HESI RN
HESI Medical Surgical Practice Quiz
1. A client with a history of calcium phosphate urinary stones is being taught by a nurse. Which statements should the nurse include in this client’s dietary teaching? (Select all that apply.)
- A. Limit your intake of food high in animal protein.
- B. Read food labels to help minimize your sodium intake.
- C. A and B
- D. Reduce your intake of milk and other dairy products.
Correct answer: C
Rationale: For a client with a history of calcium phosphate urinary stones, it is essential to limit the intake of foods high in animal protein to prevent the formation of stones. Additionally, reducing sodium intake is crucial as high sodium levels can contribute to stone formation. Therefore, choices A and B are correct. Choice D, which suggests reducing intake of milk and other dairy products, is not specifically recommended for calcium phosphate stones. Clients with calcium phosphate stones should focus on limiting animal protein, sodium, and calcium intake. Choices A and B address these dietary modifications, making them the correct options for this client. Choices D, which is not directly related to calcium phosphate stones, is incorrect.
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 nurse obtains a sterile urine specimen from a client’s Foley catheter. After applying a clamp to the drainage tubing distal to the injection port, which action should the nurse take next?
- A. Clamp another section of the tube to create a fixed sample section for retrieval.
- B. Insert a syringe into the injection port and aspirate the quantity of urine required.
- C. Clean the injection port cap of the drainage tubing with a povidone-iodine solution.
- D. Withdraw 10 mL of urine and discard it; then withdraw a fresh sample of urine.
Correct answer: C
Rationale: The correct next action for the nurse to take after applying a clamp to the drainage tubing distal to the injection port is to clean the injection port cap of the catheter drainage tubing with an appropriate antiseptic like povidone-iodine solution or alcohol. This step is crucial to prevent surface contamination before taking the urine sample. Clamping another section of the tube to create a fixed sample section or withdrawing and discarding urine are unnecessary and could lead to potential contamination. Inserting a syringe into the injection port and aspirating the required amount of urine directly from the catheter is the correct method for obtaining the urine sample, but cleaning the injection port cap should precede this step to ensure sterility.
4. When conducting discharge teaching for a client diagnosed with diverticulitis, which diet instruction should the nurse include?
- A. Have small, frequent meals and sit up for at least two hours after meals
- B. Eat a bland diet and avoid spicy foods
- C. Eat a high-fiber diet and increase fluid intake
- D. Eat a soft diet with increased intake of milk and milk products
Correct answer: C
Rationale: For a client diagnosed with diverticulitis, the nurse should instruct them to eat a high-fiber diet and increase fluid intake. This diet helps in managing diverticulitis by promoting bowel regularity and preventing complications such as diverticular inflammation or infection. Choice A of having small, frequent meals and sitting up for at least two hours after meals may be beneficial for gastroesophageal reflux disease but is not specific to diverticulitis. Choice B of eating a bland diet and avoiding spicy foods is not the preferred recommendation for diverticulitis management. Choice D of eating a soft diet with increased intake of milk and milk products may not provide enough fiber to aid in diverticulitis management, and the increased intake of dairy products may worsen symptoms in some individuals.
5. A young adult asks the nurse about the normal cholesterol level. The nurse tells the client that the total cholesterol level should be maintained at less than:
- A. 140 mg/dL
- B. 200 mg/dL
- C. 250 mg/dL
- D. 300 mg/dL
Correct answer: B
Rationale: The correct answer is B: 200 mg/dL. A normal cholesterol value ranges between 140 and 199 mg/dL. Total cholesterol levels should ideally be maintained at 200 mg/dL or less to reduce the risk of cardiovascular diseases. Choices A, C, and D are incorrect as they exceed the recommended normal range for total cholesterol levels and may increase the risk of developing heart-related issues.
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