HESI RN
HESI RN Medical Surgical Practice Exam
1. The nurse is preparing to administer amoxicillin (Amoxil) to a patient and learns that the patient previously experienced a rash when taking penicillin. Which action will the nurse take?
- A. Administer the amoxicillin and have epinephrine available.
- B. Ask the provider to order an antihistamine.
- C. Contact the provider to discuss using a different antibiotic.
- D. Request an order for a beta-lactamase-resistant drug.
Correct answer: C
Rationale: When a patient has a history of rash from penicillin, it indicates a potential allergic reaction to penicillin and other related drugs, such as amoxicillin. It is crucial to avoid administering penicillins to such patients unless there is no alternative. The nurse's best action in this situation is to contact the provider to discuss using a different antibiotic from a different class. This approach helps prevent potential severe allergic reactions. While epinephrine and antihistamines are used to manage allergic reactions, administering amoxicillin despite the known allergy is not advisable and could lead to serious consequences. Requesting a beta-lactamase-resistant drug does not address the issue of potential allergic reactions in this scenario.
2. What action should the nurse take when a child presents with fever, sore throat, swollen red spots, and fluid-filled blisters?
- A. Obtain a fluid culture from the blisters
- B. Administer a fever-reducing medication
- C. Cover the drainage vesicles with a dressing
- D. Implement transmission precautions
Correct answer: D
Rationale: When a child presents with fever, sore throat, swollen red spots, and fluid-filled blisters, it may indicate a contagious viral infection. In such cases, implementing transmission precautions is crucial to prevent the spread of the infection to others in the pediatric clinic or community. Obtaining a fluid culture from the blisters (Choice A) may not be necessary at the initial stage without knowing the cause of the infection. Administering a fever-reducing medication (Choice B) may help manage symptoms but doesn't address the need for preventing transmission. Covering the drainage vesicles with a dressing (Choice C) may provide comfort to the child but does not directly address the risk of transmission to others.
3. The nurse prepares a discharge plan for an older adult client following cataract extraction. What instructions should the nurse provide?
- A. Avoid straining, bending, or lifting heavy objects.
- B. Limit exposure to sunlight for the first 2 weeks.
- C. Irrigate the conjunctiva with saline before applying ointment.
- D. Read without direct lighting for 6 weeks.
Correct answer: A
Rationale: The correct instruction for the nurse to provide after cataract extraction is to advise the client to avoid straining, bending, or lifting heavy objects. These activities can increase intraocular pressure, which should be minimized post-surgery to promote healing and prevent complications. Choices B, C, and D are incorrect because limiting sunlight exposure, irrigating the conjunctiva with saline, and reading without direct lighting are not primary instructions following cataract extraction.
4. The patient is receiving a high dose of intravenous azithromycin to treat an infection and taking acetaminophen for pain. The nurse should expect to review which lab values when monitoring for this drug’s side effects?
- A. Complete blood counts
- B. Electrolytes
- C. Liver enzymes
- D. Urinalysis
Correct answer: C
Rationale: When a patient is receiving a high dose of intravenous azithromycin, which is a macrolide antibiotic, in combination with acetaminophen, a potentially hepatotoxic drug, the nurse should monitor liver enzymes. High doses of macrolides when taken with hepatotoxic drugs like acetaminophen can lead to hepatotoxicity. Reviewing liver enzymes helps in early detection of liver damage. Complete blood counts (Choice A) are not typically affected by azithromycin or acetaminophen. Electrolytes (Choice B) are not directly impacted by these medications. Urinalysis (Choice D) is not specifically indicated for monitoring the side effects of azithromycin and acetaminophen combination therapy.
5. A healthcare professional stops at a motor vehicle collision site to render aid until the emergency personnel arrive and applies pressure to a groin wound that is bleeding profusely. Later, the client has to have the leg amputated and sues the healthcare professional for malpractice. What is the most likely outcome of this lawsuit?
- A. The Patient's Bill of Rights protects clients from malicious intents, so the healthcare professional could lose the case.
- B. The lawsuit may be settled out of court, but the healthcare professional's license is likely to be revoked.
- C. There will be no judgment against the healthcare professional, whose actions were protected under the Good Samaritan Act.
- D. The client will win because the four elements of negligence (duty, breach, causation, and damages) can be proved.
Correct answer: C
Rationale: The Good Samaritan Act protects healthcare professionals who provide care in good faith and offer reasonable assistance in emergencies. This law shields them from malpractice claims, even if the outcome for the client is unfavorable. In this scenario, the healthcare professional is likely to be protected from judgment under the Good Samaritan Act. Choice A is incorrect because the situation does not involve the Patient's Bill of Rights, but rather the Good Samaritan Act. Choice B is incorrect as the license revocation is not a typical outcome in Good Samaritan cases. Choice D is incorrect as the Good Samaritan Act provides immunity from liability in such emergency situations.