates that the teaching has been effective?
- A. I can drink as much fluid as I want, as long as I take my medication.
- B. I will need to limit my fluid intake to prevent fluid overload.
- C. I can drink as much water as I want, as long as I limit other fluids.
- D. I will need to drink only when I am thirsty.
Correct answer: B
Rationale: The correct answer is B: 'I will need to limit my fluid intake to prevent fluid overload.' In chronic renal failure, fluid restrictions are crucial to prevent fluid overload and further damage to the kidneys. Option A is incorrect as unrestricted fluid intake can worsen the condition. Option C is also incorrect as total fluid intake needs to be restricted, not just other fluids. Option D is not ideal because thirst may not accurately reflect the body's fluid needs in chronic renal failure.
5. When giving a report about a client who had a gastrectomy from the intensive care unit to the post-surgical unit nurse, what is the most effective way to assure essential information is reported?
- A. Give the report face-to-face with both nurses in a quiet room.
- B. Audiotape the report for future reference and documentation.
- C. Use a printed checklist with information individualized for the client.
- D. Document essential transfer information in the client's electronic health record.
Correct answer: C
Rationale: Using a printed checklist with individualized information is the most effective way to ensure that all key details about the client who had a gastrectomy are covered during the report. This method helps in structuring the information systematically, reducing the risk of missing important details. Face-to-face communication in a quiet room (Choice A) is important for effective communication but may not guarantee the coverage of all essential information. Audiotaping the report (Choice B) may not be practical for immediate reference or interaction. Documenting in the electronic health record (Choice D) is essential but may not facilitate a comprehensive real-time exchange of information between the nurses.
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