HESI RN
Hesi RN Medical Surg Questions
Extract:
Question 1 of 5
The nurse is caring for a client who is receiving teletherapy radiation for a malignant tumor. Which Instruction regarding skin care of the portal site should the nurse provide?
Correct Answer: B
Rationale: Protecting the portal site from sunlight prevents exacerbated skin reactions during radiation therapy.
Question 2 of 5
The nurse is obtaining a client's fingerstick glucose level. After gently milking the client's finger, the nurse observes that the distal tip of the finger appears reddened and engorged. Which action should the nurse take?
Correct Answer: D
Rationale: Applying pressure reduces engorgement, ensuring an accurate glucose sample and preventing trauma.
Question 3 of 5
The practical nurse (PN) is assisting in a community center clinic when four clients simultaneously arrive seeking help. In which order should the PN prioritize care to be provided based on the client needs? (Arrange the client with the highest priority first, on top, and lowest priority last, on bottom.)
Correct Answer: A,B,C,D
Rationale: Prioritization is based on the urgency and potential life-threatening nature of the conditions. The asthma attack is the highest priority due to potential airway compromise. Hypoglycemia is next due to the risk of neurological complications. Bleeding lacerations pose a risk of infection and blood loss, and the incontinent episode is primarily psychosocial, making it the lowest priority.
Question 4 of 5
A nurse is preparing to administer digoxin orally to a client. Identify the sequence of steps the nurse should take (Move the steps into the box on the right, placing them in the order of performance. Use all the steps)
Correct Answer: E,A,B,D,C
Rationale: The sequence ensures safety and accuracy: checking the apical heart rate first prevents administration if contraindicated; removing the medication , verifying patient identity , opening the package , and documenting follow standard medication administration protocols.
Extract:
Patient Data
History and Physical
A 34-year-old male client presents to the emergency department (ED) for an acute asthma attack which began after jogging through a local park. The client is able to answer questions, pausing every few words to catch his breath. The client reports using a rescue inhaler three times, but he just couldn't catch his breath. The client reports that symptoms seem worse when outdoors and when exercising and that episodes like this make him extremely nervous. The client reports that it has been a couple of months since he had an asthma attack, and he came to the ED today because he noticed that his inhaler was expired and was worried the medication was not working.
The nurse reviews the client's history of the presenting illness in the electronic medical record.
Question 5 of 5
Click to highlight the two pieces of key subjective data which indicate the client is in need of health interventions.
Correct Answer: A,B
Rationale: The ineffective use of the rescue inhaler indicates a severe asthma attack requiring intervention, and worsening symptoms with exercise suggest environmental triggers needing management.