HESI RN
HESI Medical Surgical Test Bank
1. The client with chronic renal failure is being educated on dietary restrictions. Which of the following foods should the client avoid?
- A. Bananas.
- B. Oranges.
- C. Rice.
- D. Apples.
Correct answer: A
Rationale: The correct answer is A: Bananas. Bananas are high in potassium, and clients with chronic renal failure are often advised to follow a low-potassium diet to prevent hyperkalemia. Oranges and apples are also high in potassium and should be avoided by clients with renal issues. Rice, on the other hand, is low in potassium and is generally considered safe for individuals with chronic renal failure to consume in moderation.
2. The patient is receiving a high dose of tetracycline (Sumycin). Which laboratory values should the nurse monitor while caring for this patient?
- A. Blood urea nitrogen (BUN) and creatinine levels
- B. Complete blood counts
- C. Electrolytes
- D. Liver enzyme levels
Correct answer: A
Rationale: High doses of tetracyclines can lead to nephrotoxicity, especially when given along with other nephrotoxic drugs. Renal function tests, such as monitoring blood urea nitrogen (BUN) and creatinine levels, should be performed to assess for nephrotoxicity. Monitoring complete blood counts (choice B) is not directly related to tetracycline therapy. Checking electrolytes (choice C) is important but not the priority when monitoring for tetracycline-induced nephrotoxicity. Monitoring liver enzyme levels (choice D) is not typically indicated in the context of tetracycline therapy.
3. The healthcare provider prescribes diagnostic tests for a client with pneumonia identified on a chest X-ray. Which diagnostic test should the nurse review for implementation to guide the most therapeutic treatment of pneumonia?
- A. Sputum culture and sensitivity
- B. Blood cultures
- C. Arterial blood gases (ABG)
- D. Computerized tomography (CT) of the chest
Correct answer: A
Rationale: Sputum culture and sensitivity is the most appropriate diagnostic test for pneumonia as it helps in identifying the causative organism, which is crucial for guiding the selection of the most effective antibiotic therapy. Blood cultures (choice B) are more useful in identifying systemic infections rather than pneumonia specifically. Arterial blood gases (ABG) (choice C) are helpful in assessing oxygenation but do not directly aid in identifying the causative organism. Computerized tomography (CT) of the chest (choice D) is useful for evaluating structural abnormalities in the lungs but is not the initial test of choice for diagnosing pneumonia.
4. What is an expected outcome when a client is receiving an IV administration of furosemide?
- A. Increased blood pressure.
- B. Increased urine output.
- C. Decreased pain.
- D. Decreased premature ventricular contractions.
Correct answer: B
Rationale: The correct answer is B: Increased urine output. Furosemide is a loop diuretic that works by inhibiting the reabsorption of sodium and chloride in the ascending loop of Henle in the kidneys, leading to increased urine production. This diuretic effect helps to reduce fluid volume in the body, making it an expected outcome when a client is receiving furosemide. Choice A, increased blood pressure, is incorrect because furosemide typically causes a decrease in blood pressure due to its diuretic effect. Choice C, decreased pain, and choice D, decreased premature ventricular contractions, are unrelated to the pharmacological action of furosemide.
5. During CPR, when attempting to ventilate a client's lungs, the nurse notes that the chest is not moving. What action should the nurse take first?
- A. Use a laryngoscope to check for a foreign body lodged in the airway.
- B. Reposition the head to ensure that the airway is properly opened.
- C. Turn the client to the side and administer three back blows.
- D. Perform a finger sweep of the mouth to clear any obstructions.
Correct answer: B
Rationale: The most common reason for inadequate lung aeration during CPR is the incorrect positioning of the head, leading to airway obstruction. Therefore, the initial action should be to reposition the head to open the airway properly and attempt to ventilate again. Using a laryngoscope to check for foreign bodies in the airway (Choice A) is not the first step and could delay crucial interventions. Turning the client to the side and administering back blows (Choice C) is not indicated in this scenario as the focus is on ventilating the lungs. Performing a finger sweep of the mouth (Choice D) is not recommended as it may push obstructions further into the airway during CPR.
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