HESI RN
HESI RN Medical Surgical Practice Exam
1. After teaching a client with nephrotic syndrome and a normal glomerular filtration rate, the nurse assesses the client’s understanding. Which statement made by the client indicates a correct understanding of the nutritional therapy for this condition?
- A. I must decrease my intake of fat.
- B. I will increase my intake of protein.
- C. A decreased intake of carbohydrates will be required.
- D. An increased intake of vitamin C is necessary.
Correct answer: B
Rationale: In nephrotic syndrome, there is significant renal loss of protein leading to hypoalbuminemia and edema formation. If glomerular filtration is normal or near normal, increased protein loss should be matched by an increased intake of protein. Therefore, the correct statement indicating a correct understanding of the nutritional therapy for this condition is increasing protein intake. Decreasing fat, decreasing carbohydrates, or increasing vitamin C intake is not necessary for addressing the underlying issues associated with nephrotic syndrome.
2. After a urography, a client is instructed by a nurse. Which instruction should the nurse include in this client’s discharge teaching?
- A. Avoid direct contact with your urine for 24 hours until the dye clears.
- B. You may experience dribbling of urine for several weeks post-procedure.
- C. Drink at least 3 liters of fluids today to assist in dye elimination.
- D. Your skin may turn slightly yellow from the dye used in this procedure.
Correct answer: C
Rationale: It is important for the client to increase fluid intake to aid in the rapid elimination of the potentially nephrotoxic dye used in urography. This instruction will help prevent any adverse effects related to the dye. Choices A, B, and D are incorrect because the dye used in urography is not radioactive, so there is no need to avoid direct contact with urine, urine dribbling is not a common post-procedure occurrence, and the dye should not cause the client's skin to change color.
3. A patient asks the nurse about taking calcium supplements to avoid hypocalcemia. The nurse will suggest that the patient follow which instruction?
- A. Take a calcium and vitamin D combination supplement.
- B. Take calcium along with phosphorus to improve absorption.
- C. Take calcium with antacids to reduce stomach upset.
- D. Use aspirin instead of acetaminophen when taking calcium.
Correct answer: A
Rationale: The correct answer is to take a calcium and vitamin D combination supplement. Vitamin D enhances the absorption of calcium in the body, making it an essential component for calcium utilization. Choice B is incorrect because calcium and phosphorus have an inverse relationship, where an increased level of one mineral decreases the level of the other, so taking them together may not be beneficial. Choice C is incorrect because antacids often contain magnesium, which can promote calcium loss instead of absorption. Choice D is incorrect because aspirin can alter vitamin D levels and interfere with calcium absorption, so it is not recommended when taking calcium supplements.
4. The nurse is teaching a patient who will be discharged home from the hospital to take amoxicillin (Amoxil) twice daily for 10 days. Which statement by the nurse is correct?
- A. Discontinue the antibiotic when your temperature returns to normal and your symptoms have improved.
- B. If diarrhea occurs, stop taking the drug immediately and contact your provider.
- C. Stop taking the drug and notify your provider if you develop a rash while taking this drug.
- D. You may save any unused antibiotic to use if your symptoms recur.
Correct answer: C
Rationale: Patients who develop signs of allergy, such as rash, should notify their provider before continuing medication therapy. Patients should be counseled to continue taking their antibiotics until completion of the prescribed regimen even when they feel well. Diarrhea is an adverse effect but does not warrant cessation of the drug. Before deciding to stop taking a medication due to a side effect, encourage the patient to contact the provider first. Patients should discard any unused antibiotic.
5. A client taking furosemide (Lasix) reports difficulty sleeping. What question is important for the nurse to ask the client?
- A. What dose of medication are you taking?
- B. Are you eating foods rich in potassium?
- C. Have you lost weight recently?
- D. At what time do you take your medication?
Correct answer: D
Rationale: The nurse needs to determine at what time of day the client takes the Lasix. Due to the diuretic effect of Lasix, clients should take the medication in the morning to prevent nocturia, which may be contributing to the sleep difficulties. Asking about the dose of medication (Choice A) is important but addressing the timing of intake is more crucial in this situation. Inquiring about potassium-rich foods (Choice B) is relevant for clients on potassium-sparing diuretics. Weight loss (Choice C) may be relevant for monitoring the client's overall health but is not directly related to the sleep issue in this case.
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