HESI RN
HESI Medical Surgical Exam
1. After a myocardial infarction, why is the hospitalized client taught to move the legs while resting in bed?
- A. Prepare the client for ambulation.
- B. Promote urinary and intestinal elimination.
- C. Prevent thrombophlebitis and blood clot formation.
- D. Decrease the likelihood of pressure ulcer formation.
Correct answer: C
Rationale: The correct answer is C. Moving the legs helps prevent thrombophlebitis and blood clot formation by promoting venous return in clients on bed rest. This prevents stasis and clot formation in the lower extremities. Choices A, B, and D are incorrect because the primary goal of moving the legs is to prevent thrombophlebitis and blood clot formation, rather than preparing for ambulation, promoting elimination, or decreasing pressure ulcer formation. Ambulation preparation involves different exercises, urinary and intestinal elimination are not directly related to leg movements, and pressure ulcer prevention is more related to repositioning and skin care.
2. The patient will begin taking doxycycline to treat an infection. When should the nurse plan to give this medication?
- A. 1 hour before or 2 hours after a meal.
- B. with an antacid to minimize GI irritation.
- C. with food to improve absorption.
- D. with small sips of water.
Correct answer: C
Rationale: Doxycycline is a lipid-soluble tetracycline that is better absorbed when taken with milk products and food. Taking doxycycline with food helps improve its absorption. It should not be taken on an empty stomach, as this can decrease its effectiveness. Antacids can interfere with the absorption of tetracyclines, so they should not be taken together. While it is important to stay hydrated when taking medications, small sips of water are not specifically recommended for doxycycline administration.
3. In assessing cancer risk, which woman is at greatest risk of developing breast cancer?
- A. A 35-year-old multipara who never breastfed.
- B. A 50-year-old whose mother had unilateral breast cancer.
- C. A 55-year-old whose mother-in-law had bilateral breast cancer.
- D. A 20-year-old whose menarche occurred at age 9.
Correct answer: B
Rationale: The correct answer is B because family history of breast cancer, specifically in the mother, is a significant risk factor for developing breast cancer. The age of 50 is also a risk factor for breast cancer. Choice A is less likely as breastfeeding can actually reduce the risk of breast cancer. Choice C is less relevant since the risk is higher with a direct family member. Choice D, although early menarche is a risk factor, the age of the individual is much lower compared to the other age-related risk factors.
4. Which of the following is the best position for a patient experiencing dyspnea?
- A. Supine position.
- B. Fowler's position.
- C. Trendelenburg position.
- D. Lateral recumbent position.
Correct answer: B
Rationale: Fowler's position is the best position for a patient experiencing dyspnea. This position involves sitting the patient upright with the head of the bed elevated between 45-60 degrees. Fowler's position helps improve breathing in patients with dyspnea by promoting lung expansion, aiding in better oxygenation, and reducing the work of breathing. The supine position (Choice A) may worsen dyspnea by limiting lung expansion. The Trendelenburg position (Choice C) with the feet elevated and the head down is not recommended for dyspnea as it can increase pressure on the chest and compromise breathing. The lateral recumbent position (Choice D) is not ideal for dyspnea as it does not provide optimal lung expansion and may not alleviate breathing difficulty.
5. A patient with a diagnosis of Cushing's syndrome is likely to exhibit which of the following symptoms?
- A. Hyperpigmentation.
- B. Moon face.
- C. Hypotension.
- D. Hypertension.
Correct answer: B
Rationale: The correct answer is B: Moon face. Cushing's syndrome is characterized by excess cortisol levels, leading to the distinctive round and full face known as moon face. Hyperpigmentation (choice A) may occur due to increased ACTH levels, but it is not a hallmark symptom like moon face. Hypotension (choice C) is less common in Cushing's syndrome as cortisol typically leads to hypertension (choice D) due to its effects on blood pressure regulation.
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