HESI Med-Surg RN V1 Exam– 55 Questions
with Verified Answers | Latest Edition
.
1. A patientwith a history of hypertensiontreatedwith a diuretic and an angiotensin-convertingenzyme(ACE)
inhibitor arrives in the emergency department complaining of a severe headache and nausea and hasa blood
pressure (BP) of 238/118 mm Hg. Which question should the nurse ask to follow up on these findings?
a. “Have you recentlytakenany antihistamines?”
b. “Have you consistentlytakenyour medications?”
c. “Did youtakeanyacetaminophen
(Tylenol)today?”
d. “Have therebeenrecentstressfuleventsin your life?”
ANS: B
Sudden withdrawalof antihypertensivemedicationscan cause rebound hypertensionand hypertensivecrisis.
Althoughmany over-the-countermedicationscan causehypertension,antihistamines and acetaminophendo not
increase BP. Stressful events will increasebut
BP not usually to the level seen in this patient.
2. The nurse is assessinga patientwho has been admittedto the intensivecare unit (ICU) with a hypertensive
emergency. Which finding is most important to report to the health care provider?
a. Urine outputover8 hoursis 250mL lessthanthefluid intake.
b. The patientcannotmovetheleftarm and leg whenaskedto do so.
c. Tremorsarenotedin thefingerswhenthepatientextendsthearms.
d. The patientcomplainsof a headachewithpain at level7 of 10 (0 to 10 scale).ANS:
B
The patient’s inability to move the left arm and leg indicates that a stroke may be occurring and will require
immediateactionto preventfurtherneurologicdamage.The otherclinical manifestationsarealsolikely caused by the
hypertension and will require rapid nursing actions, but they do not require action as urgently as the neurologic
changes.
3. A patientwithhypertensionwhohas just startedtakingatenolol(Tenormin) returnsto thehealthclinic after2
weeks for a follow-up visit. The blood pressure (BP) is unchanged from the previous visit. Which action should the
nurse take first?
a. Tell thepatientwhya changein drug dosageis needed.
b. Ask thepatientif themedicationis beingtakenas prescribed.
c. Inform thepatientthatmultipledrugs areoftenneededto treathypertension.
d. Questionthepatientregardinganylifestylechangesmadeto helpcontrolBP.
ANS: B
Because nonadherence with antihypertensive therapy is common, the nurse’s initial action should be to determine
whetherthepatientis takingtheatenololas prescribed.The otheractionsalsomaybeimplemented, but these would
be done after assessing patient adherence with the prescribed therapy.
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, 4. The registered nurse (RN) is caring for a patient with a hypertensive crisis who is receiving sodium
nitroprusside. Which nursing actioncan thenursedelegateto an experiencedlicensed practical/vocational nurse
(LPN/LVN)?
a. Evaluateeffectiveness
of nitroprussidetherapyon bloodpressure(BP).
b. Assessthepatient’senvironmentfor adversestimulithatmightincreaseBP.
c. Titratenitroprussideto decreasemeanarterialpressure(MAP) to 115mm Hg.
d. Setup theautomaticnoninvasiveBP machineto takereadingsevery15 minutes.
ANS: D
LPN/LVN education and scope of practice include the correct use of common equipment such as automatic noninvasive
bloodpressuremachines.The otheractionsrequireadvancednursing judgmentand education,and should be done by
RNs.
5. The charge nurse observes a new registered nurse (RN) doing discharge teaching for a patient with hypertension
whohasa newprescriptionfor enalapril(Vasotec).The chargenursewill needto interveneif the new RN tells the
patient to
a. increasethedietaryintakeof high-potassiumfoods.
b. makean appointmentwiththedietitianfor teaching.
c. checkthebloodpressure(BP) at homeat leastoncea day.
d. moveslowlywhenmovingfromlying to sittingto standing.
ANS: A
The ACE inhibitors cause retention of potassium by the kidney, so hyperkalemia is a possible adverse effect.
other The
teachingby thenewRN is appropriatefor a patientwithnewlydiagnosedhypertensionwhohasjust started therapy
with enalapril.
6. Which assessmentfinding for a patientwhois receivingIV furosemide(Lasix) to treatstage 2
hypertension is most important to report to the health care provider?
a. Bloodglucoselevelof 175mg/dL
b. Serumpotassiumlevelof 3.0 mEq/L
c. OrthostaticsystolicBP decreaseof 12 mm Hg
d. Mostrecentbloodpressure(BP) readingof 168/94mm Hg
ANS: B
Hypokalemiais a frequentadverseeffectof theloopdiureticsand can causelife-threateningdysrhythmias.The health
care provider should be notified of the potassium level immediately and administration of potassium supplements
initiated. The elevated blood glucose andalso
BP indicate a need for collaborative interventions but will not require
action as urgently as the hypokalemia.
An orthostatic drop of 12 mm Hg will require intervention only if the patient is
symptomatic.
7. Which nursing actionshouldthenursetakefirst to assista patientwithnewlydiagnosedstage1
hypertension in making needed dietary changes?
a. Collecta detaileddiethistory.
b. Providea list of low-sodiumfoods.
c. Help thepatientmakean appointmentwitha dietitian.
This study source was downloaded by 100000897757654 from CourseHero.com on 10-06-2025 05:27:44 GMT -05:00
https://www.coursehero.com/file/96538672/HESI-MED-SURG-MED-SURG-55-QUESTIONS-RN-V1-MOST-ANSWERSdocx/
with Verified Answers | Latest Edition
.
