HESI RN
Evolve HESI Medical Surgical Practice Exam
1. A client with a diagnosis of hypothermia is being admitted to the hospital by a nurse. Which of the following signs does the nurse anticipate that this client will exhibit?
- A. Increased heart rate and increased blood pressure
- B. Increased heart rate and decreased blood pressure
- C. Decreased heart rate and increased blood pressure
- D. Decreased heart rate and decreased blood pressure
Correct answer: D
Rationale: Hypothermia decreases the heart rate and blood pressure due to reduced metabolic needs of the body. With lower metabolic demands, the heart's workload decreases, leading to reductions in both heart rate and blood pressure. Choices A, B, and C are incorrect because hypothermia typically results in a decrease in heart rate and blood pressure, not an increase.
2. Angiotensin-converting enzyme (ACE) inhibitors may be prescribed for the client with diabetes mellitus to reduce vascular changes and possibly prevent or delay the development of:
- A. Chronic obstructive pulmonary disease (COPD).
- B. Pancreatic cancer.
- C. Renal failure.
- D. Cerebrovascular accident.
Correct answer: C
Rationale: The correct answer is C: Renal failure. ACE inhibitors are commonly used in clients with diabetes mellitus to help reduce the progression of diabetic nephropathy by improving renal blood flow. This medication class can help prevent or delay the development of renal failure in these clients. Choices A, B, and D are incorrect because ACE inhibitors do not have a direct impact on preventing or delaying the development of chronic obstructive pulmonary disease, pancreatic cancer, or cerebrovascular accidents in clients with diabetes mellitus.
3. A client scheduled for the surgical creation of an ileal conduit expresses anxiety and asks about having a drainage tube. How should the nurse respond?
- A. I will ask the provider to prescribe you an antianxiety medication.
- B. Would you like to discuss the procedure with your doctor once more?
- C. I think it would be nice to not have to worry about finding a bathroom.
- D. Would you like to speak with someone who has an ileal conduit?
Correct answer: D
Rationale: The most appropriate response for the nurse is to offer the client the opportunity to speak with someone who has undergone the same procedure. This allows the client to gain insight, ask questions, and share concerns with someone who has firsthand experience, which can help alleviate anxiety and promote a positive self-image. Seeking an antianxiety medication does not address the client's emotional concerns or promote a positive attitude towards the procedure. Discussing the procedure with the doctor again may provide more information but may not offer the same level of emotional support and understanding as speaking with someone who has lived through the experience. Commenting on the convenience of not having to search for a bathroom minimizes the client's anxiety and overlooks the emotional aspect of the client's concerns.
4. The client is being educated by the nurse on home blood glucose monitoring. Which of the following blood glucose measurements indicates hypoglycemia?
- A. 59 mg/dL (3.3 mmol/L)
- B. 75 mg/dL (4.2 mmol/L)
- C. 108 mg/dL (6 mmol/L)
- D. 119 mg/dL (6.6 mmol/L)
Correct answer: A
Rationale: A blood glucose level of 59 mg/dL (3.3 mmol/L) is considered hypoglycemia, which is an abnormally low blood sugar level. This level requires immediate attention as it can lead to symptoms such as confusion, shakiness, and even loss of consciousness if left untreated. Choices B, C, and D have blood glucose levels within the normal range or slightly higher, indicating euglycemia or normal blood sugar levels, and not hypoglycemia.
5. Which of the following is a common sign of meningitis?
- A. Joint pain.
- B. Severe headache.
- C. Stiff neck.
- D. Coughing up blood.
Correct answer: C
Rationale: A stiff neck is a common sign of meningitis due to inflammation of the meninges. Meningitis typically presents with symptoms such as fever, severe headache, nausea, vomiting, sensitivity to light, and a stiff neck. Joint pain (Choice A) is not a typical symptom of meningitis and is more commonly associated with other conditions. While severe headache (Choice B) can be a symptom of meningitis, it is not as specific as a stiff neck. Coughing up blood (Choice D) is not a typical sign of meningitis and may indicate other respiratory or cardiovascular issues.
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