HESI RN
HESI Medical Surgical Exam
1. Which of the following is a common complication of hypertension?
- A. Diabetes.
- B. Heart failure.
- C. Kidney failure.
- D. Stroke.
Correct answer: D
Rationale: The correct answer is D: Stroke. Hypertension can lead to stroke due to the increased pressure on blood vessels in the brain, which can result in reduced blood flow and oxygen to the brain tissue. While choices B (Heart failure) and C (Kidney failure) can be complications of hypertension, they are not as directly associated as stroke. Choice A, Diabetes, is not a direct complication of hypertension but rather a separate condition that can be influenced by various factors. However, stroke is more commonly linked to the increased pressure on blood vessels in the brain in individuals with hypertension.
2. A client is receiving Cilostazol (Pletal) for peripheral arterial disease causing intermittent claudication. The nurse determines this medication is effective when the client reports which of the following?
- A. I am having fewer aches and pains.
- B. I do not have headaches anymore.
- C. I am able to walk further without leg pain.
- D. My toes are turning grayish black in color.
Correct answer: C
Rationale: The correct answer is C. Cilostazol improves blood flow to the muscles, which helps alleviate symptoms of intermittent claudication. An improvement in walking distance without leg pain indicates the effectiveness of the medication. Choices A and B are not directly related to the expected outcome of Cilostazol therapy for intermittent claudication. Choice D is concerning for a potential adverse effect and should be reported to the healthcare provider immediately.
3. Which of the following is most important for assessing when evaluating the effects of peritoneal dialysis?
- A. Serum potassium levels
- B. Blood pressure
- C. Daily weight
- D. Serum sodium levels
Correct answer: C
Rationale: Daily weight is the most crucial parameter to assess when evaluating the effects of peritoneal dialysis because it directly reflects fluid balance. Peritoneal dialysis involves the removal of excess fluid and waste products from the body. Monitoring daily weight enables the healthcare provider to track changes in fluid status, ensuring that the dialysis treatment is effective. While serum potassium levels, blood pressure, and serum sodium levels are important parameters to monitor in patients undergoing dialysis, they are not as directly indicative of the immediate effects of peritoneal dialysis on fluid balance as daily weight.
4. A client is being prepared for transfer to the operating room. Which of the following actions should the nurse take in the care of this client at this time?
- A. Ensuring that the client has voided
- B. Administering all daily medications
- C. Practicing postoperative breathing exercises
- D. Verifying that the client has not eaten for the last 24 hours
Correct answer: A
Rationale: The nurse should ensure that the client has voided, especially if a Foley catheter is not in place. This step is important to prevent urinary retention during the surgical procedure. Administering all daily medications just before surgery is not standard practice. The physician typically provides specific orders regarding which medications can be taken with a sip of water before surgery. Postoperative breathing exercises are usually taught after surgery to prevent complications like atelectasis. Verifying that the client has not eaten for the last 24 hours is not a standard preoperative practice; instead, the client is usually instructed to fast for a specific period before surgery to reduce the risk of aspiration during anesthesia.
5. A client with polycystic kidney disease (PKD is being assessed by a nurse. Which assessment finding should prompt the nurse to immediately contact the healthcare provider?
- A. Flank pain
- B. Periorbital edema
- C. Bloody and cloudy urine
- D. Enlarged abdomen
Correct answer: B
Rationale: Periorbital edema would not typically be associated with polycystic kidney disease (PKD) and could indicate other underlying issues that require immediate attention. Flank pain and an enlarged abdomen are common findings in PKD due to kidney enlargement and displacement of other organs. Bloody or cloudy urine can result from cyst rupture or infection, which are expected in PKD. Therefore, periorbital edema is the most alarming finding in this scenario and warrants prompt notification of the healthcare provider.
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