HESI RN
HESI Medical Surgical Practice Exam Questions
Question 1 of 5
A client with chronic renal failure is receiving epoetin alfa (Epogen). The nurse should assess the client for which of the following complications?
Correct Answer: A
Rationale: The correct answer is A: Hypertension. Epoetin alfa (Epogen) is known to increase blood pressure by stimulating red blood cell production. Monitoring for hypertension is crucial to prevent complications such as heart failure or stroke.
Choices B, C, and D are incorrect because hypotension, hyperglycemia, and edema are not typically associated with epoetin alfa therapy in clients with chronic renal failure.
Question 2 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.
Question 3 of 5
A client is receiving a continuous infusion of normal saline at 125 ml/hour post abdominal surgery. The client is drowsy and complaining of constant abdominal pain and a headache. Urine output is 800 ml over the past 24 hours with a central venous pressure of 15 mmHg. The nurse notes respiratory crackles and bounding central pulse. Vital signs: temperature 101.2 F (38.4 C), heart rate 96 beats/minute, respiration 24 breaths/minute, and blood pressure of 160/90 mmHg. Which intervention should the nurse implement first?
Correct Answer: C
Rationale: In this scenario, the client is showing signs of fluid volume excess, such as drowsiness, abdominal pain, headache, crackles in the lungs, bounding pulse, and elevated blood pressure. Decreasing the IV fluids to a keep vein open (KVO) rate is crucial to prevent further fluid overload. This intervention helps in balancing fluid intake and output to prevent complications associated with fluid volume excess. Calculating total intake and output (
Choice
A) may be necessary but not the immediate priority in managing fluid overload. Administering acetaminophen (
Choice
B) may help with managing the fever but does not address the underlying issue of fluid overload. Reviewing the last administration of IV pain medication (
Choice
D) is not the priority in this situation where fluid overload is a concern.
Question 4 of 5
The client is being educated by the healthcare provider about risk factors associated with atherosclerosis and methods to reduce the risk. Which of the following is a risk factor that the client cannot modify?
Correct Answer: B
Rationale: Age is a nonmodifiable risk factor for atherosclerosis because it is a natural part of the aging process. While lifestyle factors such as diabetes, exercise level, and dietary preferences can be modified to reduce the risk of atherosclerosis, age cannot be altered.
Therefore, age is the correct answer. Diabetes, exercise level, and dietary preferences can all be improved or managed through interventions and lifestyle changes to mitigate the risk of atherosclerosis.
Question 5 of 5
The healthcare provider assesses a client with cirrhosis and finds 4+ pitting edema of the feet and legs, and massive ascites. Which mechanism contributes to edema and ascites in clients with cirrhosis?
Correct Answer: D
Rationale: In clients with cirrhosis, hypoalbuminemia leads to decreased colloidal oncotic pressure. This reduction in oncotic pressure contributes to the development of edema in the feet and legs (pitting edema) and ascites in the abdomen. Hyperaldosteronism (choice
A) would lead to sodium retention but is not the primary mechanism behind edema and ascites in cirrhosis. Decreased portacaval pressure with greater collateral circulation (choice
B) is not directly related to the pathophysiology of edema and ascites in cirrhosis. Decreased renin-angiotensin response related to increased renal blood flow (choice
C) does not play a significant role in the development of edema and ascites in cirrhosis compared to the impact of hypoalbuminemia on colloidal oncotic pressure.