HESI RN
HESI Medical Surgical Practice Quiz
1. The patient is receiving sulfadiazine. The healthcare provider knows that this patient’s daily fluid intake should be at least which amount?
- A. 1000 mL/day
- B. 1200 mL/day
- C. 2000 mL/day
- D. 2400 mL/day
Correct answer: C
Rationale: Sulfadiazine may lead to crystalluria, a condition where crystals form in the urine. Adequate fluid intake helps prevent this adverse effect by ensuring urine is dilute enough to prevent crystal formation. The recommended daily fluid intake for a patient receiving sulfadiazine is at least 2000 mL/day. Choices A, B, and D are incorrect because they do not provide a sufficient amount of fluid intake to prevent crystalluria in patients on sulfadiazine.
2. The client had a thyroidectomy 24 hours ago and reports experiencing numbness and tingling of the face. Which intervention should the nurse implement?
- A. Open and prepare the tracheostomy kit.
- B. Inspect the neck for an increase in swelling.
- C. Monitor for the presence of Chvostek's sign.
- D. Assess lung sounds for laryngeal stridor.
Correct answer: C
Rationale: The correct answer is C: Monitor for the presence of Chvostek's sign. Chvostek's sign is a clinical indicator of hypocalcemia, a common complication after thyroidectomy. Numbness and tingling around the face are associated with hypocalcemia due to potential damage to the parathyroid glands during surgery, leading to decreased calcium levels. Inspecting the neck for swelling (choice B) is important but does not directly address the presenting symptoms. Opening and preparing the tracheostomy kit (choice A) is not necessary based on the client's current symptoms. Assessing lung sounds for laryngeal stridor (choice D) is not directly related to the client's reported numbness and tingling of the face.
3. Which of the following interventions is most appropriate for a patient with left-sided heart failure?
- A. Administering IV fluids.
- B. Administering oxygen.
- C. Administering diuretics.
- D. Administering antihypertensives.
Correct answer: B
Rationale: Administering oxygen is the most appropriate intervention for a patient with left-sided heart failure because it helps improve oxygenation. In left-sided heart failure, the heart struggles to pump oxygen-rich blood to the body, leading to inadequate oxygen supply to tissues. Administering oxygen can help alleviate symptoms of hypoxia and reduce the workload on the heart. IV fluids (Choice A) may exacerbate heart failure by increasing fluid volume, diuretics (Choice C) are used to reduce fluid overload in heart failure, and antihypertensives (Choice D) are more suitable for managing hypertension, which may be a comorbidity in heart failure but are not the primary intervention for left-sided heart failure.
4. Which of the following is the most appropriate diet for a client during the acute phase of myocardial infarction?
- A. Liquids as desired.
- B. Small, easily digested meals.
- C. Three regular meals per day.
- D. Nothing by mouth.
Correct answer: B
Rationale: During the acute phase of myocardial infarction, it is recommended to provide small, easily digested meals for the client. This type of diet is better tolerated as it reduces the workload on the heart, allowing for easier digestion and absorption of nutrients. Choice A, 'Liquids as desired,' may not provide adequate nutrition and may not be well-balanced. Choice C, 'Three regular meals per day,' may be too heavy for the client's weakened condition. Choice D, 'Nothing by mouth,' is not appropriate as the client still requires essential nutrients for recovery.
5. A client's urinalysis results show a urine osmolality of 1200 mOsm/L. What action should the nurse take?
- A. Encourage the client to drink more fluids.
- B. Contact the provider and recommend a low-sodium diet.
- C. Prepare to administer an intravenous diuretic.
- D. Obtain a suction device and implement seizure precautions.
Correct answer: A
Rationale: The correct action for the nurse to take when the client has a urine osmolality of 1200 mOsm/L, indicating dehydration, is to encourage the client to drink more fluids. Dehydration can lead to elevated urine osmolality, and increasing fluid intake can help rehydrate the client. A low-sodium diet is not the priority in this scenario as it would not directly address the dehydration indicated by the high urine osmolality. Administering an intravenous diuretic would further concentrate the urine, exacerbating the dehydration. Obtaining a suction device and implementing seizure precautions are not indicated based on the client's urine osmolality results and would not address the underlying issue of dehydration.
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