HESI RN
HESI RN Med Surg 3 Questions
Extract:
Question 1 of 5
The healthcare provider (HCP) changes a prescription for a nitroglycerin IV infusion from 10 mcg/min to 15 mcg/min. The IV bag contains nitroglycerin 50 mg in dextrose 5% in water (DW) 250 mL. The nurse should program the infusion pump to deliver how many mL/hr? (Enter numerical value only. If rounding is required, round to the nearest whole number.)
Correct Answer: A
Rationale: Calculation: 15 mcg/min × 60 min/hour = 900 mcg/hour. 900 mcg/hour / 1000 = 0.9 mg/hour. Concentration = 50 mg / 250 mL = 0.2 mg/mL. Infusion rate = 0.9 mg/hour / 0.2 mg/mL = 4.5 mL/hour, rounded to 5 mL/hour.
Question 2 of 5
A client diagnosed with pancreatitis reports severe epigastric pain. After administering a narcotic analgesic, the client insists on sitting up and leaning forward. Which action should the nurse implement?
Correct Answer: A
Rationale: Clients with acute pancreatitis often experience severe epigastric pain that radiates to the back. Leaning forward helps reduce pressure on the inflamed pancreas and relieves pain by minimizing peritoneal irritation. Providing a bedside table allows the client to rest in a comfortable, supported position, improving pain management without additional interventions.
Extract:
History and Physical
The client is a 29-year-old female with a history of type 1 diabetes mellitus from the age of 6. She controls her blood glucose with an insulin pump and uses a continuous glucose monitor. The client was out of town, and her insulin pump was damaged. She had forgotten her backup long-acting insulin at home, so she took the 6-hour drive home. By the time she arrived at home, she was having nausea and vomiting. Her blood glucose meter read over 500 mg/dL (27.8 mmol/L). She took a dose of insulin glargine and took herself to the emergency department (ED).
Question 3 of 5
Which are three goals of therapy for this client?
| Promote oxygenation to tissues. |
| Reverse dehydration. |
| Replace insulin. |
| Correct electrolytes that are out of normal range. |
| Provide respiratory support. |
| Prevent hyperventilation. |
Correct Answer: B,C,D
Rationale: Reversing dehydration with IV fluids, replacing insulin to suppress ketogenesis, and correcting electrolyte imbalances are primary goals in DKA management.
Extract:
Question 4 of 5
A young male adult walks into the emergency department (ED) holding a dead poisonous snake that bit him on his right calf within the last hour. After killing the snake, he tied a tablecloth about 4 inches (10 cm) above the bite. The client is now reporting numbness and tingling from the right knee to ankle. His heart rate is 123 beats/minute, respirations 28 breaths/minute, blood pressure 86/40 mm Hg, and oxygen saturation 94% on room air. Which intervention should the nurse implement?
Correct Answer: A
Rationale: Signs of shock due to envenomation require rapid IV access for fluid resuscitation and antivenom administration.
Question 5 of 5
A client was successfully extubated after several days of sedation and mechanical ventilation and is currently receiving 40% oxygen via a face mask. While making rounds, the nurse finds the client confused and attempting to get out of bed. Current vital signs are an oral temperature 99.2°F (37.3° C), heart rate 112 beats/minutes, respirations 16 breaths/minute, blood pressure 100/70 mm Hg, and an oxygen saturation of 98%. Which intervention should the nurse implement?
Correct Answer: C
Rationale: Confusion increases the risk of falls. Restraints are a last resort after non-pharmacological interventions, ensuring safety.