HESI RN
HESI Medical Surgical Exam
1. Which of the following assessments is the most important for a patient receiving IV potassium?
- A. Respiratory rate
- B. Heart rate
- C. Blood pressure
- D. Oxygen saturation
Correct answer: C
Rationale: The most important assessment for a patient receiving IV potassium is monitoring blood pressure. IV potassium can cause significant changes in cardiac function, leading to adverse effects such as arrhythmias and cardiac arrest. While respiratory rate, heart rate, and oxygen saturation are important parameters to monitor in clinical practice, blood pressure takes precedence in patients receiving IV potassium due to its direct impact on cardiovascular function. Changes in blood pressure can be an early indicator of potassium-induced cardiac complications, making it crucial to monitor closely during administration.
2. Which of the following medications is commonly prescribed for hypertension?
- A. Atenolol
- B. Aspirin
- C. Ibuprofen
- D. Metformin
Correct answer: A
Rationale: The correct answer is Atenolol. Atenolol is a beta-blocker commonly prescribed to manage hypertension due to its ability to reduce the heart rate and lower blood pressure. Options B, C, and D are incorrect because aspirin, ibuprofen, and metformin are not typically used as first-line treatments for hypertension. Aspirin is more commonly used for its antiplatelet effects, ibuprofen is a nonsteroidal anti-inflammatory drug, and metformin is primarily used for managing diabetes.
3. A 68-year-old client on day 2 after hip surgery has no cardiac history but reports having chest heaviness. The first nursing action should be to:
- A. Inquire about the onset, duration, severity, and precipitating factors of the heaviness.
- B. Administer oxygen via nasal cannula.
- C. Offer pain medication for the chest heaviness.
- D. Inform the physician of the chest heaviness.
Correct answer: A
Rationale: The correct first nursing action when a client reports chest heaviness post-hip surgery is to gather more information through assessment. Inquiring about the onset, duration, severity, and precipitating factors of the heaviness is crucial to determine the cause. This approach helps the nurse to gather essential data to make an informed decision regarding the client's care. Administering oxygen (Choice B) may be indicated based on assessment findings, but it is crucial to assess first. Offering pain medication (Choice C) without further assessment is premature and may mask symptoms. Informing the physician (Choice D) should be done after a thorough assessment to provide comprehensive information for appropriate medical decision-making.
4. A client with acute glomerulonephritis (GN) is being evaluated by a nurse. Which manifestation should the nurse recognize as a positive response to the prescribed treatment?
- A. The client has lost 11 pounds in the past 10 days.
- B. The client’s urine specific gravity is 1.048.
- C. No blood is observed in the client’s urine.
- D. The client’s blood pressure is 152/88 mm Hg.
Correct answer: A
Rationale: A weight loss of 11 pounds in the past 10 days indicates fluid loss, a positive response to treatment for acute glomerulonephritis. It signifies that the glomeruli are functioning adequately to filter excess fluid. A urine specific gravity of 1.048 is high, indicating concentrated urine, which is not a positive response in this context. Blood in the urine is not a typical finding in glomerulonephritis, so its absence is expected and does not indicate a positive response to treatment. A blood pressure of 152/88 mm Hg is elevated and may suggest kidney damage or fluid overload, which are not positive responses to treatment.
5. The healthcare provider is assessing a client with chronic renal failure who is receiving hemodialysis. Which of the following findings would indicate that the client is experiencing a complication of the treatment?
- A. Clear dialysate outflow.
- B. Blood pressure of 150/90 mm Hg.
- C. Increased heart rate.
- D. Fatigue.
Correct answer: B
Rationale: A blood pressure of 150/90 mm Hg during hemodialysis may indicate fluid overload or an ineffective dialysis session, which can lead to complications such as heart failure or pulmonary edema. This finding should be reported promptly for further evaluation and intervention. Clear dialysate outflow is a normal and expected finding during hemodialysis, indicating proper filtration of waste products. Increased heart rate can be a normal compensatory response to hemodialysis due to fluid shifts and should be monitored but does not necessarily indicate a complication. Fatigue is a common symptom in clients with chronic renal failure undergoing hemodialysis and is not specific to complications of the treatment.
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