HESI RN
HESI Medical Surgical Exam
1. The client has had a femoral-popliteal bypass surgery 6 hours ago. Which assessment provides the most accurate information about the client's postoperative status?
- A. Radial pulse.
- B. Femoral pulse.
- C. Apical pulse.
- D. Dorsalis pedis pulse.
Correct answer: D
Rationale: Assessing the dorsalis pedis pulse is crucial after a femoral-popliteal bypass surgery to determine adequate circulation distal to the surgical site. A strong dorsalis pedis pulse indicates sufficient blood flow to the foot, which is essential for monitoring postoperative status. The radial pulse (A) is not the most relevant assessment as it does not provide direct information on circulation in the lower extremities. The femoral pulse (B) may not accurately reflect circulation distal to the surgical site. The apical pulse (C) is used primarily to assess the heartbeat and cardiac function, not circulation in the lower extremities.
2. The client with chronic renal failure is being taught about fluid restrictions by the nurse. Which statement by the client indicates a need for further teaching?
- A. I can drink as much water as I want, as long as I limit my salt intake.
- B. I should limit my fluid intake to prevent fluid overload.
- C. I can skip dialysis sessions if I feel tired.
- D. I can eat whatever I want, as long as I take my medications.
Correct answer: C
Rationale: Choice C is the correct answer because clients with chronic renal failure should not skip dialysis sessions. Skipping dialysis can lead to serious complications and worsen the client's condition. It is crucial for clients to understand the importance of adhering to their dialysis schedule for optimal management of chronic renal failure. Choices A, B, and D are incorrect because they demonstrate understanding of fluid restrictions, the need to limit fluid intake to prevent overload, and the importance of medication compliance, respectively. These statements show appropriate knowledge and do not indicate a need for further teaching.
3. The client with peripheral vascular disease (PVD) and a history of heart failure may have a low tolerance for exercise due to:
- A. Decreased blood flow.
- B. Increased blood flow.
- C. Decreased pain.
- D. Increased blood viscosity.
Correct answer: A
Rationale: The correct answer is A: Decreased blood flow. In clients with peripheral vascular disease (PVD) and a history of heart failure, decreased blood flow due to heart failure can result in reduced oxygen delivery to tissues. This reduced oxygen supply can lead to low exercise tolerance. Increased blood flow (Choice B) is not typically associated with reduced exercise tolerance in these clients. Decreased pain (Choice C) and increased blood viscosity (Choice D) are not the primary factors contributing to low exercise tolerance in this scenario.
4. Which of the following assessments is the most important for a patient receiving IV potassium?
- A. Respiratory rate
- B. Heart rate
- C. Blood pressure
- D. Oxygen saturation
Correct answer: C
Rationale: The most important assessment for a patient receiving IV potassium is monitoring blood pressure. IV potassium can cause significant changes in cardiac function, leading to adverse effects such as arrhythmias and cardiac arrest. While respiratory rate, heart rate, and oxygen saturation are important parameters to monitor in clinical practice, blood pressure takes precedence in patients receiving IV potassium due to its direct impact on cardiovascular function. Changes in blood pressure can be an early indicator of potassium-induced cardiac complications, making it crucial to monitor closely during administration.
5. Which of the following conditions is the most significant risk factor for the development of type 2 diabetes mellitus?
- A. Cigarette smoking.
- B. High-cholesterol diet.
- C. Obesity.
- D. Hypertension.
Correct answer: C
Rationale: Obesity is the most significant risk factor for developing type 2 diabetes mellitus due to its role in insulin resistance. Excess body fat, especially around the abdomen, leads to increased production of inflammatory markers and hormones that can cause insulin resistance. While cigarette smoking, high-cholesterol diet, and hypertension can contribute to health issues, they are not as directly linked to the development of type 2 diabetes mellitus as obesity.
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