HESI RN
HESI Medical Surgical Practice Exam Quizlet
1. A client has been taking oral corticosteroids for the past five days because of seasonal allergies. Which assessment finding is of most concern to the nurse?
- A. White blood count of 10,000/mm³.
- B. Serum glucose of 115 mg/dL.
- C. Purulent sputum.
- D. Excessive hunger.
Correct answer: C
Rationale: The correct answer is C: Purulent sputum. Corticosteroids can suppress the immune system, increasing the risk of infections. Purulent sputum suggests a possible respiratory infection, which can rapidly progress and lead to complications, making it the most concerning finding. Choice A, a white blood count of 10,000/mm³, is within the normal range and not typically a cause for immediate concern. Choice B, a serum glucose level of 115 mg/dL, is also normal and not directly related to corticosteroid use. Choice D, excessive hunger, is a common side effect of corticosteroids but is not as concerning as a sign of infection indicated by purulent sputum.
2. An elderly client is admitted with a diagnosis of bacterial pneumonia. The nurse's assessment of the client will most likely reveal which sign/symptom?
- A. Leukocytosis and febrile.
- B. Polycythemia and crackles.
- C. Pharyngitis and sputum production.
- D. Confusion and tachycardia.
Correct answer: D
Rationale: The onset of pneumonia in the elderly may be signaled by general deterioration, confusion, increased heart rate or increased respiratory rate due to the decreased oxygen- carbon dioxide exchange at the alveoli, known as the V-Q mismatch.
3. Healthcare workers must protect themselves against becoming infected with HIV. The Center for Disease Control has issued guidelines for healthcare workers in relation to protection from HIV. These guidelines include which recommendation?
- A. Place HIV-positive clients in strict isolation and limit visitors.
- B. Wear gloves when coming in contact with the blood or body fluids of any client.
- C. Conduct mandatory HIV testing of those who work with clients with AIDS.
- D. Freeze HIV blood specimens at -70°F to kill the virus.
Correct answer: B
Rationale: The correct answer is B. The CDC guidelines recommend that healthcare workers wear gloves when coming in contact with blood or body fluids from any client since HIV can be infectious before the client becomes aware of their exposure and/or symptomatic. Choice A is incorrect because placing HIV-positive clients in strict isolation and limiting visitors is not a standard practice for HIV infection control. Choice C is incorrect as mandatory HIV testing for those working with AIDS clients is not a CDC recommendation for routine infection control. Choice D is incorrect because freezing HIV blood specimens at -70°F does not kill the virus; HIV can remain infectious even at very low temperatures.
4. A client with heart disease is on a continuous telemetry monitor and has developed sinus bradycardia. In determining the possible cause of the bradycardia, the nurse assesses the client's medication record. Which medication is most likely the cause of the bradycardia?
- A. Propranolol (Inderal).
- B. Captopril (Capoten).
- C. Furosemide (Lasix).
- D. Dobutamine (Dobutrex).
Correct answer: A
Rationale: Propranolol (Inderal) is a beta-adrenergic blocking agent that acts to decrease heart rate and contractility. Sinus bradycardia is a common side effect of beta blockers due to their negative chronotropic effect on the heart. Captopril (Capoten) is an ACE inhibitor used for hypertension and heart failure, not associated with causing bradycardia. Furosemide (Lasix) is a loop diuretic that can lead to electrolyte imbalances but not commonly linked to bradycardia. Dobutamine (Dobutrex) is a beta-1 adrenergic agonist that increases heart rate and contractility, making it an unlikely cause of bradycardia in this scenario.
5. What is the most important content for the nurse to include in discharge teaching for a 51-year-old truck driver who smokes two packs of cigarettes a day, is 30 pounds overweight, and has been diagnosed with a gastric ulcer?
- A. Information about smoking cessation.
- B. Diet instructions for a low-residue diet.
- C. Instructions on a weight-loss program.
- D. The importance of increasing milk in the diet.
Correct answer: A
Rationale: The correct answer is A: Information about smoking cessation. Smoking is a significant risk factor for ulcer formation. It is crucial for the nurse to include smoking cessation information in the discharge teaching to help manage the gastric ulcer and prevent further complications. Choices B, C, and D are less relevant in this scenario. While diet modifications may be beneficial, addressing smoking cessation takes precedence due to its direct correlation with ulcer development.
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