HESI Medical Surgical Assignment Exam

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After delegating to an unlicensed assistive personnel (UAP) the task of completing a bladder scan examination for a client, the nurse evaluates the UAP's performance. Which action by the UAP indicates the nurse must provide additional instructions when delegating this task?

  • A. Selecting the female icon for all female clients and the male icon for all male clients
  • B. Explaining to the client, 'This test measures the amount of urine in your bladder.'
  • C. Applying ultrasound gel to the scanning head and cleaning it after use
  • D. Taking at least two readings using the aiming icon to position the scanning head
Correct Answer: A

Rationale: The correct answer is A because the UAP should select the female icon for women who have not had a hysterectomy to allow the scanner to subtract the volume of the uterus from readings. If a woman has had a hysterectomy, the UAP should choose the male icon. Choice B is incorrect as it is essential for the UAP to explain the procedure to the client to ensure understanding. Choice C is incorrect because applying ultrasound gel to the scanning head and cleaning it after use are appropriate actions. Choice D is incorrect as it is necessary for the UAP to take at least two readings using the aiming icon to position the scanning head accurately for an effective bladder scan examination.

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The patient is beginning furosemide and has started a 2-week course of a steroid medication. What should the nurse recommend?

  • A. Avoid consuming licorice to prevent excess potassium loss.
  • B. Report a urine output less than 600 mL/24 hours.
  • C. Obtain an order for a potassium supplement.
  • D. Take the furosemide in the morning.
Correct Answer: C

Rationale: When a patient is taking furosemide and a steroid medication, there is an increased risk of potassium loss due to the interaction between the two drugs. Consuming licorice should be avoided as it can worsen potassium loss. Reporting a urine output less than 600 mL/24 hours is not directly related to the drug interaction and may not be necessary. Taking furosemide at bedtime is not the primary concern when a patient is concurrently on a steroid medication and furosemide. Therefore, obtaining an order for a potassium supplement is the most appropriate recommendation to counteract the potential potassium loss.

The nurse is caring for five clients on the medical-surgical unit. Which clients would the nurse consider to be at risk for post-renal acute kidney injury (AKI)? (Select all that apply.)

  • A. Man with prostate cancer
  • B. Woman with blood clots in the urinary tract
  • C. Client with ureterolithiasis
  • D. All of the above
Correct Answer: D

Rationale: Post-renal acute kidney injury (AKI) occurs due to urine flow obstruction, which can result from conditions such as prostate cancer, blood clots in the urinary tract, and ureterolithiasis (kidney stones). Severe burns would lead to pre-renal AKI by reducing blood flow to the kidneys. Lupus would cause intrarenal AKI by affecting the kidney tissue directly. Therefore, options A, B, and C are correct choices for clients at risk for post-renal AKI, making option D the correct answer.

During a paracentesis procedure on a client with abdominal ascites, into which position would the nurse assist the client?

  • A. Supine
  • B. Upright
  • C. Left side-lying
  • D. Right side-lying
Correct Answer: B

Rationale: During a paracentesis procedure for a client with abdominal ascites, the nurse should assist the client into an upright position. Placing the client upright allows the intestines to float posteriorly, reducing the risk of intestinal laceration during catheter insertion. Choices A, C, and D are incorrect because a supine, left side-lying, or right side-lying position would not provide the same benefit of intestinal mobility and protection during the procedure.

A client has a chest drainage system in place. The fluid in the water seal chamber rises and falls during inspiration and expiration. The nurse interprets this finding as an indication that:

  • A. The tube is patent
  • B. There is probably a kink in the tubing
  • C. Suction should be added to the system
  • D. The client is retaining airway secretions
Correct Answer: A

Rationale: The correct answer is A: 'The tube is patent.' When the fluid in the water seal chamber rises and falls during inspiration and expiration, it indicates that the chest tube is patent, allowing for proper drainage. Choice B is incorrect because a kink in the tubing would obstruct the flow of fluid, leading to abnormal fluctuations in the water seal chamber. Choice C is incorrect as adding suction to the system is not indicated based on the described finding. Choice D is incorrect as the rising and falling of fluid in the water seal chamber is not indicative of the client retaining airway secretions.

Which is a characteristic that distinguishes sulfonamides from other drugs used to treat bacterial infections?

  • A. Sulfonamides are bactericidal.
  • B. Sulfonamides are synthetic compounds.
  • C. Sulfonamides have antifungal and antiviral properties.
  • D. Sulfonamides increase bacterial synthesis of folic acid.
Correct Answer: B

Rationale: The characteristic that distinguishes sulfonamides from other drugs used to treat bacterial infections is that sulfonamides are synthetic compounds, not derived from biologic substances. Choice A is incorrect because sulfonamides are bacteriostatic, not bactericidal. Choice C is incorrect because sulfonamides do not have antifungal and antiviral properties. Choice D is incorrect because sulfonamides act by inhibiting bacterial synthesis of folic acid, not increasing it.

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