HESI RN
HESI RN Medical Surgical Nursing Questions
Extract:
Question 1 of 5
A client is scheduled for a scleral buckling procedure after previously having multiple laser coagulation procedures done for retinal tears. Which Information about the immediate postoperative period should the nurse provide this client?
Correct Answer: A
Rationale: Reporting signs of retinal detachment is critical to ensure the success of the scleral buckling procedure.
Question 2 of 5
A client is admitted with heart failure (HF) and left ventricular hypertrophy. Which intervention is most likely to avert development of cardiomegaly and improve myocardial contractility?
Correct Answer: A
Rationale: Reducing blood pressure decreases cardiac workload, preventing cardiomegaly and improving contractility.
Question 3 of 5
The nurse reviews discharge instructions with a client who has gastroesophageal reflux disease (GERD). Which instruction is most important for the nurse to emphasize?
Correct Answer: B
Rationale: Remaining upright after meals prevents acid reflux by facilitating digestion, making it the most critical instruction for GERD management.
Question 4 of 5
The nurse assists a client with Parkinson's disease (PD) to ambulate in the hallway. The client appears to 'freeze' and then carefully lifts one leg and steps forward. The client tells the nurse of pretending to step over a crack on the floor. How should the nurse respond?
Correct Answer: B
Rationale: Pretending to step over an object is a known technique to manage freezing in Parkinson's, aiding ambulation.
Extract:
Nurses' Notes
0900
The 54-year-old female client returned to room from postanesthesia care unit (PACU). Situation- background-assessment-recommendation (SBAR) communication reveals client has had no urine output during the anesthesia recovery period. Last void was 8 hours ago. Client positioned in bed. Warm blanket applied for comfort. IV fluids infusing.
1045
Client requesting pain medication and says has the urge to void. Wishes to use bedpan. Voided 75 mL.
1130
Client informs she continues to have the urge to void and feels, "Wet." Placed on bedpan. Voided 50 mL. Bladder palpated and feels full. Bladder scanner applied and revealed 600 mL residual urine.
Question 5 of 5
The nurse is planning care for the client. Complete the diagram by dragging from the choices area to specify which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress.
| Actions to Take Choices A. Request prescription for external catheter device B. Request prescription for straight catheter C. Insert indwelling urinary catheter D. Assist client to bathroom for voiding E. Increase the IV fluid rate |
| Potential Condition Choices A. Urinary Retention B. Urinary tract obstruction C. Overflow Urinary Incontinence D. IV fluid intake E. Frequency of voiding |
| Parameters to monitor Choices A. Amount of urine output B. Residual urine C. Pain medication effects D. IV fluid intake E. Frequency of voiding |
Correct Answer: A
Rationale: Urinary retention, indicated by high residual urine, requires straight and indwelling catheters, with monitoring of urine output and residual urine.