HESI Medical Surgical Test Bank

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An adult who was recently diagnosed with glaucoma tells the nurse, 'it feels like I am driving through a tunnel.' The client expresses great concern about going blind. Which nursing instruction is most important for the nurse to provide this client?

  • A. Maintain prescribed eye drop regimen
  • B. Avoid frequent eye pressure measurements
  • C. Wear prescription glasses
  • D. Eat a diet high in carotene
Correct Answer: A

Rationale: The correct answer is A: Maintain prescribed eye drop regimen. In glaucoma, maintaining the prescribed eye drop regimen is crucial for controlling intraocular pressure, which helps in preventing vision loss. Consistent use of eye drops as directed can slow down the progression of the disease and preserve vision. Choice B is incorrect because avoiding frequent eye pressure measurements does not address the primary treatment for glaucoma. Choice C is incorrect as wearing prescription glasses may be helpful for vision correction but does not directly address the management of glaucoma. Choice D is incorrect because while a diet high in carotene may promote overall eye health, it is not the most important instruction for managing glaucoma.

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The nurse is monitoring a client who is receiving continuous ambulatory peritoneal dialysis. The nurse should notify the physician of which of the following findings?

  • A. Clear dialysate outflow.
  • B. Cloudy dialysate outflow.
  • C. Decreased urine output.
  • D. Increased blood pressure.
Correct Answer: B

Rationale: Cloudy dialysate outflow is an indication of peritonitis, a serious complication of peritoneal dialysis that requires immediate medical attention. Clear dialysate outflow is a normal finding indicating proper dialysis function and should not raise concern. Decreased urine output may be expected in a client undergoing dialysis due to the removal of excess fluids from the body. Increased blood pressure is a common complication in clients with kidney disease but is not directly related to cloudy dialysate outflow.

The client with chronic renal failure is receiving education on managing fluid intake. Which of the following statements by the client indicates a need for further teaching?

  • A. I can drink as much water as I want.
  • B. I should increase my intake of high-sodium foods.
  • C. I can skip a dialysis session if I feel tired.
  • D. I can eat whatever I want as long as I take my medications.
Correct Answer: C

Rationale: Choice C is the correct answer. Clients with chronic renal failure should not skip dialysis sessions, as this can lead to serious complications. Dialysis is crucial for managing fluid and electrolyte balance in these clients. Choice A is incorrect because clients with renal failure often have fluid restrictions. Choice B is incorrect as high-sodium foods can worsen fluid retention in clients with renal failure. Choice D is incorrect because dietary restrictions are important in managing chronic renal failure, and eating whatever one wants can lead to further complications.

The nurse is caring for a client with chronic renal failure who is on a low-potassium diet. Which of the following foods should the client avoid?

  • A. Bananas
  • B. Potatoes
  • C. Rice
  • D. Apples
Correct Answer: A

Rationale: Bananas are high in potassium content, which can lead to hyperkalemia in clients with chronic renal failure who are on a low-potassium diet. Therefore, it is crucial for these clients to avoid bananas. Potatoes, rice, and apples are lower in potassium compared to bananas and are generally considered safe for consumption in clients with chronic renal failure on a low-potassium diet.

What is an expected outcome when a client is receiving an IV administration of furosemide?

  • A. Increased blood pressure.
  • B. Increased urine output.
  • C. Decreased pain.
  • D. Decreased premature ventricular contractions.
Correct Answer: B

Rationale: The correct answer is B: Increased urine output. Furosemide is a loop diuretic that works by inhibiting the reabsorption of sodium and chloride in the ascending loop of Henle in the kidneys, leading to increased urine production. This diuretic effect helps to reduce fluid volume in the body, making it an expected outcome when a client is receiving furosemide. Choice A, increased blood pressure, is incorrect because furosemide typically causes a decrease in blood pressure due to its diuretic effect. Choice C, decreased pain, and choice D, decreased premature ventricular contractions, are unrelated to the pharmacological action of furosemide.

The nurse is obtaining a health history from a new client who has a history of kidney stones. Which statement by the client indicates an increased risk for renal calculi?

  • A. Eats a vegetarian diet with cheese 2 to 3 times a day
  • B. Experiences additional stress since adopting a child
  • C. Jogs more frequently than usual daily routine
  • D. Drinks several bottles of carbonated water daily
Correct Answer: D

Rationale: The correct answer is D. Drinking several bottles of carbonated water daily may contribute to renal calculi formation due to the high mineral content. Carbonated drinks can increase the risk of kidney stones due to their high levels of phosphoric acid and caffeine, which can lead to the formation of crystals in the urine. Choices A, B, and C are less likely to directly contribute to an increased risk of renal calculi compared to the excessive consumption of carbonated water.

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