HESI RN
HESI Medical Surgical Test Bank Questions
Question 1 of 5
A middle-aged adult with a family history of CAD has the following: total cholesterol 198 (11 mmol/L); LDL cholesterol 120 (6.7 mmol/L); HDL cholesterol 58 (3.2 mmol/L); triglycerides 148 (8.2 mmol/L); blood sugar 102 (5.7 mmol/L); and C-reactive protein (CRP) 4.2. The health care provider prescribes a statin medication and aspirin. The client asks the nurse why these medications are needed. Which is the best response by the nurse?
Correct Answer: C
Rationale: The correct answer is C) The CRP is elevated indicating inflammation seen in cardiovascular disease, which can be lowered by the medications prescribed. Explanation: Elevated CRP levels indicate inflammation, which plays a crucial role in the development and progression of cardiovascular disease (CVD). Statin medications are commonly prescribed to reduce LDL cholesterol levels and have been shown to decrease inflammation in addition to lowering cholesterol. Aspirin is often recommended for its anti-inflammatory properties, which can help reduce the risk of clot formation in blood vessels. By addressing inflammation, these medications can help prevent further damage to the arteries and reduce the risk of cardiovascular events like heart attacks and strokes. Why the other options are wrong: A) The labs do not indicate severe hyperlipidemia, as the total cholesterol and LDL levels are within acceptable ranges. While lowering LDL cholesterol is important, the primary indication for prescribing the medications in this case is to address inflammation related to CVD. B) While elevated triglycerides can be a concern, they are not the primary focus in this scenario. The medications are prescribed mainly to target inflammation and reduce cardiovascular risk. D) While statins have been shown to have some benefits in reducing the risk of type 2 diabetes, the primary reason for prescribing them in this case is to address inflammation associated with CVD. Educational context: Understanding the rationale behind prescribing medications for cardiovascular risk factors is essential for nurses caring for patients with a history of CAD. Recognizing the role of inflammation in CVD and how medications like statins and aspirin can help address this aspect of the disease is crucial for providing effective patient education and promoting adherence to treatment plans. By explaining the reasons behind medication regimens, nurses can empower patients to take an active role in managing their cardiovascular health.
Question 2 of 5
The best indicator that the client has learned how to give an insulin self-injection correctly is when the client can:
Correct Answer: A
Rationale: The best indicator of learning is the ability to perform the procedure safely and correctly, demonstrating skill acquisition. Choice A is correct because the client's ability to perform the insulin self-injection safely and correctly shows practical understanding and application of the skill. Choice B is incorrect because critiquing the nurse's performance does not necessarily demonstrate the client's ability to carry out the procedure themselves. Choice C is incorrect as merely explaining the steps verbally does not confirm the client's practical execution of the task. Choice D is also incorrect as answering a post-test does not directly assess the client's ability to physically perform the insulin self-injection.
Question 3 of 5
The nurse is caring for a client who is receiving an IV infusion of normal saline and notices that the infusion is not flowing. The insertion site is not inflamed or swollen. What should the nurse do first?
Correct Answer: A
Rationale: The correct first action for the nurse to take when an IV infusion is not flowing despite a normal insertion site is to check the tubing for kinks or obstructions. This step is crucial to ensure that there are no preventable issues impeding the flow of the IV solution. Increasing the flow rate without addressing potential obstructions could lead to complications such as infiltration. Reinserting the IV catheter in another vein should only be considered after ruling out tubing issues. Calling the physician for further instructions is not necessary at this stage as troubleshooting the tubing should be the initial intervention.
Question 4 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: Rationale: The correct answer is A) "I will take my medication only when I have chest pain." This statement indicates a need for further teaching because medications for coronary artery disease (CAD), such as antiplatelets, statins, and beta-blockers, are prescribed to be taken regularly, not just when symptoms occur. This misconception can lead to inadequate management of the disease and increased risk of complications. Option B) "I will follow a heart-healthy diet and exercise regularly" is a correct statement in managing CAD. A heart-healthy diet low in saturated fats and regular exercise help improve cardiovascular health and reduce the progression of CAD. Option C) "I will avoid smoking and limit alcohol intake" is also a correct statement. Smoking and excessive alcohol consumption are major risk factors for CAD, so avoiding them is crucial in preventing disease progression. Option D) "I will contact my doctor if I experience chest pain or shortness of breath" is a correct statement. Promptly contacting a healthcare provider when experiencing these symptoms is essential for timely intervention and management of CAD. Educational Context: Teaching patients about the importance of medication adherence in managing chronic conditions like CAD is crucial. Emphasizing the necessity of taking medications as prescribed, regardless of symptom presence, helps ensure optimal control of the disease and reduces the risk of complications. It is vital for nurses to provide clear and thorough education to empower patients to take an active role in their healthcare and make informed decisions regarding their treatment plan.
Question 5 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.