HESI RN
HESI Medical Surgical Exam
1. Which of the following is an expected finding in a patient with hypothyroidism?
- A. Weight gain.
- B. Weight loss.
- C. Increased appetite.
- D. Diarrhea.
Correct answer: A
Rationale: Weight gain is an expected finding in hypothyroidism due to the decreased metabolic rate. Hypothyroidism leads to a slowing down of bodily functions, including metabolism, which can result in weight gain. Weight loss (Choice B) is more commonly associated with hyperthyroidism where there is an increase in metabolic rate. Increased appetite (Choice C) is also more typical of hyperthyroidism as the body is burning energy at a faster rate. Diarrhea (Choice D) is not a typical symptom of hypothyroidism; instead, constipation is more often observed due to the slowing down of the digestive system.
2. A client has been scheduled for magnetic resonance imaging (MRI). For which of the following conditions, a contraindication to MRI, does the nurse check the client’s medical history?
- A. Pancreatitis
- B. Pacemaker insertion
- C. Type 1 diabetes mellitus
- D. Chronic airway limitation
Correct answer: B
Rationale: The correct answer is B: Pacemaker insertion. Patients with metal devices or implants are contraindicated for MRI. These include pacemakers, orthopedic hardware, artificial heart valves, aneurysm clips, and intrauterine devices. These metal objects can be affected by the strong magnetic field of the MRI, leading to serious risks for the patient. Pancreatitis (choice A), Type 1 diabetes mellitus (choice C), and chronic airway limitation (choice D) are not contraindications to MRI based on the presence of metal objects. Therefore, the nurse should be particularly concerned about pacemaker insertion when reviewing the client's medical history prior to an MRI.
3. Upon arrival of a client transferred to the surgical unit, what should the nurse plan to do first?
- A. Assess the patency of the airway
- B. Check tubes and drains for patency
- C. Check the dressing for bleeding
- D. Assess the vital signs to compare them with preoperative measurements
Correct answer: A
Rationale: The initial action for the nurse upon the arrival of a client to the surgical unit is to assess the patency of the airway. This step takes priority to ensure that the client has a clear airway for adequate breathing. Checking tubes and drains for patency, inspecting the dressing for bleeding, and assessing vital signs to compare with preoperative measurements are important subsequent steps in the assessment process. However, ensuring the airway is patent is the immediate priority to maintain the client's respiratory function and overall well-being.
4. When planning care for a client newly diagnosed with open-angle glaucoma, the nurse identifies a priority nursing problem of 'visual sensory/perceptual alterations.' This problem is based on which etiology?
- A. Blurred distance vision
- B. Limited eye movement
- C. Decreased peripheral vision
- D. Photosensitivity
Correct answer: C
Rationale: The correct answer is 'C: Decreased peripheral vision.' Open-angle glaucoma leads to a gradual loss of peripheral vision due to damage to the optic nerve. This loss of peripheral vision is a hallmark sign of the condition and a primary reason for the visual sensory/perceptual alterations experienced by the client. Blurred distance vision (choice A) may occur but is not the priority nursing problem. Limited eye movement (choice B) and photosensitivity (choice D) are not typically associated with the sensory/perceptual alterations seen in open-angle glaucoma.
5. When planning activities for a socialization group for older residents of a long-term facility, what information would be most useful for the nurse?
- A. The length of time each resident has resided at the facility.
- B. A brief description of each resident's family life.
- C. The age of each resident.
- D. The usual activity patterns of each resident.
Correct answer: D
Rationale: The most useful information for the nurse when planning activities for a socialization group for older residents of a long-term facility would be the usual activity patterns of each resident. An older person's level of activity is a determining factor in adjustment to aging, as described by the Activity Theory of Aging. By understanding the usual activity patterns of each resident, the nurse can tailor activities that cater to their interests and abilities, promoting social engagement and overall well-being. The other options, such as the length of time residing at the facility, a brief description of family life, or the age of each resident, may provide some insights but do not directly relate to planning activities that support adjustment to aging and socialization within the group.
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