HESI RN
HESI Medical Surgical Assignment Exam
1. 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.
2. When obtaining the health history of a client suspected of having bladder cancer, which question should the nurse ask to determine the client's risk factors?
- A. Do you smoke cigarettes?
- B. Do you consume alcohol?
- C. Do you use recreational drugs?
- D. Do you take any prescription drugs?
Correct answer: A
Rationale: The correct answer is A: 'Do you smoke cigarettes?' Smoking is a major risk factor for bladder cancer. Cigarette smoke contains harmful chemicals that can accumulate in the urine and damage the lining of the bladder, increasing the risk of developing cancer. Alcohol use, recreational drug use, and most prescription drugs are not directly linked to an increased risk of bladder cancer. It is important for the nurse to assess smoking history as a significant risk factor in determining the client's risk for bladder cancer.
3. When a patient is receiving high doses of a cephalosporin, which laboratory values will this patient's nurse monitor closely?
- A. Blood urea nitrogen (BUN), serum creatinine, and liver function tests
- B. Complete blood count and electrolytes
- C. Serum calcium and magnesium
- D. Serum glucose and lipids
Correct answer: A
Rationale: When a patient is receiving high doses of a cephalosporin, such as cefazolin, the nurse should closely monitor laboratory values that indicate renal and hepatic function. This includes checking the Blood Urea Nitrogen (BUN) and serum creatinine levels to assess kidney function. Additionally, monitoring liver function tests, such as AST, ALT, ALP, LDH, and bilirubin, is essential as cephalosporins can affect liver enzymes. Therefore, options B, C, and D are incorrect as they do not specifically address the parameters that are most pertinent when administering high doses of cephalosporins.
4. A client who has just undergone a skin biopsy is listening to discharge instructions from the nurse. The nurse determines that the client has misunderstood the directions if the client indicates that as part of aftercare he plans to:
- A. Use the antibiotic ointment as prescribed
- B. Return in 7 days to have the sutures removed
- C. Apply cool compresses to the site twice a day for 20 minutes
- D. Call the physician if excessive drainage from the wound occurs
Correct answer: C
Rationale: The correct answer is C. Applying cool compresses to the site twice a day for 20 minutes is not a recommended aftercare practice for a skin biopsy. After a skin biopsy, it is important to keep the dressing dry and in place for a minimum of 8 hours. Choice A is correct as using the antibiotic ointment as prescribed is a common post-biopsy instruction to prevent infection. Choice B is also correct as returning in 7 days to have the sutures removed is part of the typical follow-up care after a skin biopsy. Choice D is correct as it is important to call the physician if excessive drainage from the wound occurs to prevent complications.
5. The nurse is caring for a patient who is taking trimethoprim-sulfamethoxazole (TMP-SMX). The nurse learns that the patient takes an angiotensin-converting enzyme (ACE) inhibitor. To monitor for drug interactions, the nurse will request an order for which laboratory test(s)?
- A. A complete blood count
- B. BUN and creatinine
- C. Electrolytes
- D. Glucose
Correct answer: C
Rationale: The correct answer is 'C. Electrolytes.' When trimethoprim-sulfamethoxazole (TMP-SMX) is taken with an ACE inhibitor, there is an increased risk of hyperkalemia due to the combined effects on potassium levels. Monitoring electrolytes, specifically potassium, is essential to detect and manage this potential drug interaction. Choices A, B, and D are incorrect because while they are important tests in general patient care, they are not specifically indicated to monitor for the drug interaction between TMP-SMX and ACE inhibitors.
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