HESI RN
HESI Medical Surgical Assignment Exam
1. 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.
2. In a patient with chronic kidney disease, which of the following is a common electrolyte imbalance?
- A. Hyperkalemia.
- B. Hypokalemia.
- C. Hypernatremia.
- D. Hyponatremia.
Correct answer: A
Rationale: Hyperkalemia is a common electrolyte imbalance in chronic kidney disease. In chronic kidney disease, the kidneys' reduced function leads to the decreased excretion of potassium, resulting in elevated serum potassium levels. This can be dangerous as hyperkalemia can lead to life-threatening arrhythmias. Hypokalemia (Choice B) is less common in chronic kidney disease as the impaired kidneys tend to retain potassium. Hypernatremia (Choice C) is more commonly seen in conditions such as dehydration, not primarily in chronic kidney disease. Hyponatremia (Choice D) is also possible in chronic kidney disease but is less common compared to hyperkalemia.
3. In a patient with anemia, which of the following is the primary symptom to assess?
- A. Fever.
- B. Chest pain.
- C. Shortness of breath.
- D. Muscle cramps.
Correct answer: C
Rationale: The correct answer is C: Shortness of breath. In a patient with anemia, the primary symptom to assess is shortness of breath. Anemia leads to a reduced oxygen-carrying capacity of the blood, resulting in tissues not receiving adequate oxygen. This can manifest as shortness of breath, especially during physical exertion. Fever (Choice A), chest pain (Choice B), and muscle cramps (Choice D) are not typically primary symptoms of anemia. Fever may suggest an infection, chest pain can be indicative of cardiac issues, and muscle cramps may be related to electrolyte imbalances or neuromuscular disorders.
4. Blood is drawn from a client with suspected uric acid calculi for a serum uric acid determination. Which value does the nurse recognize as a normal uric acid level?
- A. 1.7 mg/dL
- B. 5.8 mg/dL
- C. 8.9 mg/dL
- D. 12.8 mg/dL
Correct answer: B
Rationale: The normal range for uric acid is 4.5 to 8 mg/dL for males and 2.5 to 6.2 mg/dL for females. A uric acid level of 5.8 mg/dL falls within the normal range. Choices A, C, and D are outside the normal reference range, making them incorrect. Choice B is the correct answer as it aligns with the typical uric acid levels in the blood.
5. Which of the following is a priority intervention for a patient with suspected sepsis?
- A. Administering antibiotics.
- B. Administering IV fluids.
- C. Administering antipyretics.
- D. Monitoring blood cultures.
Correct answer: D
Rationale: Monitoring blood cultures is a crucial intervention in suspected sepsis because it helps identify the causative organism, which is essential for guiding appropriate antibiotic therapy. Administering antibiotics (Choice A) is important but should be guided by blood culture results. Administering IV fluids (Choice B) is also essential to support hemodynamic stability in sepsis. Administering antipyretics (Choice C) may help reduce fever but is not a priority compared to identifying the causative organism through blood cultures.
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