HESI Medical Surgical Practice Exam Quizlet

HESI Medical Surgical Practice Exam Quizlet Related

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In a 46-year-old female client admitted for acute renal failure secondary to diabetes and hypertension, which test is the best indicator of adequate glomerular filtration?

  • A. Serum creatinine.
  • B. Blood urea nitrogen (BUN).
  • C. Sedimentation rate.
  • D. Urine specific gravity.
Correct Answer: A

Rationale: The correct answer is A: Serum creatinine. Creatinine is a product of muscle metabolism that is filtered by the glomerulus. Blood levels of creatinine are not affected by dietary or fluid intake, making it a reliable indicator of kidney function. An elevated creatinine level strongly suggests nephron loss, indicating decreased glomerular filtration rate. Choice B, Blood Urea Nitrogen (BUN), reflects the amount of urea nitrogen in the blood and can be influenced by factors other than kidney function, such as protein intake and liver health, making it less specific for evaluating glomerular filtration. Choice C, Sedimentation rate, is a measure of how quickly red blood cells settle in a test tube and is not a direct marker of kidney function. Choice D, Urine specific gravity, mainly reflects the kidney's ability to concentrate urine and is not a direct indicator of glomerular filtration rate. Therefore, Serum creatinine is the most appropriate test to assess glomerular filtration in this scenario.

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What is the most important content for the nurse to include in discharge teaching for a 51-year-old truck driver who smokes two packs of cigarettes a day, is 30 pounds overweight, and has been diagnosed with a gastric ulcer?

  • A. Information about smoking cessation.
  • B. Diet instructions for a low-residue diet.
  • C. Instructions on a weight-loss program.
  • D. The importance of increasing milk in the diet.
Correct Answer: A

Rationale: The correct answer is A: Information about smoking cessation. Smoking is a significant risk factor for ulcer formation. It is crucial for the nurse to include smoking cessation information in the discharge teaching to help manage the gastric ulcer and prevent further complications. Choices B, C, and D are less relevant in this scenario. While diet modifications may be beneficial, addressing smoking cessation takes precedence due to its direct correlation with ulcer development.

A client with a completed ischemic stroke has a blood pressure of 180/90 mm Hg. Which action should the nurse implement?

  • A. Position the head of the bed (HOB) flat.
  • B. Withhold intravenous fluids.
  • C. Administer a bolus of IV fluids.
  • D. Give an antihypertensive medication.
Correct Answer: D

Rationale: In a client with a completed ischemic stroke, an elevated blood pressure like 180/90 mm Hg requires immediate intervention to prevent further damage. Giving an antihypertensive medication is essential to reduce the risk of recurrent stroke or complications related to hypertension. Positioning the head of the bed flat, withholding IV fluids, or administering a bolus of IV fluids are not appropriate actions for managing elevated blood pressure in this scenario and may not address the underlying cause of the hypertension or prevent potential complications.

A client who has undergone abdominal surgery calls the nurse and reports that she just felt 'something give way' in the abdominal incision. The nurse checks the incision and notes the presence of wound dehiscence. The nurse immediately:

  • A. Contacts the physician
  • B. Documents the findings
  • C. Places the client in a supine position with the legs flat
  • D. Covers the abdominal wound with a sterile dressing moistened with sterile saline solution
Correct Answer: D

Rationale: In the scenario described, the presence of wound dehiscence indicates a separation of the layers of the surgical incision. The immediate priority for the nurse is to cover the abdominal wound with a sterile dressing moistened with sterile saline solution. This helps to protect the wound from contamination and promotes a moist environment conducive to healing. Contacting the physician (Choice A) is important, but the initial action should be to address the wound. Documenting the findings (Choice B) is necessary but not the immediate priority. Placing the client in a supine position with the legs flat (Choice C) is not indicated in this situation as wound dehiscence requires wound care intervention.

The nurse assesses a client with advanced cirrhosis of the liver for signs of hepatic encephalopathy. Which finding would the nurse consider an indication of progressive hepatic encephalopathy?

  • A. An increase in abdominal girth.
  • B. Hypertension and a bounding pulse.
  • C. Decreased bowel sounds.
  • D. Difficulty in handwriting.
Correct Answer: D

Rationale: Difficulty in handwriting is a common early sign of hepatic encephalopathy. Changes in handwriting can indicate progression or reversal of hepatic encephalopathy leading to coma. Choice (A) is a sign of ascites, not hepatic encephalopathy. Hypertension and a bounding pulse (Choice B) are not typically associated with hepatic encephalopathy. Decreased bowel sounds (Choice C) do not directly indicate an increase in serum ammonia level, which is the primary cause of hepatic encephalopathy.

During an interview with a client planning elective surgery, the client asks the nurse, 'What is the advantage of having a preferred provider organization insurance plan?' Which response is best for the nurse to provide?

  • A. Neither plan allows the selection of healthcare providers or hospitals.
  • B. There are fewer healthcare providers to choose from than in an HMO plan.
  • C. An individual may select healthcare providers from outside of the PPO network.
  • D. An individual can become a member of a PPO without belonging to a group.
Correct Answer: C

Rationale: The best response for the nurse to provide is option C, as it highlights a key advantage of a preferred provider organization (PPO) insurance plan. By stating that an individual may select healthcare providers from outside of the PPO network, the nurse emphasizes the flexibility and freedom of choice that PPO plans offer. This feature allows individuals to seek care from providers who are not part of the PPO network, albeit at a higher cost. Option A is incorrect because both PPO and HMO plans allow the selection of healthcare providers, although with different restrictions. Option B is incorrect as PPO plans typically offer a larger selection of healthcare providers compared to HMO plans. Option D is incorrect as membership in a PPO usually requires affiliation with a group, such as through employment or membership in an organization.

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