1. A patientwith a history of hypertensiontreatedwith a diuretic and an angiotensin-convertingenzyme(ACE)
inhibitor arrives in the emergency department complaining of a severe headache and nausea and hasa blood
pressure (BP) of 238/118 mm Hg. Which question should the nurse ask to follow up on these findings?
a. “Have you recentlytakenany antihistamines?”
b. “Have you consistentlytakenyour medications?”
c. “Did youtakeanyacetaminophen
(Tylenol)today?”
d. “Have therebeenrecentstressfuleventsin your life?”
ANS: B
Sudden withdrawalof antihypertensivemedicationscan cause rebound hypertensionand hypertensivecrisis.
Althoughmany over-the-countermedicationscan causehypertension,antihistamines and acetaminophendo not
increase BP. Stressful events will increasebut
BP not usually to the level seen in this patient.
2. The nurse is assessinga patientwho has been admittedto the intensivecare unit (ICU) with a hypertensive
emergency. Which finding is most important to report to the health care provider?
a. Urine outputover8 hoursis 250mL lessthanthefluid intake.
b. The patientcannotmovetheleftarm and leg whenaskedto do so.
c. Tremorsarenotedin thefingerswhenthepatientextendsthearms.
d. The patientcomplainsof a headachewithpain at level7 of 10 (0 to 10 scale).ANS:
B
The patient’s inability to move the left arm and leg indicates that a stroke may be occurring and will require
immediateactionto preventfurtherneurologicdamage.The otherclinical manifestationsarealsolikely caused by the
hypertension and will require rapid nursing actions, but they do not require action as urgently as the neurologic
changes.
3. A patientwithhypertensionwhohas just startedtakingatenolol(Tenormin) returnsto thehealthclinic after2
weeks for a follow-up visit. The blood pressure (BP) is unchanged from the previous visit. Which action should the
nurse take first?
a. Tell thepatientwhya changein drug dosageis needed.
b. Ask thepatientif themedicationis beingtakenas prescribed.
c. Inform thepatientthatmultipledrugs areoftenneededto treathypertension.
d. Questionthepatientregardinganylifestylechangesmadeto helpcontrolBP.
ANS: B
Because nonadherence with antihypertensive therapy is common, the nurse’s initial action should be to determine
whetherthepatientis takingtheatenololas prescribed.The otheractionsalsomaybeimplemented, but these would
be done after assessing patient adherence with the prescribed therapy.
This study source was downloaded by 100000897757654 from CourseHero.com on 10-06-2025 05:27:44 GMT -05:00
https://www.coursehero.com/file/96538672/HESI-MED-SURG-MED-SURG-55-QUESTIONS-RN-V1-MOST-ANSWERSdocx/
, 4. The registered nurse (RN) is caring for a patient with a hypertensive crisis who is receiving sodium
nitroprusside. Which nursing actioncan thenursedelegateto an experiencedlicensed practical/vocational nurse
(LPN/LVN)?
a. Evaluateeffectiveness
of nitroprussidetherapyon bloodpressure(BP).
b. Assessthepatient’senvironmentfor adversestimulithatmightincreaseBP.
c. Titratenitroprussideto decreasemeanarterialpressure(MAP) to 115mm Hg.
d. Setup theautomaticnoninvasiveBP machineto takereadingsevery15 minutes.
ANS: D
LPN/LVN education and scope of practice include the correct use of common equipment such as automatic noninvasive
bloodpressuremachines.The otheractionsrequireadvancednursing judgmentand education,and should be done by
RNs.
5. The charge nurse observes a new registered nurse (RN) doing discharge teaching for a patient with hypertension
whohasa newprescriptionfor enalapril(Vasotec).The chargenursewill needto interveneif the new RN tells the
patient to
a. increasethedietaryintakeof high-potassiumfoods.
b. makean appointmentwiththedietitianfor teaching.
c. checkthebloodpressure(BP) at homeat leastoncea day.
d. moveslowlywhenmovingfromlying to sittingto standing.
ANS: A
The ACE inhibitors cause retention of potassium by the kidney, so hyperkalemia is a possible adverse effect.
other The
teachingby thenewRN is appropriatefor a patientwithnewlydiagnosedhypertensionwhohasjust started therapy
with enalapril.
6. Which assessmentfinding for a patientwhois receivingIV furosemide(Lasix) to treatstage 2
hypertension is most important to report to the health care provider?
a. Bloodglucoselevelof 175mg/dL
b. Serumpotassiumlevelof 3.0 mEq/L
c. OrthostaticsystolicBP decreaseof 12 mm Hg
d. Mostrecentbloodpressure(BP) readingof 168/94mm Hg
ANS: B
Hypokalemiais a frequentadverseeffectof theloopdiureticsand can causelife-threateningdysrhythmias.The health
care provider should be notified of the potassium level immediately and administration of potassium supplements
initiated. The elevated blood glucose andalso
BP indicate a need for collaborative interventions but will not require
action as urgently as the hypokalemia.
An orthostatic drop of 12 mm Hg will require intervention only if the patient is
symptomatic.
7. Which nursing actionshouldthenursetakefirst to assista patientwithnewlydiagnosedstage1
hypertension in making needed dietary changes?
a. Collecta detaileddiethistory.
b. Providea list of low-sodiumfoods.
c. Help thepatientmakean appointmentwitha dietitian.
This study source was downloaded by 100000897757654 from CourseHero.com on 10-06-2025 05:27:44 GMT -05:00
https://www.coursehero.com/file/96538672/HESI-MED-SURG-MED-SURG-55-QUESTIONS-RN-V1-MOST-ANSWERSdocx/
