HESI Medical Surgical Test Bank

Correct Answer: A

Rationale: Administering insulin is a crucial intervention for a patient with diabetic ketoacidosis (DKA) because it helps in managing hyperglycemia and ketosis by promoting the uptake of glucose by cells and inhibiting the production of ketones. IV fluids are necessary to correct dehydration and electrolyte imbalances commonly seen in DKA but are not the primary treatment for the condition. Administering oral glucose would exacerbate hyperglycemia in a patient with DKA, while administering oral fluids alone would not effectively address the underlying metabolic disturbances seen in DKA.

Correct Answer: B

Rationale: The correct answer is B. Crackles in the bases of the lungs are indicative of fluid accumulation, which is common in left-sided heart failure. In left-sided heart failure, the heart is unable to effectively pump blood from the lungs to the rest of the body, leading to a backup of fluid in the lungs. This results in crackles heard on auscultation. Choices A, C, and D are not specific to left-sided heart failure. An enlarged, distended abdomen may indicate ascites or liver congestion. Jugular vein distension is more commonly associated with right-sided heart failure, and peripheral edema is a sign of fluid accumulation in the tissues, which can occur in both types of heart failure but is not as specific to left-sided heart failure as crackles in the lungs.

Correct Answer: B

Rationale: A low-protein diet is necessary for clients with chronic renal failure because it helps prevent the buildup of waste products, such as urea, in the body. Excess protein can lead to the accumulation of waste products that the compromised kidneys may not effectively filter out, further burdening the already impaired renal function. Choices A, C, and D are incorrect because the primary reason for a low-protein diet in chronic renal failure is to reduce the workload on the kidneys by minimizing the production of waste products that can exacerbate the condition, not specifically to reduce kidney workload, maintain electrolyte balance, or prevent dehydration.

Correct Answer: C

Rationale: Daily weight is the most crucial parameter to assess when evaluating the effects of peritoneal dialysis because it directly reflects fluid balance. Peritoneal dialysis involves the removal of excess fluid and waste products from the body. Monitoring daily weight enables the healthcare provider to track changes in fluid status, ensuring that the dialysis treatment is effective. While serum potassium levels, blood pressure, and serum sodium levels are important parameters to monitor in patients undergoing dialysis, they are not as directly indicative of the immediate effects of peritoneal dialysis on fluid balance as daily weight.

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.