HESI RN
HESI Medical Surgical Practice Exam Questions
Question 1 of 5
In a patient with chronic kidney disease, which of the following lab values would be expected?
Correct Answer: A
Rationale: In chronic kidney disease, elevated creatinine levels are expected due to impaired kidney function. Creatinine is a waste product that is typically filtered out by the kidneys. With kidney disease, the clearance of creatinine is reduced, leading to its accumulation in the blood. Low hemoglobin levels (choice B) may be seen in chronic kidney disease due to decreased production of erythropoietin. However, elevated potassium levels (choice C) and low sodium levels (choice D) are more commonly associated with kidney dysfunction but are not as specific indicators of chronic kidney disease as elevated creatinine levels.
Question 2 of 5
A client is scheduled to have an arteriogram. During the arteriogram, the client reports having nausea, tingling, and dyspnea. The nurse's immediate action should be to:
Correct Answer: B
Rationale: The correct immediate action for the nurse to take in this situation is to inform the physician. The symptoms described - nausea, tingling, and dyspnea - indicate a potential allergic reaction to the contrast dye used in the arteriogram. It is crucial to notify the physician promptly so that further assessment and appropriate interventions can be initiated. Administering epinephrine without physician guidance can be dangerous as the physician needs to evaluate the severity of the reaction and determine the necessary treatment. Administering oxygen may be needed but should be done under the physician's direction. Informing the client that the procedure is almost over is not a priority when the client is experiencing symptoms of a possible allergic reaction.
Question 3 of 5
A client with a history of peptic ulcer disease (PUD) is admitted after vomiting bright red blood several times over the course of 2 hours. In reviewing the laboratory results, the nurse finds the client's hemoglobin is 12 g/dL (120g/L) and the hematocrit is 35% (0.35). Which action should the nurse prepare to take?
Correct Answer: D
Rationale: The correct answer is to prepare the client for emergency surgery. The client's presentation with bright red blood in vomitus suggests active bleeding, which is a medical emergency. With a hemoglobin of 12 g/dL and a hematocrit of 35%, the client is likely experiencing significant blood loss that may require surgical intervention to address the source of bleeding. Continuing to monitor for blood loss (Choice A) is not appropriate in this acute situation where immediate action is necessary. Administering normal saline (Choice B) may help with fluid resuscitation but does not address the underlying cause of bleeding. Transfusing platelets (Choice C) is not indicated in this scenario as platelets are involved in clot formation and are not the primary treatment for active bleeding in this context.
Question 4 of 5
A client has driven himself to the emergency department. He is 50 years old, has a history of hypertension, and informs the nurse that his father died from a heart attack at age 60. The client has indigestion. The nurse connects him to an electrocardiogram monitor and begins administering oxygen at 2 L/min via nasal cannula. What should the nurse do next?
Correct Answer: B
Rationale: In a client presenting with possible myocardial infarction who is receiving oxygen therapy and cardiac monitoring, the next priority action is to establish IV access by starting an IV infusion. This allows for prompt administration of medications and fluids as needed in the management of acute coronary syndromes. Calling the physician (Choice A) may be necessary but is not the immediate next step. Obtaining a portable chest radiograph (Choice C) may help in further assessment but is not as crucial as establishing IV access. Drawing blood for laboratory studies (Choice D) is important for diagnostic purposes but is not as urgent compared to starting an IV infusion in the setting of a potential myocardial infarction.
Question 5 of 5
The nurse explains to the client with Hodgkin's disease that a bone marrow biopsy will be taken after the aspiration. What should the nurse explain about the biopsy?
Correct Answer: D
Rationale: A bone marrow biopsy helps determine the best treatment plan for Hodgkin's disease by providing crucial information about the extent and nature of the disease. While confirming the diagnosis is important, the primary purpose of the biopsy in this case is to guide treatment decisions. The biopsy is not primarily for assessing the extent of the disease in the bones or checking for infections in the bones.
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