HESI RN
HESI Medical Surgical Practice Exam
1. Which of the following is a key symptom of hypothyroidism?
- A. Weight loss.
- B. Heat intolerance.
- C. Cold intolerance.
- D. Increased appetite.
Correct answer: C
Rationale: Cold intolerance is a key symptom of hypothyroidism because a decreased metabolic rate leads to a reduced ability to regulate body temperature. Weight loss (Choice A) is more commonly associated with hyperthyroidism, where the metabolic rate is increased. Heat intolerance (Choice B) is also more indicative of hyperthyroidism, where excess thyroid hormone leads to an increased sensitivity to heat. Increased appetite (Choice D) is not typically seen in hypothyroidism; instead, individuals with hypothyroidism may experience weight gain due to the slowed metabolism.
2. Desmopressin acetate (DDAVP) is prescribed for the treatment of diabetes insipidus. The nurse monitors the client after medication administration for which therapeutic response?
- A. Decreased urinary output
- B. Decreased blood pressure
- C. Decreased peripheral edema
- D. Decreased blood glucose level
Correct answer: A
Rationale: Desmopressin promotes renal conservation of water by increasing the permeability of kidney collecting ducts to water, resulting in decreased urinary output. Therefore, the therapeutic response expected after administering desmopressin for diabetes insipidus is a reduction in urinary output.
3. When reviewing developmental changes with the parents of a 6-month-old infant, what information should the practical nurse reinforce?
- A. Encourage the infant to self-feed finger foods.
- B. Teach the parents strategies to help the infant sit up.
- C. Provide a developmentally safe environment for the infant.
- D. Explain that an increased appetite typically occurs in the next 6 months.
Correct answer: C
Rationale: The correct answer is C because providing a developmentally safe environment for a 6-month-old infant is crucial as they begin to explore their surroundings more actively. This includes ensuring that the environment is free of hazards and that the infant is supervised to prevent accidents. Choice A is incorrect because self-feeding finger foods may not be developmentally appropriate for a 6-month-old infant. Choice B is incorrect as most infants are able to sit up with support around 6 months of age without the need for specific teaching strategies. Choice D is also incorrect as while appetite changes can occur, explaining a specific increase in appetite over the next 6 months is not a primary focus when discussing developmental changes with parents of a 6-month-old.
4. An adolescent with major depressive disorder has been taking duloxetine (Cymbalta) for the past 12 days. Which assessment finding requires immediate follow-up?
- A. Increased appetite
- B. Describes life without purpose
- C. Exhibits mood swings
- D. Complains of insomnia
Correct answer: B
Rationale: An adolescent expressing 'life without purpose' after taking duloxetine (Cymbalta) may be indicating suicidal ideation, which requires immediate attention. The initial period of antidepressant treatment can increase the risk of suicidal thoughts, especially in younger populations. Increased appetite (Choice A) is a common side effect of duloxetine and may not require immediate follow-up. Mood swings (Choice C) and insomnia (Choice D) are also possible side effects of the medication but are not as urgent as addressing suicidal ideation.
5. When teaching parents of a 5-year-old child with sickle cell anemia about pain management, what information should be included?
- A. Apply cold compresses to painful areas.
- B. Encourage the child to rest as much as possible.
- C. Administer prescribed pain medication at the first sign of pain.
- D. Offer a high-protein diet to help with pain management.
Correct answer: C
Rationale: Administering prescribed pain medication at the first sign of pain is crucial in managing sickle cell anemia-related pain effectively. Prompt administration helps prevent the pain from escalating and becoming severe, enhancing the child's comfort and quality of life. Cold compresses, rest, and diet modifications may play supportive roles but are not as directly impactful in addressing acute pain episodes associated with sickle cell anemia. Therefore, while comforting measures like cold compresses and rest are helpful, they should not replace the importance of timely administration of prescribed pain medication. Additionally, offering a high-protein diet, although important for overall health, is not directly linked to managing acute pain in sickle cell anemia.