HESI RN
HESI Medical Surgical Practice Exam Quizlet
1. A female client taking oral contraceptives reports to the nurse that she is experiencing calf pain. What action should the nurse implement?
- A. Determine if the client has also experienced breast tenderness and weight gain.
- B. Encourage the client to begin a regular, daily program of walking and exercise.
- C. Advise the client to notify the healthcare provider for immediate medical attention.
- D. Tell the client to stop taking the medication for a week to see if symptoms subside.
Correct answer: C
Rationale: Calf pain is indicative of thrombophlebitis, a serious, life-threatening complication associated with the use of oral contraceptives which requires further assessment and possibly immediate medical intervention.
2. A 57-year-old male client is scheduled to have a stress-thallium test the following morning and is NPO after midnight. At 0130, he is agitated because he cannot eat and is demanding food. Which response is best for the nurse to provide to this client?
- A. I'm sorry sir, you have a prescription for nothing by mouth from midnight tonight.
- B. I will let you have one cracker, but that is all you can have for the rest of tonight.
- C. What did the healthcare provider tell you about the test you are having tomorrow?
- D. The test you are having tomorrow requires that you have nothing by mouth tonight.
Correct answer: D
Rationale: Being direct and explaining to the client that the test requires him to be NPO, is the most therapeutic statement because the nurse is responding to the client's question and providing him the reason why.
3. The nurse notes that the only ECG for a 55-year-old male client scheduled for surgery in two hours is dated two years ago. The client reports that he has a history of 'heart trouble,' but has no problems at present. Hospital protocol requires that those over 50 years of age have a recent ECG prior to surgery. What nursing action is best for the nurse to implement?
- A. Ask the client to explain what he means by 'heart trouble.'
- B. Call for an ECG to be performed immediately.
- C. Notify surgery that the ECG is over two years old.
- D. Notify the client's surgeon immediately.
Correct answer: B
Rationale: In this scenario, the client is 55 years old with a history of 'heart trouble,' which necessitates a recent ECG before surgery as per hospital policy. The nurse should prioritize patient safety and adhere to the protocol by arranging for an ECG to be performed immediately. Option A is not the best initial action as the focus should be on obtaining the necessary test first. Option C is not the immediate action required, and option D is premature without obtaining the necessary ECG first.
4. A 58-year-old client who has been post-menopausal for five years is concerned about the risk for osteoporosis because her mother has the condition. Which information should the nurse offer?
- A. Osteoporosis is a progressive genetic disease with no effective treatment.
- B. Calcium loss from bones can be slowed by increasing calcium intake and exercise.
- C. Estrogen replacement therapy should be started to prevent the progression of osteoporosis.
- D. Low-dose corticosteroid treatment effectively halts the course of osteoporosis.
Correct answer: B
Rationale: Post-menopausal females are at risk for osteoporosis due to the cessation of estrogen secretion. While genetics can play a role, osteoporosis is not solely a genetic disease. Increasing calcium intake, along with vitamin D supplementation and weight-bearing exercise, can help prevent further bone loss by slowing down calcium loss from bones. Estrogen replacement therapy is no longer recommended as a first-line treatment for osteoporosis due to associated risks. Corticosteroid treatment is not typically used as a primary treatment for osteoporosis.
5. The client is being taught about the best time to plan sexual intercourse in order to conceive. Which information should be provided?
- A. Two weeks before menstruation.
- B. Vaginal mucous discharge is thick.
- C. Low basal temperature.
- D. First thing in the morning.
Correct answer: A
Rationale: The correct answer is A: 'Two weeks before menstruation.' Ovulation typically occurs 14 days before menstruation begins during a typical 28-day cycle. To increase the chances of conception, sexual intercourse should occur within 24 hours of ovulation. High estrogen levels during ovulation lead to changes in vaginal mucous discharge, making it more 'slippery' and stretchy. Basal temperature rises during ovulation. The timing of intercourse during the day is less significant than ensuring it happens around ovulation. The other options are incorrect because planning intercourse two weeks before menstruation is likely to miss the fertile window, thick vaginal mucous discharge indicates ovulation is approaching, and low basal temperature is not indicative of the fertile period.
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