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. In a patient with asthma, which of the following is a primary goal of treatment?
- A. Improving oxygenation.
- B. Reducing inflammation.
- C. Improving airflow.
- D. Reducing airway constriction.
Correct answer: C
Rationale: The primary goal in the treatment of asthma is to improve airflow. Asthma is characterized by airway inflammation, constriction, and increased mucus production, leading to airflow limitation. Improving airflow helps ensure adequate oxygenation and reduces symptoms. While reducing inflammation and airway constriction are important aspects of asthma management, the primary goal is to optimize airflow to improve respiratory function and quality of life.
3. A client with chronic obstructive pulmonary disease (COPD) presented with shortness of breath. Oxygen therapy was started at 2 liters/minute via nasal cannula. The arterial blood gases (ABGs) after treatment were pH 7.36, PaO2 62, PaCO2 59, and HCO3. Which statement describes the most likely cause of the simultaneous increase in both the PaO2 and the PaCO2?
- A. The hypercapnia resulted from the rapid respirations.
- B. The hypoxic drive was reduced by the oxygen therapy.
- C. The client had a pneumothorax which restricted ventilation.
- D. The client had a pulmonary embolism that reduced perfusion.
Correct answer: B
Rationale: In patients with COPD, oxygen therapy can reduce the hypoxic drive, which is the primary stimulus for breathing in these individuals. By providing supplemental oxygen, the hypoxic drive is diminished, resulting in decreased respiratory effort. As a consequence, the PaO2 may increase due to the supplemental oxygen, but this can lead to a decrease in the respiratory drive and subsequent retention of carbon dioxide, causing an increase in PaCO2 levels. Option A is incorrect because rapid respirations would typically lower PaCO2 levels. Option C is incorrect as a pneumothorax would lead to impaired gas exchange and decreased PaO2 levels without necessarily affecting PaCO2 levels. Option D is incorrect as a pulmonary embolism would typically result in ventilation-perfusion mismatch and decreased PaO2 levels without directly impacting PaCO2 levels.
4. The nurse is caring for a patient who is receiving furosemide (Lasix) and an aminoglycoside antibiotic. The nurse will be most concerned if the patient reports which symptom?
- A. Dizziness
- B. Dysuria
- C. Nausea
- D. Tinnitus
Correct answer: D
Rationale: The correct answer is D: Tinnitus. When furosemide and an aminoglycoside antibiotic are used together, there is an increased risk of ototoxicity. Tinnitus, a ringing in the ears, is a common early sign of ototoxicity. Dizziness (choice A) is a common side effect of furosemide but not specifically related to this drug interaction. Dysuria (choice B) is painful urination and is not directly associated with this drug combination. Nausea (choice C) is a common side effect of furosemide but is not specifically indicative of ototoxicity caused by the drug interaction.
5. Which of the following is a common sign of meningitis?
- A. Joint pain.
- B. Severe headache.
- C. Stiff neck.
- D. Coughing up blood.
Correct answer: C
Rationale: A stiff neck is a common sign of meningitis due to inflammation of the meninges. Meningitis typically presents with symptoms such as fever, severe headache, nausea, vomiting, sensitivity to light, and a stiff neck. Joint pain (Choice A) is not a typical symptom of meningitis and is more commonly associated with other conditions. While severe headache (Choice B) can be a symptom of meningitis, it is not as specific as a stiff neck. Coughing up blood (Choice D) is not a typical sign of meningitis and may indicate other respiratory or cardiovascular issues.
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