HESI RN
Evolve HESI Medical Surgical Practice Exam
1. A client presents with a fungal urinary tract infection (UTI). Which assessments should the nurse complete? (Select all that apply.)
- A. Palpate the kidneys and bladder.
- B. Assess the medical history and current medical problems.
- C. Perform a bladder scan to assess post-void residual.
- D. Inquire about recent travel to foreign countries.
Correct answer: B
Rationale: When assessing a client with a fungal UTI, the nurse should prioritize gathering information related to the medical history and current medical problems. Clients who are severely immunocompromised or have conditions like diabetes mellitus are more susceptible to fungal UTIs. Assessing the medical history helps identify risk factors and potential causes of the infection. While physical examinations like palpating the kidneys and bladder and performing a bladder scan may be necessary, they should follow the initial assessment of medical history. Inquiring about recent travel to foreign countries is less relevant in the context of a fungal UTI, as the focus should be on immediate medical factors predisposing the client to the infection.
2. Which client should the nurse recognize as most likely to experience sleep apnea?
- A. Middle-aged female who takes a diuretic nightly.
- B. Obese older male client with a short, thick neck.
- C. Adolescent female with a history of tonsillectomy.
- D. School-aged male with a history of hyperactivity disorder.
Correct answer: B
Rationale: The correct answer is B. Sleep apnea is characterized by pauses in breathing during sleep, often due to a collapsed or blocked airway. Obesity and having a short, thick neck are risk factors for sleep apnea because excess fat around the neck can obstruct the airway. Option A (middle-aged female who takes a diuretic nightly) does not present as a common risk factor for sleep apnea. Option C (adolescent female with a history of tonsillectomy) may have had tonsils removed, which could reduce the risk of sleep apnea. Option D (school-aged male with a history of hyperactivity disorder) is not directly associated with an increased risk of sleep apnea.
3. Which of the following is the best indicator of fluid balance in a patient with heart failure?
- A. Daily weight measurements.
- B. Monitoring intake and output.
- C. Assessing skin turgor.
- D. Checking for peripheral edema.
Correct answer: A
Rationale: Daily weight measurements are the best indicator of fluid balance in a patient with heart failure. Changes in weight reflect fluid retention or loss more accurately than other methods. Monitoring intake and output (choice B) is essential but may not provide a comprehensive picture of fluid status. Skin turgor (choice C) and checking for peripheral edema (choice D) are more indicative of dehydration and fluid overload, respectively, rather than overall fluid balance.
4. The patient is taking low-dose erythromycin prophylactically and will start cefaclor for treating an acute infection. The nurse should discuss this with the provider because taking both medications simultaneously can cause which effect?
- A. Decreased effectiveness of cefaclor.
- B. Increased effectiveness of cefaclor.
- C. Decreased effectiveness of erythromycin.
- D. Increased effectiveness of erythromycin.
Correct answer: A
Rationale: When erythromycin and cefaclor are taken together, erythromycin can inhibit the metabolism of cefaclor, leading to elevated cefaclor levels and potentially causing adverse effects. This results in a decrease in the effectiveness of cefaclor. Therefore, the nurse should discuss this potential drug interaction with the provider to consider an alternative treatment or adjust the dosages to prevent complications. Choices B, C, and D are incorrect because the concern lies with the effect on cefaclor when combined with erythromycin, not the effect on erythromycin itself.
5. After teaching a client with bacterial cystitis who is prescribed phenazopyridine (Pyridium), the nurse assesses the client’s understanding. Which statement made by the client indicates a correct understanding of the teaching?
- A. I will not take this drug with food or milk.
- B. If I suspect pregnancy, I will discontinue the drug.
- C. An orange color in my urine should not alarm me.
- D. I will consume two glasses of cranberry juice daily.
Correct answer: C
Rationale: The correct answer is C. Phenazopyridine commonly discolors urine to a deep reddish orange, which can be mistaken for blood. It is important for the client to understand that this color change is an expected side effect and should not be a cause for alarm. Additionally, the urine can stain clothing. There are no dietary restrictions or precautions related to food or milk intake while taking phenazopyridine. Stopping the medication if suspecting pregnancy is not necessary as phenazopyridine is safe to use during pregnancy. Drinking cranberry juice is not directly related to the use of phenazopyridine and is not a specific instruction given for managing bacterial cystitis.
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