HESI RN
Evolve HESI Medical Surgical Practice Exam Questions
Question 1 of 5
Polyethylene glycol-electrolyte solution (GoLYTELY) is prescribed for a hospitalized client scheduled for a colonoscopy. The client begins to experience diarrhea after drinking the solution. Which action by the nurse is appropriate?
Correct Answer: C
Rationale: The correct action by the nurse in this situation is to document the diarrhea in the medical record. Polyethylene glycol-electrolyte solution (GoLYTELY) is a bowel evacuant used to cleanse the bowel before a colonoscopy. It is expected to cause mild diarrhea, which is a normal response to the medication. The diarrhea helps clear the bowel in preparation for the procedure. Calling the physician is not necessary unless there are complications. Administering a cleansing enema or giving intravenous replacement fluids in large amounts are not appropriate actions as they are not indicated for managing the expected diarrhea caused by GoLYTELY.
Question 2 of 5
A client with cardiovascular disease is scheduled to receive a daily dose of furosemide (Lasix). Which potassium level would cause the nurse to contact the physician before administering the dose?
Correct Answer: A
Rationale: The normal serum potassium level in adults ranges from 3.5 to 5.1 mEq/L. A potassium level of 3.0 mEq/L is low, indicating hypokalemia and necessitating physician notification before administering furosemide, a loop diuretic that can further lower potassium levels. Potassium levels of 3.8 and 4.2 mEq/L are within the normal range, while a level of 5.1 mEq/L is high (hyperkalemia), but the critical value in this case is the low potassium level that requires immediate attention to prevent potential complications.
Question 3 of 5
A client with type 1 diabetes mellitus has a blood glucose level of 620 mg/dL. After the nurse calls the physician to report the finding and monitors the client closely for:
Correct Answer: A
Rationale: In the scenario described, a client with a blood glucose level of 620 mg/dL and type 1 diabetes mellitus is at risk of developing metabolic acidosis. In type 1 diabetes, the lack of sufficient circulating insulin leads to an increase in blood glucose levels. As the body cells utilize all available glucose, the breakdown of fats for energy results in the production of ketones, leading to metabolic acidosis. Metabolic alkalosis, respiratory acidosis, and respiratory alkalosis are not typically associated with uncontrolled type 1 diabetes. Metabolic alkalosis is more commonly linked to conditions such as vomiting or excessive diuretic use, while respiratory acidosis and respiratory alkalosis are related to respiratory system imbalances in carbon dioxide levels.
Question 4 of 5
A client tells the nurse that he has been experiencing frequent heartburn and has been 'living on antacids.' For which acid-base disturbance does the nurse recognize a risk?
Correct Answer: B
Rationale: The correct answer is B: Metabolic alkalosis. In this scenario, the client's frequent use of antacids containing alkaline components can lead to an excess of bicarbonate in the body, causing metabolic alkalosis. Oral antacids work by neutralizing stomach acid, potentially leading to an alkaline shift in the body's pH balance. Choices A, C, and D are incorrect. Metabolic acidosis is not typically associated with antacid use. Respiratory acidosis and respiratory alkalosis are related to respiratory system dysfunction rather than antacid ingestion.
Question 5 of 5
A client who has received sodium bicarbonate in large amounts is at risk for metabolic alkalosis. For which of the following signs and symptoms does the nurse assess this client?
Correct Answer: D
Rationale: The correct answer is D. A client with metabolic alkalosis may present with dysrhythmias and a decreased respiratory rate and depth as the body tries to compensate by retaining carbon dioxide. Options A, B, and C do not typically correlate with the signs and symptoms of metabolic alkalosis. Disorientation, dyspnea, drowsiness, headache, tachypnea, dizziness, and paresthesias are not commonly associated with metabolic alkalosis. Therefore, they are incorrect choices.