HESI RN
HESI Medical Surgical Practice Exam
1. What is the priority assessment for a patient receiving intravenous morphine?
- A. Assessing the patient's blood pressure.
- B. Monitoring the patient's respiratory rate.
- C. Checking the patient's pain level.
- D. Monitoring the patient's oxygen saturation.
Correct answer: B
Rationale: The correct answer is monitoring the patient's respiratory rate. When a patient receives intravenous morphine, the priority assessment is to monitor the respiratory rate due to the risk of respiratory depression associated with morphine. This assessment helps in detecting and managing any potential respiratory complications promptly. Assessing blood pressure, checking pain level, and monitoring oxygen saturation are important aspects of patient care but are not the priority when considering the specific risk of respiratory depression with intravenous morphine.
2. Alteplase recombinant, or tissue plasminogen activator (t-PA), a thrombolytic enzyme, is administered during the first 6 hours after onset of myocardial infarction (MI) to:
- A. Control chest pain.
- B. Reduce coronary artery vasospasm.
- C. Control the arrhythmias associated with MI.
- D. Revascularize the blocked coronary artery.
Correct answer: D
Rationale: Alteplase recombinant, or t-PA, is a thrombolytic enzyme used to dissolve clots and revascularize the blocked coronary artery in patients experiencing a myocardial infarction (MI). Administering t-PA within the first 6 hours of MI onset is crucial to restore blood flow to the affected area and minimize cardiac tissue damage. Therefore, the correct answer is to revascularize the blocked coronary artery. Choices A, B, and C are incorrect because while controlling chest pain, reducing coronary artery vasospasm, and managing arrhythmias are important goals in managing MI, the primary purpose of administering t-PA within the first 6 hours is to restore blood flow by dissolving clots and revascularizing the blocked coronary artery.
3. A nurse cares for a client with urinary incontinence. The client states, “I am so embarrassed. My bladder leaks like a young child’s bladder.” How should the nurse respond?
- A. I understand how you feel. I would be mortified.
- B. Incontinence pads will minimize leaks in public.
- C. I can teach you strategies to help control your incontinence.
- D. More women experience incontinence than you might think.
Correct answer: C
Rationale: The nurse should accept and acknowledge the client’s concerns, and assist the client to learn techniques that will allow control of urinary incontinence. The nurse should not diminish the client’s concerns with the use of pads or stating statistics about the occurrence of incontinence.
4. A 58-year-old client who has been post-menopausal for five years is concerned about the risk for osteoporosis because her mother has the condition. Which information should the nurse offer?
- A. Osteoporosis is a progressive genetic disease with no effective treatment.
- B. Calcium loss from bones can be slowed by increasing calcium intake and exercise.
- C. Estrogen replacement therapy should be started to prevent the progression of osteoporosis.
- D. Low-dose corticosteroid treatment effectively halts the course of osteoporosis.
Correct answer: B
Rationale: Post-menopausal females are at risk for osteoporosis due to the cessation of estrogen secretion. While genetics can play a role, osteoporosis is not solely a genetic disease. Increasing calcium intake, along with vitamin D supplementation and weight-bearing exercise, can help prevent further bone loss by slowing down calcium loss from bones. Estrogen replacement therapy is no longer recommended as a first-line treatment for osteoporosis due to associated risks. Corticosteroid treatment is not typically used as a primary treatment for osteoporosis.
5. Which of the following medications is commonly prescribed for hypertension?
- A. Atenolol
- B. Aspirin
- C. Ibuprofen
- D. Metformin
Correct answer: A
Rationale: The correct answer is Atenolol. Atenolol is a beta-blocker commonly prescribed to manage hypertension due to its ability to reduce the heart rate and lower blood pressure. Options B, C, and D are incorrect because aspirin, ibuprofen, and metformin are not typically used as first-line treatments for hypertension. Aspirin is more commonly used for its antiplatelet effects, ibuprofen is a nonsteroidal anti-inflammatory drug, and metformin is primarily used for managing diabetes.
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