HESI Medical Surgical Specialty Exam

HESI Medical Surgical Specialty Exam Related

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A client is being discharged after lithotripsy for a urinary calculus. Which statements should the nurse include in the discharge teaching? (Select all that apply.)

  • A. Finish the prescribed antibiotic even if you are feeling better.
  • B. Drink at least 3 liters of fluid each day.
  • C. The bruising on your back may take several weeks to resolve.
  • D. All of the above
Correct Answer: D

Rationale: After lithotripsy for a urinary calculus, it is important for the client to complete the prescribed antibiotic course to prevent urinary tract infections. Drinking at least 3 liters of fluid daily helps dilute stone-forming crystals, prevent dehydration, and promote urine flow. Bruising on the back may occur after the procedure and can take several weeks to resolve. Additionally, the client may experience blood in the urine for several days post-procedure. Reporting any pain, fever, chills, or urination difficulties to the healthcare provider is essential, as these symptoms could indicate infection or stone formation. Choice D is correct as all the statements are appropriate for the client's discharge teaching. Choices A, B, and C are individually correct based on the rationale provided, making D the correct answer.

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A nurse teaches a client who is recovering from a nephrectomy secondary to kidney trauma. Which statement should the nurse include in this client's teaching?

  • A. Since you only have one kidney, a salt and fluid restriction is required.
  • B. Your therapy will include hemodialysis while you recover.
  • C. Medication will be prescribed to control your high blood pressure.
  • D. You need to avoid participating in contact sports like football.
Correct Answer: D

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

After a urography, a client is instructed by a nurse. Which instruction should the nurse include in this client's discharge teaching?

  • A. Avoid direct contact with your urine for 24 hours until the dye clears.
  • B. You may experience dribbling of urine for several weeks post-procedure.
  • C. Drink at least 3 liters of fluids today to assist in dye elimination.
  • D. Your skin may turn slightly yellow from the dye used in this procedure.
Correct Answer: C

Rationale: It is important for the client to increase fluid intake to aid in the rapid elimination of the potentially nephrotoxic dye used in urography. This instruction will help prevent any adverse effects related to the dye. Choices A, B, and D are incorrect because the dye used in urography is not radioactive, so there is no need to avoid direct contact with urine, urine dribbling is not a common post-procedure occurrence, and the dye should not cause the client's skin to change color.

When a patient is receiving high doses of a cephalosporin, which laboratory values will this patient's nurse monitor closely?

  • A. Blood urea nitrogen (BUN), serum creatinine, and liver function tests
  • B. Complete blood count and electrolytes
  • C. Serum calcium and magnesium
  • D. Serum glucose and lipids
Correct Answer: A

Rationale: When a patient is receiving high doses of a cephalosporin, such as cefazolin, the nurse should closely monitor laboratory values that indicate renal and hepatic function. This includes checking the Blood Urea Nitrogen (BUN) and serum creatinine levels to assess kidney function. Additionally, monitoring liver function tests, such as AST, ALT, ALP, LDH, and bilirubin, is essential as cephalosporins can affect liver enzymes. Therefore, options B, C, and D are incorrect as they do not specifically address the parameters that are most pertinent when administering high doses of cephalosporins.

A client has just returned to the nursing unit after bronchoscopy. To which intervention should the nurse give priority?

  • A. Assessing the client for the return of the gag reflex
  • B. Administering pain medication
  • C. Encouraging copious fluid intake
  • D. Ambulating the client
Correct Answer: A

Rationale: After bronchoscopy, the priority intervention for the nurse is to assess the client for the return of the gag reflex. This assessment is crucial to ensure the client's safety and prevent aspiration. Keeping the client on nothing-by-mouth status until the gag reflex returns is essential. Administering pain medication, encouraging fluid intake, and ambulating the client are important interventions but assessing the gag reflex takes precedence due to the risk of aspiration post-bronchoscopy.

The nurse is caring for a patient who will receive 10% calcium gluconate to treat a serum potassium level of 5.9 mEq/L. The nurse performs a drug history prior to beginning the infusion. Which drug taken by the patient would cause concern?

  • A. Digitalis
  • B. Hydrochlorothiazide
  • C. Hydrocortisone
  • D. Vitamin D
Correct Answer: A

Rationale: Calcium gluconate is administered to treat hyperkalemia by reducing myocardial irritability. When given to a patient taking digitalis, it can lead to digitalis toxicity. Digitalis and calcium gluconate both affect cardiac function, and their concomitant use can potentiate adverse effects. Hydrochlorothiazide, Hydrocortisone, and Vitamin D may impact potassium levels, but they do not interact with calcium gluconate in a way that would cause concern for toxicity.

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