HESI Medical Surgical Test Bank

Questions 61

HESI RN

HESI RN Test Bank

HESI Medical Surgical Test Bank Questions

Question 1 of 5

The nurse assesses a client who is newly diagnosed with hyperthyroidism and observes that the client's eyeballs are protuberant, causing a wide-eyed appearance and eye discomfort. Based on this finding, which action should the nurse include in the client's plan of care?

Correct Answer: D

Rationale: In hyperthyroidism, eye discomfort due to protuberant eyeballs (exophthalmos) can be alleviated by using artificial tear drops. These drops help prevent complications associated with dry eyes and promote comfort. Assessing for signs of increased intracranial pressure (Choice A) is not directly related to the client's eye discomfort from hyperthyroidism. Administering intravenous levothyroxine (Choice B) is not the appropriate intervention for managing eye discomfort in hyperthyroidism. Reviewing serum electrolyte values (Choice C) is important in hyperthyroidism but is not directly addressing the client's current eye discomfort and protuberant eyeballs.

Question 2 of 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?

Correct Answer: A

Rationale: The statement indicates a misunderstanding because medication for CAD should be taken as prescribed, not only when chest pain occurs.

Question 3 of 5

Which lab result would be most indicative of renal failure?

Correct Answer: A

Rationale: The correct answer is A: Elevated creatinine levels. Creatinine is a waste product that is normally filtered by the kidneys. Elevated creatinine levels indicate impaired kidney function, which is commonly seen in renal failure. Choice B, low potassium levels, is not typically associated with renal failure. In fact, renal failure is more likely to cause high potassium levels due to the kidneys' inability to excrete potassium effectively. Choice C, low calcium levels, are not directly indicative of renal failure. Renal failure can lead to disturbances in calcium levels, but low calcium levels alone are not a specific marker for renal failure. Choice D, high sodium levels, are also not typically associated with renal failure. In renal failure, there may be disturbances in sodium levels, but high sodium levels alone are not a direct indicator of renal failure.

Question 4 of 5

A client is to have a transsphenoidal hypophysectomy to remove a large, invasive pituitary tumor. The nurse should instruct the client that the surgery will be performed through an incision in the:

Correct Answer: D

Rationale: The correct answer is D: Upper gingival mucosa in the space between the upper gums and lip. A transsphenoidal hypophysectomy involves accessing the pituitary gland through an incision in the upper gingival mucosa, providing direct access to the pituitary gland without external scars. Choices A, B, and C are incorrect because the surgery is not performed through the back of the mouth, the nose, or the sinus channel below the right eye. It is crucial for the client to understand the specific location of the incision to ensure accurate preoperative education and expectations.

Question 5 of 5

The nurse is monitoring a client who is receiving continuous ambulatory peritoneal dialysis. The nurse should notify the physician of which of the following findings?

Correct Answer: B

Rationale: Cloudy dialysate outflow is an indication of peritonitis, a serious complication of peritoneal dialysis that requires immediate medical attention. Clear dialysate outflow is a normal finding indicating proper dialysis function and should not raise concern. Decreased urine output may be expected in a client undergoing dialysis due to the removal of excess fluids from the body. Increased blood pressure is a common complication in clients with kidney disease but is not directly related to cloudy dialysate outflow.

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