HESI RN
RN Medical/Surgical NGN HESI 2023
1. A healthcare professional is reviewing laboratory results for a client who is at risk for nephrotoxicity due to medications. Which of the following serum creatinine results does the healthcare professional document as normal?
- A. 0.2 mg/dL
- B. 1.0 mg/dL
- C. 2.8 mg/dL
- D. 3.9 mg/dL
Correct answer: B
Rationale: The normal serum creatinine level typically ranges from 0.6 to 1.3 mg/dL. A result of 1.0 mg/dL falls within this normal range. A serum creatinine level of 0.2 mg/dL is abnormally low and may indicate decreased muscle mass or malnutrition. On the other hand, results of 2.8 mg/dL and 3.9 mg/dL are elevated, signifying impaired kidney function and potential nephrotoxicity from medications.
2. A healthcare professional reviews the allergy list of a client scheduled for an intravenous urography. Which client allergy should prompt urgent contact with the healthcare provider?
- A. Seafood
- B. Penicillin
- C. Bee stings
- D. Red food dye
Correct answer: A
Rationale: Clients with seafood allergies should alert healthcare professionals to urgently contact the healthcare provider before an intravenous urography. The standard dyes used in this procedure can trigger severe allergic reactions in individuals with seafood allergies. Penicillin, bee stings, and red food dye allergies do not pose a direct threat during intravenous urography, making them less critical for immediate intervention.
3. A client is receiving intermittent bolus feedings via a nasogastric tube. In which position should the nurse place the client once the feeding is complete?
- A. Supine
- B. Head of bed flat
- C. Left lateral position
- D. Head of bed elevated 30 to 45 degrees
Correct answer: B
Rationale: After intermittent bolus feedings through a nasogastric tube, the correct position for the client is to keep the head of the bed flat. This position helps prevent vomiting and aspiration. Placing the client in a supine position (choice A) can increase the risk of aspiration. The left lateral position (choice C) is not typically used after nasogastric tube feedings. Elevating the head of the bed 30 to 45 degrees (choice D) is suitable for continuous tube feedings to reduce the risk of aspiration, but for intermittent bolus feedings, keeping the head of the bed flat is preferred to prevent regurgitation and aspiration.
4. The client with chronic renal failure is being educated on dietary restrictions. Which of the following foods should the client avoid?
- A. Bananas.
- B. Oranges.
- C. Rice.
- D. Apples.
Correct answer: A
Rationale: The correct answer is A: Bananas. Bananas are high in potassium, and clients with chronic renal failure are often advised to follow a low-potassium diet to prevent hyperkalemia. Oranges and apples are also high in potassium and should be avoided by clients with renal issues. Rice, on the other hand, is low in potassium and is generally considered safe for individuals with chronic renal failure to consume in moderation.
5. The nurse is preparing to administer doses of hydrochlorothiazide (HydroDIURIL) and digoxin (Lanoxin) to a patient who has heart failure. The patient reports having blurred vision. The nurse notes a heart rate of 60 beats per minute and a blood pressure of 140/78 mm Hg. Which action will the nurse take?
- A. Administer the medications and request an order for serum electrolytes.
- B. Give both medications and evaluate serum blood glucose frequently.
- C. Hold the digoxin and notify the provider.
- D. Hold the hydrochlorothiazide and notify the provider.
Correct answer: C
Rationale: In this scenario, the patient is experiencing symptoms of digoxin toxicity, such as blurred vision and bradycardia. When thiazide diuretics like hydrochlorothiazide are taken with digoxin, the patient is at risk of digoxin toxicity due to the potential for thiazides to cause hypokalemia. Therefore, the correct action for the nurse to take is to hold the digoxin and notify the provider. Administering the medications without addressing the potential toxicity could worsen the patient's condition. Requesting serum electrolytes (Choice A) may be necessary but holding the digoxin takes priority. Evaluating serum blood glucose (Choice B) is not relevant to the current situation. Holding hydrochlorothiazide (Choice D) is not the best option as the primary concern is the digoxin toxicity that needs to be addressed promptly.
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