HESI RN
HESI Medical Surgical Practice Exam Questions
Question 1 of 5
Angiotensin-converting enzyme (ACE) inhibitors may be prescribed for the client with diabetes mellitus to reduce vascular changes and possibly prevent or delay the development of:
Correct Answer: C
Rationale: The correct answer is C: Renal failure. ACE inhibitors are commonly used in clients with diabetes mellitus to help reduce the progression of diabetic nephropathy by improving renal blood flow. This medication class can help prevent or delay the development of renal failure in these clients.
Choices A, B, and D are incorrect because ACE inhibitors do not have a direct impact on preventing or delaying the development of chronic obstructive pulmonary disease, pancreatic cancer, or cerebrovascular accidents in clients with diabetes mellitus.
Question 2 of 5
After three days of persistent epigastric pain, a female client presents to the clinic. She has been taking oral antacids without relief. Her vital signs are heart rate 122 beats/minute, respirations 16 breaths/minute, oxygen saturation 96%, and blood pressure 116/70. The nurse obtains a 12-lead electrocardiogram (ECG). Which assessment finding is most critical?
Correct Answer: C
Rationale: ST elevation in three leads is a critical finding that suggests myocardial infarction, requiring immediate attention. This finding indicates ischemia or injury to the heart muscle.
Choices A, B, and D are not as critical in this scenario. Irregular pulse rhythm may be concerning but does not indicate an immediate life-threatening condition like myocardial infarction. Bile-colored emesis and complaint of radiating jaw pain are relevant but not as indicative of a myocardial infarction as ST elevation in three leads.
Question 3 of 5
In a patient with chronic obstructive pulmonary disease (COPD), which of the following interventions is most important?
Correct Answer: C
Rationale: Monitoring oxygen saturation is the most important intervention in a patient with COPD because it helps assess the adequacy of oxygenation. In COPD, patients often have compromised lung function, leading to decreased oxygen levels in the blood. Monitoring oxygen saturation allows healthcare providers to promptly identify and address any potential hypoxemia, which is vital in managing COPD exacerbations. While encouraging the patient to stop smoking (
Choice
A) is critical for long-term management, monitoring oxygen saturation takes precedence in the immediate care of a COPD patient. Administering bronchodilators (
Choice
B) and providing nutritional support (
Choice
D) are important aspects of managing COPD but are secondary to monitoring oxygen saturation, which directly impacts the patient's oxygenation status.
Question 4 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 5 of 5
The nurse is assessing an older adult with a pacemaker who leads a sedentary lifestyle. The client reports being unable to perform activities that require physical exertion. The nurse should further assess the client for which of the following?
Correct Answer: A
Rationale: The correct answer is A: Left ventricular atrophy. Older adults who lead sedentary lifestyles are at risk of developing left ventricular atrophy, which can lead to decreased cardiac output during physical exertion. This condition can contribute to the client's inability to perform activities requiring physical exertion.
Choice B, irregular heartbeats, may be a consideration due to the presence of a pacemaker, but the client's reported inability to perform physically exerting activities is more indicative of a structural issue like left ventricular atrophy rather than a rhythm-related problem. Peripheral vascular occlusion (
Choice
C) is less likely to be the cause of the client's symptoms compared to the cardiac-related issue of left ventricular atrophy. While assessing pacemaker function (
Choice
D) is important, the client's symptoms are more suggestive of a cardiac structural issue rather than a malfunction of the pacemaker.