HESI RN
RN Medical/Surgical NGN HESI 2023
1. What is an ideal goal of treatment set by the nurse in the care plan for a client diagnosed with chronic kidney disease (CKD) to reduce the risk of pulmonary edema?
- A. Maintaining oxygen saturation above 92%
- B. Absence of crackles and wheezes in lung sounds
- C. Maintaining a balanced intake and output
- D. Absence of shortness of breath at rest
Correct answer: C
Rationale: The ideal goal of treatment for a client with chronic kidney disease (CKD) to reduce the risk of pulmonary edema is to maintain a balanced intake and output. This helps in achieving optimal fluid balance, enabling the heart to eject blood effectively without increasing pressure in the left ventricle and pulmonary vessels. While maintaining oxygen saturation above 92% is important for adequate tissue oxygenation, the primary focus in this scenario is fluid balance. Absence of crackles and wheezes in lung sounds is important to assess for pulmonary status, but it is not the primary goal to prevent pulmonary edema specifically. Similarly, absence of shortness of breath at rest is a relevant goal, but the emphasis in CKD management is on fluid balance to prevent pulmonary complications.
2. Which of the following conditions is most commonly associated with a high risk of stroke?
- A. Hypertension.
- B. Diabetes.
- C. Obesity.
- D. Smoking.
Correct answer: A
Rationale: Hypertension is the correct answer. Hypertension, also known as high blood pressure, is a major risk factor for stroke because it puts increased pressure on blood vessels in the brain, making them more prone to damage and increasing the likelihood of a stroke. While diabetes, obesity, and smoking are also risk factors for stroke, hypertension is the most commonly associated condition with a high risk of stroke due to its direct impact on the blood vessels.
3. What is the most common side effect of diuretics such as furosemide (Lasix)?
- A. Hypokalemia.
- B. Hyperkalemia.
- C. Hypernatremia.
- D. Hyponatremia.
Correct answer: A
Rationale: The correct answer is 'Hypokalemia.' Diuretics like furosemide increase the excretion of potassium, leading to hypokalemia as a common side effect. Hyperkalemia (choice B) is the opposite condition characterized by high potassium levels, which is not typically associated with furosemide use. Hypernatremia (choice C) is increased sodium levels, while hyponatremia (choice D) is decreased sodium levels, neither of which are the most common side effects of furosemide. Therefore, choice A is the best answer.
4. What types of medications should the healthcare provider expect to administer to a client during an acute respiratory distress episode?
- A. Vasodilators and hormones.
- B. Analgesics and sedatives.
- C. Anticoagulants and expectorants.
- D. Bronchodilators and steroids.
Correct answer: D
Rationale: During an acute respiratory distress episode, the priority is to widen air passages, increase air space, and reduce alveolar membrane inflammation. Therefore, the client would likely require bronchodilators to open up the airways and steroids to reduce inflammation. Vasodilators and hormones (Choice A) are not typically indicated in this situation. Analgesics and sedatives (Choice B) may be used for pain management and anxiety but are not primary treatments for respiratory distress. Anticoagulants and expectorants (Choice C) are not the main medications used during an acute respiratory distress episode and may not address the immediate needs of the client.
5. A client admitted to the hospital with a diagnosis of acute pancreatitis has blood drawn for several serum laboratory tests. Which of the following serum amylase values, noted by the nurse reviewing the results, would be expected in this client at this time?
- A. 48 units/L
- B. 97 units/L
- C. 150 units/L
- D. 395 units/L
Correct answer: D
Rationale: The correct answer is D: "395 units/L." The normal serum amylase range is 25 to 151 units/L. In acute pancreatitis, the amylase level is greatly increased, typically exceeding the upper limit of the normal range. Choices A, B, and C fall within the normal range of serum amylase levels and would not be expected in a client with acute pancreatitis.
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