HESI RN
HESI Medical Surgical Practice Exam
1. Which of the following interventions is most appropriate for a patient with left-sided heart failure?
- A. Administering IV fluids.
- B. Administering oxygen.
- C. Administering diuretics.
- D. Administering antihypertensives.
Correct answer: B
Rationale: Administering oxygen is the most appropriate intervention for a patient with left-sided heart failure because it helps improve oxygenation. In left-sided heart failure, the heart struggles to pump oxygen-rich blood to the body, leading to inadequate oxygen supply to tissues. Administering oxygen can help alleviate symptoms of hypoxia and reduce the workload on the heart. IV fluids (Choice A) may exacerbate heart failure by increasing fluid volume, diuretics (Choice C) are used to reduce fluid overload in heart failure, and antihypertensives (Choice D) are more suitable for managing hypertension, which may be a comorbidity in heart failure but are not the primary intervention for left-sided heart failure.
2. A client is receiving intermittent bolus feedings via a nasogastric tube. In which position should the nurse place the client once the feeding is complete?
- A. Supine
- B. Head of bed flat
- C. Left lateral position
- D. Head of bed elevated 30 to 45 degrees
Correct answer: B
Rationale: After intermittent bolus feedings through a nasogastric tube, the correct position for the client is to keep the head of the bed flat. This position helps prevent vomiting and aspiration. Placing the client in a supine position (choice A) can increase the risk of aspiration. The left lateral position (choice C) is not typically used after nasogastric tube feedings. Elevating the head of the bed 30 to 45 degrees (choice D) is suitable for continuous tube feedings to reduce the risk of aspiration, but for intermittent bolus feedings, keeping the head of the bed flat is preferred to prevent regurgitation and aspiration.
3. 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.
4. In a patient with asthma, which of the following is a primary goal of treatment?
- A. Improving oxygenation.
- B. Reducing inflammation.
- C. Improving airflow.
- D. Reducing airway constriction.
Correct answer: C
Rationale: The primary goal in the treatment of asthma is to improve airflow. Asthma is characterized by airway inflammation, constriction, and increased mucus production, leading to airflow limitation. Improving airflow helps ensure adequate oxygenation and reduces symptoms. While reducing inflammation and airway constriction are important aspects of asthma management, the primary goal is to optimize airflow to improve respiratory function and quality of life.
5. A client with type 1 diabetes mellitus who jogs daily is being taught by a nurse about the preferred sites for insulin absorption. What is the most appropriate site for this client?
- A. Arms
- B. Legs
- C. Abdomen
- D. Iliac crest
Correct answer: C
Rationale: The abdomen is the most appropriate site for insulin absorption in a client who jogs. When a client is involved in physical activity like jogging, the abdomen is preferred as it provides more consistent absorption compared to the arms or legs, which can have altered absorption rates due to increased blood flow during exercise. The iliac crest is not a common site for insulin injections and may not provide optimal absorption rates compared to the abdomen.
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