RN Medical/Surgical NGN HESI 2023

RN Medical/Surgical NGN HESI 2023 Related

Review RN Medical/Surgical NGN HESI 2023 related questions and content

A client with polycystic kidney disease (PKD) is being discharged. Which statements should the nurse include in this client's discharge teaching? (Select all that apply.)

  • A. Take your blood pressure every morning.
  • B. Weigh yourself at the same time each day.
  • C. Contact your provider if you have visual disturbances.
  • D. All of the above
Correct Answer: D

Rationale: A client with polycystic kidney disease (PKD) should be educated on monitoring their blood pressure daily and weighing themselves consistently to detect any changes promptly. It is essential to contact the healthcare provider if visual disturbances occur, as this could indicate a complication such as a berry aneurysm associated with PKD. Foul-smelling or bloody urine should also prompt notification to the provider as they could signify urinary tract infections or glomerular injury. Choices A, B, and C are correct as they address crucial aspects of managing PKD and its potential complications. Choices A and B help in monitoring for changes in blood pressure and fluid status, while choice C focuses on detecting possible neurological complications. Choices A, B, and C are relevant to PKD management and should be included in the client's discharge teaching. Choices that mention diarrhea and renal stones are not directly associated with PKD; therefore, teaching related to these conditions would be irrelevant in this context.

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A nurse obtains a sterile urine specimen from a client's Foley catheter. After applying a clamp to the drainage tubing distal to the injection port, which action should the nurse take next?

  • A. Clamp another section of the tube to create a fixed sample section for retrieval.
  • B. Insert a syringe into the injection port and aspirate the quantity of urine required.
  • C. Clean the injection port cap of the drainage tubing with a povidone-iodine solution.
  • D. Withdraw 10 mL of urine and discard it; then withdraw a fresh sample of urine.
Correct Answer: C

Rationale: The correct next action for the nurse to take after applying a clamp to the drainage tubing distal to the injection port is to clean the injection port cap of the catheter drainage tubing with an appropriate antiseptic like povidone-iodine solution or alcohol. This step is crucial to prevent surface contamination before taking the urine sample. Clamping another section of the tube to create a fixed sample section or withdrawing and discarding urine are unnecessary and could lead to potential contamination. Inserting a syringe into the injection port and aspirating the required amount of urine directly from the catheter is the correct method for obtaining the urine sample, but cleaning the injection port cap should precede this step to ensure sterility.

The nurse is preparing to administer an antibiotic to a patient who has been receiving the antibiotic for 2 days after a culture was obtained. The nurse notes increased erythema and swelling, and the patient has a persistent high fever of 39°C. What is the nurse's next action?

  • A. Administer the antibiotic as ordered.
  • B. Contact the provider to request another culture.
  • C. Discuss the need to add a second antibiotic with the provider.
  • D. Review the sensitivity results from the patient's culture.
Correct Answer: D

Rationale: In this scenario, the nurse is observing signs of a possible lack of response to the current antibiotic therapy, such as increased erythema, swelling, and persistent high fever. The next appropriate action for the nurse is to review the sensitivity results from the patient's culture. This step is crucial to determine if the current antibiotic is effective against the causative organism. If the sensitivity results indicate resistance to the current antibiotic, the antibiotic should be discontinued, and the provider should be notified for a change in therapy. Contacting the provider to request another culture is not the immediate priority, as the existing culture results need to be reviewed first. Adding a second antibiotic should only be considered after confirming the sensitivity results, as unnecessary antibiotic use can lead to antimicrobial resistance.

A client has just had a central line catheter placed that is specific for hemodialysis. What is the most appropriate action by the nurse?

  • A. Use the catheter for the next laboratory blood draw.
  • B. Monitor the central venous pressure through this line.
  • C. Access the line for the next intravenous medication.
  • D. Place a heparin or heparin/saline dwell after hemodialysis.
Correct Answer: D

Rationale: The most appropriate action for the nurse after a central line catheter placement for hemodialysis is to place a heparin or heparin/saline dwell after hemodialysis treatment. This helps prevent clot formation in the line and maintain patency for future use. Using the catheter for blood draws is not recommended as it may increase the risk of infection. Monitoring central venous pressure is not indicated with this type of catheter. Accessing the line for medications is also not recommended to prevent complications and ensure the line is solely used for hemodialysis purposes.

The patient will begin taking penicillin G procaine (Wycillin). The nurse notes that the solution is milky in color. What action will the nurse take?

  • A. Call the pharmacist and report the milky color.
  • B. Add normal saline to dilute the medication.
  • C. Call the physician and report the milky appearance.
  • D. Administer the medication as ordered by the physician.
Correct Answer: D

Rationale: The correct answer is to administer the medication as ordered by the physician. Penicillin G procaine (Wycillin) is known to have a milky appearance, which is normal. The milky color should not raise concerns for the nurse as it is an expected characteristic of this medication. Calling the pharmacist (choice A) or the physician (choice C) unnecessarily would delay the administration of the medication. Adding normal saline to dilute the medication (choice B) is not appropriate and could alter the medication's effectiveness. Therefore, the nurse should proceed with administering the medication as prescribed without any further action based on its milky appearance.

A client with diabetes mellitus is scheduled to have blood drawn for a fasting blood glucose determination in the morning. What does the nurse tell the client is acceptable to consume on the morning of the test?

  • A. Water
  • B. Tea without sugar
  • C. Coffee without milk
  • D. Clear liquids like apple juice
Correct Answer: A

Rationale: The correct answer is A: Water. A client scheduled for a fasting blood glucose test should only consume water after midnight to ensure accurate test results. Choosing options B, C, or D, which include tea, coffee, or clear liquids like apple juice, is incorrect as they may contain substances that can affect the blood glucose levels, leading to inaccurate test results.

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