HESI RN
RN Medical/Surgical NGN HESI 2023
1. A client recently diagnosed with chronic kidney disease (CKD) is receiving discharge instructions from a nurse. Which statements made by the client indicate a correct understanding of the teaching? (Select all that apply.)
- A. I need to ask for an antibiotic when scheduling a dental appointment.
- B. I’ll need to check my blood sugar often to prevent hypoglycemia.
- C. The dose of my pain medication may have to be adjusted.
- D. The need to watch for bleeding with anticoagulants.
Correct answer: A
Rationale: The correct statements indicating a proper understanding of the teaching include the need for antibiotics for dental work, the potential need to adjust pain medication doses, and the importance of monitoring blood sugar levels. The statement about watching for bleeding with anticoagulants is not directly related to CKD and discharge instructions for this condition. Therefore, option A is correct, as it addresses relevant concerns for a client with CKD, while the other options are either unrelated or not specifically mentioned in the scenario.
2. A young female client prescribed amoxicillin (Amoxil) for a urinary tract infection is being taught by a nurse. Which statement should the nurse include in this client’s teaching?
- A. Use a second form of birth control while taking this medication.
- B. You will experience increased menstrual bleeding while on this medication.
- C. You may experience an irregular heartbeat while on this medication.
- D. Watch for blood in your urine while taking this drug.
Correct answer: A
Rationale: The correct statement for the nurse to include in the teaching is to advise the client to use a second form of birth control while taking amoxicillin. Penicillin, like amoxicillin, may reduce the effectiveness of estrogen-containing contraceptives, making it important to use additional contraceptive measures. The incorrect choices are B, C, and D. Increased menstrual bleeding, irregular heartbeat, or blood in the urine are not common side effects associated with amoxicillin use for a urinary tract infection.
3. A healthcare professional reviews a client’s laboratory results. Which results from the client’s urinalysis should the healthcare professional identify as normal? (Select all that apply.)
- A. pH: 6
- B. Specific gravity: 1.015
- C. Glucose: negative
- D. All of the above
Correct answer: D
Rationale: In a urinalysis, a pH of 6 is within the normal range (typically between 4.6 and 8); a specific gravity of 1.015 is considered normal (usually ranging between 1.005 to 1.030); and a negative glucose result is also normal. Therefore, choices A, B, and C are correct as they fall within the normal values for a urinalysis. Choices A, B, and C are the correct answers, as the pH, specific gravity, and glucose levels are within the normal range for a urinalysis. Choice D is correct because all the listed values are normal. Choices A, B, and C are the correct options as they meet the criteria for normal urinalysis values. The other choices do not fall within the normal range for a urinalysis.
4. A nurse administers scopolamine as prescribed to a client in preparation for surgery. For which side effect of this medication does the nurse monitor the client?
- A. Pupil constriction
- B. Increased urine output
- C. Complaints of dry mouth
- D. Complaints of feeling sweaty
Correct answer: D
Rationale: The correct answer is D: 'Complaints of feeling sweaty.' Scopolamine, an anticholinergic medication, commonly causes the side effect of decreased sweating, not increased urine output or pupil constriction. While dry mouth is a possible side effect, it is less likely than the altered sweating pattern. Therefore, the nurse should monitor the client for complaints of feeling sweaty due to the potential side effect of decreased sweating associated with scopolamine.
5. The patient is receiving a high dose of intravenous azithromycin to treat an infection and taking acetaminophen for pain. The nurse should expect to review which lab values when monitoring for this drug’s side effects?
- A. Complete blood counts
- B. Electrolytes
- C. Liver enzymes
- D. Urinalysis
Correct answer: C
Rationale: When a patient is receiving a high dose of intravenous azithromycin, which is a macrolide antibiotic, in combination with acetaminophen, a potentially hepatotoxic drug, the nurse should monitor liver enzymes. High doses of macrolides when taken with hepatotoxic drugs like acetaminophen can lead to hepatotoxicity. Reviewing liver enzymes helps in early detection of liver damage. Complete blood counts (Choice A) are not typically affected by azithromycin or acetaminophen. Electrolytes (Choice B) are not directly impacted by these medications. Urinalysis (Choice D) is not specifically indicated for monitoring the side effects of azithromycin and acetaminophen combination therapy.
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