HESI RN
HESI Medical Surgical Exam
1. Which of the following is a common complication of hypertension?
- A. Diabetes.
- B. Heart failure.
- C. Kidney failure.
- D. Stroke.
Correct answer: D
Rationale: The correct answer is D: Stroke. Hypertension can lead to stroke due to the increased pressure on blood vessels in the brain, which can result in reduced blood flow and oxygen to the brain tissue. While choices B (Heart failure) and C (Kidney failure) can be complications of hypertension, they are not as directly associated as stroke. Choice A, Diabetes, is not a direct complication of hypertension but rather a separate condition that can be influenced by various factors. However, stroke is more commonly linked to the increased pressure on blood vessels in the brain in individuals with hypertension.
2. What is the most important nursing intervention for a patient with increased intracranial pressure (ICP)?
- A. Elevate the head of the bed to 30 degrees.
- B. Administer diuretics to reduce fluid volume.
- C. Administer corticosteroids to reduce inflammation.
- D. Keep the patient in a supine position.
Correct answer: A
Rationale: Elevating the head of the bed to 30 degrees is crucial for a patient with increased intracranial pressure (ICP) because it helps promote venous drainage from the brain, thereby reducing ICP. Keeping the head of the bed elevated helps facilitate cerebral perfusion and can prevent a further increase in ICP. Administering diuretics (Choice B) may be considered in some cases to reduce fluid volume, but it is not the most critical intervention for immediate ICP management. Administering corticosteroids (Choice C) is not typically indicated for managing increased ICP unless there is a specific underlying condition requiring their use. Keeping the patient in a supine position (Choice D) can actually worsen ICP by impeding venous outflow from the brain, making it an incorrect choice for this scenario.
3. Which information about mammograms is most important to provide a post-menopausal female client?
- A. Breast self-examinations are not necessary if annual mammograms are obtained.
- B. Radiation exposure is minimized by shielding the abdomen with a lead-lined apron.
- C. Yearly mammograms should be done regardless of previous normal screenings.
- D. Women at high risk should have annual routine and ultrasound mammograms.
Correct answer: C
Rationale: The most important information to provide a post-menopausal female client regarding mammograms is that yearly mammograms should be done regardless of previous normal screenings. It is crucial for post-menopausal women to continue regular mammograms as they are at a higher risk for breast cancer. Option A is incorrect as breast self-examinations are still recommended in addition to mammograms. Option B is not the most important information compared to the importance of regular mammograms. Option D is not the most important advice for all post-menopausal females but specifically for those at high risk, indicating a more targeted approach.
4. A client recovering from a cystoscopy is being assessed by a nurse. Which assessment findings should alert the nurse to urgently contact the health care provider? (Select all that apply.)
- A. Decrease in urine output
- B. Blood clots present in the urine
- C. Prescription for metformin
- D. A & B
Correct answer: D
Rationale: After a cystoscopy, the nurse should monitor urine output and promptly contact the provider if there is a decrease or absence of urine output. Additionally, the nurse should assess for blood in the urine. While some pink-tinged urine may be expected, the presence of gross bleeding or blood clots warrants immediate provider notification. Tolerating oral fluids is a positive sign and does not require urgent intervention. Metformin would be a concern if the client received contrast dye, which is not used in a cystoscopy. A burning sensation when urinating is a common post-procedure experience and does not necessitate contacting the provider. Therefore, choices A and B are the correct answers as they indicate potentially serious complications that require immediate attention, while choices C and D do not align with urgent concerns following a cystoscopy.
5. A nurse plans care for an older adult client. Which interventions should the nurse include in this client’s plan of care to promote kidney health? (Select all that apply.)
- A. Ensure adequate fluid intake.
- B. Leave the bathroom light on at night.
- C. Encourage use of the toilet every 6 hours.
- D. A & B
Correct answer: D
Rationale: The correct interventions to promote kidney health in an older adult client include ensuring adequate fluid intake to maintain hydration and leaving the bathroom light on at night to promote safe ambulation. Adequate hydration supports kidney function and helps prevent urinary tract infections. Encouraging the use of the toilet every 6 hours is not specific to kidney health and may not be individualized to the client's needs. Providing thorough perineal care after each voiding is important for hygiene but not directly related to promoting kidney health. Assessing for urinary retention and urinary tract infections is crucial but falls under assessment rather than interventions for promoting kidney health specifically.
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