HESI RN
HESI Medical Surgical Practice Exam
1. Which of the following is a key symptom of myocardial infarction (MI)?
- A. Chest pain.
- B. Shortness of breath.
- C. Nausea.
- D. Fatigue.
Correct answer: A
Rationale: The correct answer is A: Chest pain. Chest pain is a hallmark symptom of myocardial infarction (MI) due to inadequate blood flow to the heart muscle. This pain can be severe, crushing, or squeezing, and may radiate to the left arm, jaw, or back. Shortness of breath (choice B), nausea (choice C), and fatigue (choice D) can accompany MI but are not as specific or characteristic as chest pain in diagnosing this condition. Therefore, chest pain is the primary symptom to recognize for suspected MI.
2. Which of the following assessments is the most important for a patient receiving IV potassium?
- A. Respiratory rate
- B. Heart rate
- C. Blood pressure
- D. Oxygen saturation
Correct answer: C
Rationale: The most important assessment for a patient receiving IV potassium is monitoring blood pressure. IV potassium can cause significant changes in cardiac function, leading to adverse effects such as arrhythmias and cardiac arrest. While respiratory rate, heart rate, and oxygen saturation are important parameters to monitor in clinical practice, blood pressure takes precedence in patients receiving IV potassium due to its direct impact on cardiovascular function. Changes in blood pressure can be an early indicator of potassium-induced cardiac complications, making it crucial to monitor closely during administration.
3. A client has had a pulmonary artery catheter inserted. In performing hemodynamic monitoring with the catheter, the nurse will wedge the catheter to gain information about which of the following?
- A. Cardiac output.
- B. Right atrial blood flow.
- C. Left end-diastolic pressure.
- D. Cardiac index.
Correct answer: C
Rationale: The correct answer is C: Left end-diastolic pressure. Wedging the pulmonary artery catheter allows the nurse to obtain the pulmonary artery wedge pressure, which reflects the left end-diastolic pressure. This pressure is essential in assessing left ventricular function and diagnosing conditions like heart failure. Choices A, B, and D are incorrect because wedging the catheter does not directly provide information about cardiac output, right atrial blood flow, or cardiac index.
4. 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.
5. A 49-year-old female client arrives at the clinic for an annual exam and asks the nurse why she becomes excessively diaphoretic and feels warm during nighttime. What is the nurse's best response?
- A. Explain the effects of follicle-stimulating and luteinizing hormones.
- B. Discuss perimenopause and related comfort measures.
- C. Assess lung fields and check for a cough productive of blood-tinged mucus.
- D. Inquire if a fever above 101°F (38.3°C) has occurred in the last 24 hours.
Correct answer: B
Rationale: The correct answer is B. The symptoms described by the client, excessive diaphoresis and feeling warm at night, are characteristic of perimenopause. During this period, lower estrogen levels lead to surges in follicle-stimulating hormone (FSH) and luteinizing hormone (LH), resulting in vasomotor instability, night sweats, and hot flashes. Therefore, discussing perimenopause and related comfort measures with the client is essential to provide education and support. Choice A is incorrect because explaining the effects of FSH and LH alone does not directly address the client's current symptoms. Choice C is irrelevant as it focuses on assessing lung fields and cough symptoms, which are not related to the client's menopausal symptoms. Choice D is not the best response as it is more focused on ruling out fever as a cause, which is not typically associated with the symptoms described by the client.
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