HESI RN
HESI Medical Surgical Practice Quiz
1. The nurse is teaching a nursing student about the minimal effective concentration (MEC) of antibiotics. Which statement by the nursing student indicates understanding of this concept?
- A. A serum drug level greater than the MEC ensures that the drug is bacteriostatic.
- B. A serum drug level greater than the MEC broadens the spectrum of the drug.
- C. A serum drug level greater than the MEC helps eradicate bacterial infections.
- D. A serum drug level greater than the MEC increases the therapeutic index.
Correct answer: C
Rationale: The MEC is the minimum amount of drug needed to halt the growth of a microorganism. A level greater than the MEC helps eradicate infections. Drugs at or above the MEC are usually bactericidal, not bacteriostatic. Therefore, choice A is incorrect. Broadening the spectrum of a drug refers to its range of activity against different microorganisms, which is not directly related to MEC. Thus, choice B is incorrect. Increasing the therapeutic index involves maximizing the effectiveness of a drug while minimizing its toxicity, which is not specifically related to MEC. Therefore, choice D is also incorrect.
2. An older client with long-term type 2 diabetes Mellitus (DM) is seen in the clinic for a routine health assessment. Which assessment would the nurse complete to determine if a patient with type 2 diabetes Mellitus (DM) is experiencing long-term complications?
- A. Signs of respiratory tract infection
- B. Sensation in feet and legs
- C. Skin condition of lower extremities
- D. Serum creatinine and blood urea nitrogen (BUN)
Correct answer: B
Rationale: Assessing sensation in the feet and legs is crucial for detecting diabetic neuropathy, a common long-term complication of diabetes. While signs of respiratory tract infection, skin condition of lower extremities, and serum creatinine and blood urea nitrogen levels are important assessments in diabetic care, they are not specific for detecting long-term complications like neuropathy.
3. A nurse cares for adult clients who experience urge incontinence. For which client should the nurse plan a habit training program?
- A. A 78-year-old female who is confused
- B. A 65-year-old male with diabetes mellitus
- C. A 52-year-old female with kidney failure
- D. A 47-year-old male with arthritis
Correct answer: A
Rationale: For a bladder training program to succeed in a client with urge incontinence, the client must be alert, aware, and able to resist the urge to urinate. Habit training will work best for a confused client. This includes going to the bathroom (or being assisted to the bathroom) at set times. The other clients may benefit from other types of bladder training. A confused client may need structured assistance to establish a regular bathroom routine, which can help manage urge incontinence effectively. Clients with diabetes mellitus, kidney failure, or arthritis may require different strategies tailored to their specific conditions.
4. A nurse plans care for clients with urinary incontinence. Which client is correctly paired with the appropriate intervention?
- A. A 29-year-old client after a difficult vaginal delivery – Habit training
- B. A 58-year-old postmenopausal client who is not taking estrogen therapy – Electrical stimulation
- C. A 64-year-old female with Alzheimer’s-type senile dementia – Bladder training
- D. A 77-year-old female who has difficulty ambulating – Exercise therapy
Correct answer: B
Rationale: The correct pairing is a 58-year-old postmenopausal client who is not taking estrogen therapy with electrical stimulation. Electrical stimulation is used for clients with stress incontinence related to menopause and low estrogen levels. Exercise therapy improves pelvic wall strength and is not specifically for ambulation issues. Habit training is more effective for cognitively impaired clients, like those with Alzheimer's-type senile dementia. Bladder training requires the client to be alert, aware, and able to resist the urge to urinate, which may not be suitable for clients with cognitive impairments.
5. A client who has had two episodes of bacterial cystitis in the last 6 months is being assessed by a nurse. Which questions should the nurse ask? (Select all that apply.)
- A. How much water do you drink every day?
- B. Do you take estrogen replacement therapy?
- C. Does anyone in your family have a history of cystitis?
- D. All of the Above
Correct answer: D
Rationale: The correct answers are all of the above (D). Asking about fluid intake (choice A) is important as it can affect the risk of cystitis. Estrogen levels (choice B) can also impact the likelihood of recurrent cystitis. Family history (choice C) is relevant as certain genetic factors can predispose individuals to cystitis. Cranberry juice, not grapefruit or orange juice, has been found to reduce the risk of bacterial cystitis by increasing the acidic pH. Therefore, choices A, B, and C are all pertinent questions to ask during the assessment of a client with recurrent bacterial cystitis.
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