HESI RN Medical-Surgical NGN
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Free HESI RN Medical-Surgical NGN Questions
The nurse is caring for a client with acute kidney injury (AKI). Which assessment finding warrants immediate intervention?
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Productive cough and fever.
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Dyspnea and sinus tachycardia.
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Reports of a bad taste in the mouth.
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Low, concentrated urine output.
Explanation
Dyspnea and sinus tachycardia indicate fluid overload and potential pulmonary edema, both of which are life-threatening complications of acute kidney injury (AKI). When the kidneys fail to excrete excess fluid, it accumulates in the vascular and pulmonary systems, leading to respiratory distress, hypoxia, and cardiac strain. Immediate intervention is required—such as oxygen administration, diuretics (if indicated), or dialysis—to prevent respiratory or cardiac failure.
The nurse is preparing a client for an outpatient thoracentesis. Which statement made by the client should the nurse recognize as needing additional education?
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Expect a persistent cough after the procedure.
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Limit activity for a day or two after returning home.
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Prepare to sit forward with arms propped on a table.
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Anticipate a stinging feeling during needle insertion.
Explanation
A persistent cough after a thoracentesis is not expected and may indicate lung injury, pneumothorax, or re-expansion pulmonary edema, all of which are potential complications that require immediate medical attention. The client should be instructed to report continuous coughing, shortness of breath, or chest pain immediately following the procedure.
A client with diabetes mellitus is admitted with an upper respiratory infection (URI). Which changes in blood glucose management should the nurse tell the client to expect?
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Restriction of caloric intake.
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Higher doses of insulin.
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Fewer fingerstick glucose checks.
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Increased oral fluid intake.
Explanation
During an infection or illness, the body releases stress hormones such as cortisol and epinephrine, which increase blood glucose levels and lead to insulin resistance. Therefore, clients with diabetes often require higher doses of insulin or adjustments to their regimen, even if they have reduced appetite. This helps prevent hyperglycemia and diabetic ketoacidosis (DKA). The nurse should teach the client to monitor glucose closely and continue insulin therapy as prescribed during illness.
A client who suffered an electrical injury with the entrance site on the left hand and the exit site on the left foot is admitted to the burn unit. Which intervention is most important for the nurse to include in this client's plan of care (POC)?
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Continuous cardiac monitoring.
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Assess lung sounds every 4 hours.
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Evaluate level of consciousness.
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Perform passive range of motion.
Explanation
Electrical injuries can cause severe internal tissue damage and disrupt cardiac electrical conduction, even when external burns appear minor. The current travels through the body, potentially injuring the myocardium and triggering fatal arrhythmias, such as ventricular fibrillation or asystole. Therefore, continuous cardiac monitoring is the most important intervention to detect and treat any rhythm abnormalities promptly. Monitoring should begin immediately upon admission and continue for at least 24 hours.
A client is recovering from the surgical removal of glass in the right eye. Which intervention should the nurse implement immediately following the procedure?
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Teach a family member to administer eye drops.
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Obtain vital signs every 2 hours during hospitalization.
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Provide an eye shield to be worn while sleeping.
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Encourage deep breathing and coughing exercises.
Explanation
After eye surgery, the immediate priority is protection of the operative site to prevent accidental trauma, infection, or increased intraocular pressure. Applying or providing an eye shield ensures the client does not inadvertently rub or press on the affected eye—especially during sleep—when such movements are unconscious. This intervention helps maintain the integrity of the surgical repair and supports optimal healing.
The nurse is providing discharge instructions to a client who is receiving prednisone 5 mg PO daily for a rash due to contact with poison ivy. Which symptom should the nurse tell the client to report to the healthcare provider?
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Gastric irritation.
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Rapid weight gain.
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Abdominal striae.
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Moon facies.
Explanation
Rapid weight gain may indicate fluid retention and sodium imbalance, a serious adverse effect of prednisone, suggesting Cushingoid changes or early corticosteroid-induced fluid overload. This can lead to hypertension, edema, and potential heart complications if unaddressed. Because prednisone alters metabolism and electrolyte balance, sudden weight changes can signal systemic effects requiring dosage adjustment or further evaluation by the healthcare provider.
Select the 3 areas of teaching that should be included when providing education to the client with symptomatic benign prostate hyperplasia.
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A Avoid cough or cold remedies that contain pseudoephedrine or phenylephrine.
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B Urinate every 4 to 6 hours or when you first feel the urge.
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C Refrain from exercise because it can lead to incontinence.
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D Limit your intake of alcohol and caffeine.
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E Schedule yearly prostate-specific antigen blood test.
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F Decrease fluid intake to lessen the severity of symptoms.
Explanation
A. Avoid cough or cold remedies that contain pseudoephedrine or phenylephrine
These decongestants can cause urinary retention by tightening smooth muscles in the bladder neck and prostate. Clients with BPH should avoid these medications to prevent worsening urinary obstruction.
D. Limit your intake of alcohol and caffeine
Both alcohol and caffeine act as bladder irritants and diuretics, increasing urinary frequency and urgency. Reducing intake helps minimize nocturia and incontinence episodes.
E. Schedule yearly prostate-specific antigen (PSA) blood test
Although PSA is not diagnostic of BPH, annual monitoring is recommended to screen for prostate cancer, which can coexist with BPH and present with similar urinary symptoms.
The nurse assesses a client with petechiae and ecchymosis scattered across the arms and legs. Which laboratory result should the nurse review?
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Platelet count.
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White blood cell count.
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Red blood cell count.
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Hemoglobin levels.
Explanation
Petechiae (small pinpoint spots) and ecchymosis (bruising) are classic signs of impaired platelet function or thrombocytopenia—a low platelet count. Platelets are essential for blood clot formation and vascular integrity. When platelet levels drop significantly, spontaneous bleeding under the skin can occur, leading to these visible findings. The nurse should review the platelet count to assess the severity of thrombocytopenia and report critically low values immediately, as they increase the risk of internal or external hemorrhage.
A young adult client with osteoarthritis of both knees tells the nurse of the desire to continue daily walks in the park with friends. How should the nurse respond?
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Suggest a calcium supplement along with continued walking.
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Advise less weight bearing to prevent joint destruction.
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Recommend walking indoors for improved stability and safety.
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Encourage continued maintenance of the walking routine.
Explanation
Low-impact exercise, such as walking, is highly beneficial for clients with osteoarthritis (OA) because it helps maintain joint mobility, strengthen supporting muscles, and reduce stiffness and pain. The nurse should encourage the client to continue daily walks, emphasizing pacing, wearing supportive shoes, and avoiding uneven terrain when possible. Regular activity prevents further functional decline and promotes social and emotional well-being.
The nurse is assessing a group of older adult clients. Which factor in a client's history places the client at greatest risk for developing colon cancer?
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Has intestinal polyps.
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Is excessively exposed to sunlight.
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Smokes cigars.
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Eats a high-fat diet.
Explanation
The presence of intestinal (colorectal) polyps is the greatest risk factor for developing colon cancer. Polyps are benign growths on the lining of the colon that can undergo malignant transformation over time if left untreated. Clients with a history of polyps require regular colonoscopy screenings to detect and remove precancerous lesions early, significantly reducing the risk of colon cancer.
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