HESI RN
HESI RN Medical Surgical Practice Exam
1. A client presents with a urine specific gravity of 1.018. What action should the nurse take?
- A. Evaluate the client’s intake and output for the past 24 hours.
- B. Document the finding in the chart and continue to monitor.
- C. Obtain a specimen for a urine culture and sensitivity.
- D. Encourage the client to drink more fluids, especially water.
Correct answer: B
Rationale: A urine specific gravity of 1.018 falls within the normal range, indicating adequate hydration. Therefore, the appropriate action is to document this finding in the client's chart and continue monitoring. There is no need to evaluate intake and output, as the specific gravity is normal. Obtaining a urine culture and sensitivity or encouraging increased fluid intake is unnecessary in this situation.
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. The nurse is teaching a nursing student about the minimal effective concentration (MEC) of antibiotics. Which statement by the nursing student indicates understanding of this concept?
- A. A serum drug level greater than the MEC ensures that the drug is bacteriostatic.
- B. A serum drug level greater than the MEC broadens the spectrum of the drug.
- C. A serum drug level greater than the MEC helps eradicate bacterial infections.
- D. A serum drug level greater than the MEC increases the therapeutic index.
Correct answer: C
Rationale: The MEC is the minimum amount of drug needed to halt the growth of a microorganism. A level greater than the MEC helps eradicate infections. Drugs at or above the MEC are usually bactericidal, not bacteriostatic. Therefore, choice A is incorrect. Broadening the spectrum of a drug refers to its range of activity against different microorganisms, which is not directly related to MEC. Thus, choice B is incorrect. Increasing the therapeutic index involves maximizing the effectiveness of a drug while minimizing its toxicity, which is not specifically related to MEC. Therefore, choice D is also incorrect.
4. 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.
5. What is a priority intervention for a patient experiencing a thyroid storm?
- A. Administering antipyretics.
- B. Cooling the patient.
- C. Administering beta-blockers.
- D. Administering antithyroid medications.
Correct answer: D
Rationale: During a thyroid storm, the priority intervention is to administer antithyroid medications to reduce thyroid hormone levels quickly. These medications, such as propylthiouracil or methimazole, help inhibit the production of thyroid hormones. Administering antipyretics (choice A) may help reduce fever, but it does not address the underlying cause of the thyroid storm. Cooling the patient (choice B) may provide symptomatic relief but does not address the thyroid hormone dysregulation. Administering beta-blockers (choice C) can help manage symptoms like tachycardia and hypertension, but it does not target the root cause of the thyroid storm.
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