HESI RN
HESI Medical Surgical Practice Quiz Questions
Question 1 of 5
The patient will take a high dose of azithromycin after discharge from the hospital. Which statement by the patient indicates understanding of the teaching?
Correct Answer: A
Rationale: The correct answer is A. Azithromycin peak levels may be reduced by antacids when taken at the same time, so patients should be cautioned to take antacids 2 hours before or 2 hours after taking the drug.
Choice B is incorrect because high-dose azithromycin carries a risk for hepatotoxicity when taken with other potentially hepatotoxic drugs such as acetaminophen.
Choice C is incorrect as diarrhea may indicate pseudomembranous colitis and should be reported, not expected as a common mild side effect.
Choice D is incorrect; there is no restriction for dairy products while taking azithromycin.
Question 2 of 5
The healthcare professional is reviewing a patient's chart prior to administering gentamicin (Garamycin) and notes that the last serum peak drug level was 9 mcg/mL and the last trough level was 2 mcg/mL. What action will the healthcare professional take?
Correct Answer: C
Rationale: Gentamicin peak levels should ideally be between 5 to 8 mcg/mL, and trough levels should be within the range of 0.5 to 2 mcg/mL to ensure therapeutic efficacy while minimizing toxicity risk. In this case, the patient's peak level is above the recommended range, and the trough level is at the higher end, indicating potential drug toxicity.
Therefore, the correct action for the healthcare professional is to report the possibility of drug toxicity to the patient's healthcare provider. Administering the next dose as prescribed (
Choice
A) would exacerbate the toxicity risk. Obtaining repeat peak and trough levels (
Choice
B) may confirm the current levels but does not address the immediate concern of potential toxicity. Reporting a decreased drug therapeutic level (
Choice
D) is not the priority in this scenario, as the focus should be on addressing the potential toxicity issue.
Question 3 of 5
A middle-aged female client with diabetes mellitus is being treated for the third episode of acute pyelonephritis in the past year. The client asks, 'What can I do to help prevent these infections?' How should the nurse respond?
Correct Answer: C
Rationale: The correct answer is C. Clients with long-standing diabetes mellitus are at risk for pyelonephritis due to various reasons. Elevated blood glucose levels in diabetes can lead to glucose spilling into the urine, altering the pH and creating a conducive environment for bacterial growth. Neuropathy associated with diabetes can reduce bladder tone and diminish the sensation of bladder fullness, resulting in less frequent voiding and increased risk of stasis and bacterial overgrowth. Increasing fluid intake, particularly water, and voiding regularly can help prevent stasis and microbial overgrowth. Testing urine for ketones and proteins or using tampons instead of sanitary napkins are not effective strategies for preventing pyelonephritis. Keeping the hemoglobin A1c levels below 9% is crucial for managing diabetes, but it alone does not directly prevent pyelonephritis.
Question 4 of 5
A client with a history of calcium phosphate urinary stones is being taught by a nurse. Which statements should the nurse include in this client's dietary teaching? (Select all that apply.)
Correct Answer: C
Rationale: For a client with a history of calcium phosphate urinary stones, it is essential to limit the intake of foods high in animal protein to prevent the formation of stones. Additionally, reducing sodium intake is crucial as high sodium levels can contribute to stone formation.
Therefore, choices A and B are correct.
Choice D, which suggests reducing intake of milk and other dairy products, is not specifically recommended for calcium phosphate stones. Clients with calcium phosphate stones should focus on limiting animal protein, sodium, and calcium intake.
Choices A and B address these dietary modifications, making them the correct options for this client.
Choices D, which is not directly related to calcium phosphate stones, is incorrect.
Question 5 of 5
After checking the client's gag reflex following an esophagogastroduodenoscopy (EGD), which action should the nurse take?
Correct Answer: A
Rationale: After an esophagogastroduodenoscopy (EG
D), the nurse's priority is to assess the client's airway by checking the gag reflex. Once this assessment is done, the next step is to take the client's vital signs to monitor for any signs of complications such as bleeding or changes in respiratory status. Giving the client water immediately after the procedure may not be appropriate, as the client may still have a compromised gag reflex and is at risk for aspiration. Monitoring for a sore throat is important but not the immediate priority post-procedure. Being alert to complaints of heartburn is relevant for assessing the client's symptoms but is not the priority immediately after checking the gag reflex.