HESI RN
HESI Medical Surgical Practice Exam Quizlet
1. What discharge instruction is most important for a client after a kidney transplant?
- A. Weigh weekly.
- B. Report symptoms of secondary Candidiasis.
- C. Use daily reminders to take immunosuppressants.
- D. Stop cigarette smoking.
Correct answer: C
Rationale: After a kidney transplant, it is crucial for the client to adhere to the prescribed immunosuppressive therapy to prevent organ rejection. The client must take medications like corticosteroids and azathioprine (Imuran) regularly for the rest of their life. Using daily reminders is essential to ensure compliance with the medication regimen, as missing doses can increase the risk of organ rejection. Weighing weekly, reporting symptoms of secondary Candidiasis, and stopping cigarette smoking are important aspects of post-transplant care but may not be as critical as ensuring proper intake of immunosuppressants to prevent rejection.
2. A woman at 36-weeks' gestation who is Rh negative is admitted to labor and delivery reporting abdominal cramping. She is placed on strict bedrest, and the fetal heart rate and contraction pattern are monitored with an external fetal monitor. The nurse notes a large amount of bright red vaginal bleeding. Which nursing intervention has the highest priority?
- A. Perform a sterile vaginal examination to determine dilatation.
- B. Determine fetal position by performing Leopold maneuvers.
- C. Assess the fetal heart rate and client's contraction pattern.
- D. Confirm Rh and Coombs status for Rho(D) immunoglobulin administration.
Correct answer: C
Rationale: The highest priority nursing intervention in this scenario is to assess the fetal heart rate and the client's contraction pattern. The presence of a large amount of bright red vaginal bleeding in a woman at 36-weeks' gestation who is Rh negative raises concerns about the well-being of the fetus. Monitoring the fetal heart rate and contraction pattern will provide crucial information about fetal status and help determine the appropriate course of action to ensure the safety and health of both the mother and the baby.
3. The practical nurse (PN) is caring for an adolescent who has been diagnosed with mononucleosis. Which activity should the PN advise the adolescent to avoid?
- A. Playing video games.
- B. Drinking caffeinated beverages.
- C. Participating in contact sports.
- D. Eating spicy foods.
Correct answer: C
Rationale: Contact sports should be avoided in mononucleosis due to the risk of spleen rupture, which is a serious complication of the disease. The spleen can enlarge in mononucleosis, making it more susceptible to injury from contact sports, potentially leading to a life-threatening situation if rupture occurs.
4. The nurse is caring for a client with chronic renal failure who is on a low-potassium diet. Which of the following foods should the client avoid?
- A. Bananas
- B. Potatoes
- C. Rice
- D. Apples
Correct answer: A
Rationale: Bananas are high in potassium content, which can lead to hyperkalemia in clients with chronic renal failure who are on a low-potassium diet. Therefore, it is crucial for these clients to avoid bananas. Potatoes, rice, and apples are lower in potassium compared to bananas and are generally considered safe for consumption in clients with chronic renal failure on a low-potassium diet.
5. Why is complete bedrest necessary for a pregnant client with mitral stenosis Class III?
- A. Complete bedrest decreases oxygen needs and demands on the heart muscle tissue.
- B. We want your baby to be healthy, and this is the only way we can ensure that will happen.
- C. I know you're upset. Would you like to talk about some activities you could do while in bed?
- D. Labor is difficult, and you need to use this time to rest before assuming child-caring duties.
Correct answer: A
Rationale: Complete bedrest is necessary for a pregnant client with mitral stenosis Class III to reduce the workload on the heart, lower oxygen consumption, and prevent complications associated with cardiac conditions like mitral stenosis. By remaining in bed, the client can help maintain cardiac function and promote a safer pregnancy outcome. Choice B is incorrect as it does not provide a specific reason related to the client's medical condition. Choice C is not addressing the medical necessity of bedrest for this particular client. Choice D is irrelevant and does not explain the importance of bedrest for a pregnant client with mitral stenosis Class III.