HESI RN
HESI Medical Surgical Practice Exam
1. Which of the following lab values would be most concerning in a patient receiving heparin therapy?
- A. Elevated hemoglobin levels.
- B. Low platelet count.
- C. High potassium levels.
- D. Low sodium levels.
Correct answer: B
Rationale: A low platelet count is most concerning in patients receiving heparin therapy due to the risk of heparin-induced thrombocytopenia. Heparin can sometimes cause a drop in platelet count, leading to a potentially serious condition where blood does not clot as it should. This can result in excessive bleeding or clot formation in blood vessels. Elevated hemoglobin levels, high potassium levels, and low sodium levels are not typically associated with heparin therapy and are less likely to cause immediate concerns or complications in this context.
2. A client who has undergone pleural biopsy is being monitored by a nurse. Which finding indicates a potential complication for the client?
- A. Warm, dry skin
- B. Mild pain at the biopsy site
- C. Complaints of shortness of breath
- D. Capillary refill time of less than 3 seconds
Correct answer: C
Rationale: Complaints of shortness of breath are a concerning finding post-pleural biopsy, as they may indicate a complication such as a pneumothorax or hemothorax. Shortness of breath can be a sign of respiratory distress that requires immediate attention. Warm, dry skin, mild pain at the biopsy site, and a capillary refill time of less than 3 seconds are not typically associated with immediate complications following a pleural biopsy. Warm, dry skin may be a normal finding, mild pain can be expected at the biopsy site, and a capillary refill time of less than 3 seconds is within normal limits.
3. A patient with a diagnosis of Cushing's syndrome is likely to exhibit which of the following symptoms?
- A. Hyperpigmentation.
- B. Moon face.
- C. Hypotension.
- D. Hypertension.
Correct answer: B
Rationale: The correct answer is B: Moon face. Cushing's syndrome is characterized by excess cortisol levels, leading to the distinctive round and full face known as moon face. Hyperpigmentation (choice A) may occur due to increased ACTH levels, but it is not a hallmark symptom like moon face. Hypotension (choice C) is less common in Cushing's syndrome as cortisol typically leads to hypertension (choice D) due to its effects on blood pressure regulation.
4. A nurse teaches a client who is recovering from a nephrectomy secondary to kidney trauma. Which statement should the nurse include in this client’s teaching?
- A. Since you only have one kidney, a salt and fluid restriction is required.
- B. Your therapy will include hemodialysis while you recover.
- C. Medication will be prescribed to control your high blood pressure.
- D. You need to avoid participating in contact sports like football.
Correct answer: D
Rationale: Clients with one kidney need to avoid contact sports because the kidneys are easily injured. The client will not be required to restrict salt and fluids, end up on dialysis, or have new hypertension because of the nephrectomy.
5. The nurse is providing discharge teaching to a client with coronary artery disease (CAD). Which of the following statements by the client indicates a need for further teaching?
- A. I will take my medication only when I have chest pain.
- B. I will follow a heart-healthy diet and exercise regularly.
- C. I will avoid smoking and limit alcohol intake.
- D. I will contact my doctor if I experience chest pain or shortness of breath.
Correct answer: A
Rationale: The statement indicates a misunderstanding because medication for CAD should be taken as prescribed, not only when chest pain occurs.
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