HESI RN
HESI Medical Surgical Specialty Exam
1. A nurse reviews laboratory results for a client with glomerulonephritis. The client’s glomerular filtration rate (GFR) is 40 mL/min as measured by a 24-hour creatinine clearance. How should the nurse interpret this finding? (Select all that apply.)
- A. Excessive GFR
- B. Reduced GFR
- C. Fluid retention and risks for hypertension
- D. Pulmonary edema
Correct answer: B
Rationale: A GFR of 40 mL/min indicates a reduced glomerular filtration rate. In a healthy adult, the normal GFR ranges between 100 and 120 mL/min. A GFR of 40 mL/min signifies a significant reduction, leading to fluid retention and risks for hypertension and pulmonary edema due to excess vascular fluid. Choices A, C, and D are incorrect. Choice A is incorrect as a GFR of 40 mL/min is not excessive but rather reduced. Choices C and D do not directly address the interpretation of GFR but instead describe potential consequences of a reduced GFR.
2. A nurse teaches a client who is recovering from a nephrectomy secondary to kidney trauma. Which statement should the nurse include in this client’s teaching?
- A. Since you only have one kidney, a salt and fluid restriction is required.
- B. Your therapy will include hemodialysis while you recover.
- C. Medication will be prescribed to control your high blood pressure.
- D. You need to avoid participating in contact sports like football.
Correct answer: D
Rationale: Clients with one kidney need to avoid contact sports because the kidneys are easily injured. The client will not be required to restrict salt and fluids, end up on dialysis, or have new hypertension because of the nephrectomy.
3. A client with chronic renal failure is receiving epoetin alfa (Epogen). The nurse should assess the client for which of the following complications?
- A. Hypertension.
- B. Hypotension.
- C. Hyperglycemia.
- D. Edema.
Correct answer: A
Rationale: The correct answer is A: Hypertension. Epoetin alfa (Epogen) is known to increase blood pressure by stimulating red blood cell production. Monitoring for hypertension is crucial to prevent complications such as heart failure or stroke. Choices B, C, and D are incorrect because hypotension, hyperglycemia, and edema are not typically associated with epoetin alfa therapy in clients with chronic renal failure.
4. A client is receiving Cilostazol (Pletal) for peripheral arterial disease causing intermittent claudication. The nurse determines this medication is effective when the client reports which of the following?
- A. I am having fewer aches and pains.
- B. I do not have headaches anymore.
- C. I am able to walk further without leg pain.
- D. My toes are turning grayish black in color.
Correct answer: C
Rationale: The correct answer is C. Cilostazol improves blood flow to the muscles, which helps alleviate symptoms of intermittent claudication. An improvement in walking distance without leg pain indicates the effectiveness of the medication. Choices A and B are not directly related to the expected outcome of Cilostazol therapy for intermittent claudication. Choice D is concerning for a potential adverse effect and should be reported to the healthcare provider immediately.
5. The client with chronic renal failure is being taught about fluid restrictions by the nurse. Which statement by the client indicates a need for further teaching?
- A. I can drink as much water as I want, as long as I limit my salt intake.
- B. I should limit my fluid intake to prevent fluid overload.
- C. I can skip dialysis sessions if I feel tired.
- D. I can eat whatever I want, as long as I take my medications.
Correct answer: C
Rationale: Choice C is the correct answer because clients with chronic renal failure should not skip dialysis sessions. Skipping dialysis can lead to serious complications and worsen the client's condition. It is crucial for clients to understand the importance of adhering to their dialysis schedule for optimal management of chronic renal failure. Choices A, B, and D are incorrect because they demonstrate understanding of fluid restrictions, the need to limit fluid intake to prevent overload, and the importance of medication compliance, respectively. These statements show appropriate knowledge and do not indicate a need for further teaching.
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