HESI RN
HESI Medical Surgical Specialty Exam
1. The nurse is providing discharge teaching for a patient who will receive oral levofloxacin (Levaquin) to treat pneumonia. The patient takes an oral hypoglycemic medication and uses over-the-counter (OTC) antacids to treat occasional heartburn. The patient reports frequent arthritis pain and takes acetaminophen when needed. Which statement by the nurse is correct when teaching this patient?
- A. You may take antacids with levofloxacin to decrease gastrointestinal upset.
- B. You may take nonsteroidal anti-inflammatory medications (NSAIDs) for arthritis pain.
- C. You should monitor your serum glucose more closely while taking levofloxacin.
- D. You should take levofloxacin on an empty stomach to improve absorption.
Correct answer: C
Rationale: Levofloxacin may increase the effects of oral hypoglycemic medications, so patients taking these should be advised to monitor their serum glucose levels closely.
2. A client has undergone insertion of a permanent pacemaker. When developing a discharge teaching plan, the nurse writes a goal of, 'The client will verbalize symptoms of pacemaker failure.' Which symptoms are most important to teach the client?
- A. Facial flushing.
- B. Fever.
- C. Pounding headache.
- D. Feelings of dizziness.
Correct answer: D
Rationale: The correct answer is 'D: Feelings of dizziness.' Feelings of dizziness may occur as a result of a decreased heart rate, leading to decreased cardiac output, which can be an indication of pacemaker failure. Teaching the client to recognize symptoms of decreased cardiac output, like dizziness, is crucial for early detection of pacemaker malfunction. Choices A, B, and C are less specific to pacemaker failure and are not commonly associated with this condition. Facial flushing, fever, and pounding headache are not typical signs of pacemaker failure and are not directly related to cardiac output, making them less relevant for teaching the client about pacemaker failure.
3. A healthcare professional reviews the blood gas results of a client in respiratory distress. The pH is 7.32, and the PCO2 is 50 mm Hg. Which of the following acid-base imbalances does the professional recognize in these findings?
- A. Metabolic acidosis
- B. Metabolic alkalosis
- C. Respiratory acidosis
- D. Respiratory alkalosis
Correct answer: C
Rationale: In respiratory acidosis, the pH is low (<7.35) and the PCO2 is increased (>45 mm Hg). These findings indicate that the client is experiencing respiratory acidosis, a condition where there is an excess of carbon dioxide in the blood due to inadequate ventilation, commonly seen in respiratory distress. Metabolic acidosis (Choice A) is characterized by a low pH and decreased bicarbonate levels, which is not the case in this scenario. Metabolic alkalosis (Choice B) is associated with a high pH and increased bicarbonate levels. Respiratory alkalosis (Choice D) is marked by a high pH and decreased PCO2, opposite to the values presented in the blood gas results of this client.
4. The nurse is preparing to give a dose of oral clindamycin (Cleocin) to a patient being treated for a skin infection caused by Staphylococcus aureus. The patient has experienced nausea after several doses. What should the nurse do next?
- A. Administer the next dose when the patient has an empty stomach.
- B. Hold the next dose and contact the patient’s provider.
- C. Instruct the patient to take the next dose with a full glass of water.
- D. Request an order for an antacid to give along with the next dose.
Correct answer: C
Rationale: The correct action for the nurse to take next is to instruct the patient to take the next dose of clindamycin with a full glass of water. This is important to minimize gastrointestinal (GI) irritation such as nausea, vomiting, and stomatitis that the patient has been experiencing. Administering the medication on an empty stomach would likely worsen the GI upset. Holding the next dose and contacting the provider is not necessary at this point unless symptoms persist or worsen. Additionally, requesting an antacid is not indicated as the primary intervention for managing the nausea related to clindamycin.
5. What is the most common side effect of diuretics such as furosemide (Lasix)?
- A. Hypokalemia.
- B. Hyperkalemia.
- C. Hypernatremia.
- D. Hyponatremia.
Correct answer: A
Rationale: The correct answer is 'Hypokalemia.' Diuretics like furosemide increase the excretion of potassium, leading to hypokalemia as a common side effect. Hyperkalemia (choice B) is the opposite condition characterized by high potassium levels, which is not typically associated with furosemide use. Hypernatremia (choice C) is increased sodium levels, while hyponatremia (choice D) is decreased sodium levels, neither of which are the most common side effects of furosemide. Therefore, choice A is the best answer.
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