______________________________________
HESI RN
MEDSURG V2
(NGN-STYLE QUESTIONS & CASE
“SCENARIOS”)
QUESTIONS AND VERIFIED ANSWERS|
100% CORRECT| GRADED A+
EXAM COVER SHEET
PROGRAM: RN Nursing Program
COURSE NAME: Medical-Surgical Nursing
EXAM NAME: HESI RN Medical-Surgical Exam Version 2
3 FULL SET EXAMS
,Table of Contents
HESI MEDSURG V2 EXAM SET 1.................................. 2
HESI MEDSURG V2 EXAM SET 2................................ 34
HESI MEDSURG V2 EXAM SET 3................................ 57
HESI MEDSURG V2 EXAM SET 1
Contraindication to Peritoneal Dialysis
A client with chronic kidney disease (CKD) is preparing to begin dialysis therapy.
The healthcare team is evaluating whether the client is a candidate for
peritoneal dialysis (PD) or hemodialysis. During the review of the client's
medical history, the nurse identifies several conditions that may affect the
choice of dialysis modality. Which condition should the nurse recognize as a
contraindication to peritoneal dialysis?
a. Nephrotic syndrome history
b. Crohn's disease with colectomy
c. Diabetes Mellitus
d. Latent Hepatitis C
b. Crohn's disease with colectomy
Rationale: Peritoneal dialysis uses the peritoneal membrane within the abdomen
as a filter to remove waste products and excess fluid from the body. Clients with
Crohn's disease, a history of major abdominal surgery, colectomy, severe
inflammatory bowel disease, adhesions, or other significant abdominal disorders
,may not be suitable candidates for peritoneal dialysis. These conditions can
interfere with the effectiveness of the dialysis process and increase the risk of
complications such as infection, poor dialysate flow, leakage, and impaired
peritoneal membrane function. Therefore, a history of Crohn's disease with
colectomy is considered a contraindication to peritoneal dialysis.
Assessing for Excessive Levothyroxine Dosage
A client is admitted to the hospital for treatment of a simple goiter and has
been prescribed levothyroxine sodium. The nurse understands that
levothyroxine is a synthetic thyroid hormone used to replace or supplement
thyroid hormone levels. Because the medication dosage must be carefully
adjusted, the nurse monitors the client for signs of overmedication. Which
symptoms indicate that the prescribed dosage may be too high?
a. Palpitations and shortness of breath
b. Bradycardia and constipation
c. Muscle cramping and dry, flushed skin
d. Lethargy and lack of appetite
a. Palpitations and shortness of breath
Rationales: Levothyroxine replaces thyroid hormone and increases the body's
metabolic activity. When the dosage is too high, the client may develop
symptoms similar to hyperthyroidism, including palpitations, tachycardia,
shortness of breath, nervousness, tremors, increased sweating, insomnia, and
weight loss. These symptoms indicate excessive thyroid hormone levels and may
place the client at risk for serious cardiovascular complications. The nurse should
report these findings promptly so the dosage can be evaluated and adjusted if
necessary.
, Mechanism of Edema and Ascites in Cirrhosis
A nurse is assessing a client with cirrhosis of the liver and notes 4+ pitting
edema in both lower extremities and massive ascites. The nurse understands
that liver dysfunction affects the body's ability to regulate fluid balance. To
provide appropriate care, the nurse must understand the underlying mechanism
responsible for the development of edema and ascites in clients with cirrhosis.
Which mechanism contributes to these findings?
a. Decreased portacaval pressure with greater collateral circulation.
b. Hyperaldosteronism causing an increased sodium reabsorption in renal
tubules.
c. Decreased renin-angiotensin response related to an increase in renal
bloodflow.
d. Hypoalbuminemia that results in a decreased colloidal oncotic pressure.
d. Hypoalbuminemia that results in a decreased colloidal oncotic pressure.
Rationale: In Cirrhosis, liver damaged leads to decreased synthesis of albumin.
Albumin plays a crucial role in maintaining colloidal oncotic pressure, and when it
is decreased (hypoalbuminemia), fluid is more likely to leak out of blood vessels,
resulting in anemia. The same mechanism contributes to the development of
ascities in the abdominal cavity.
Nursing Care for a Client in Skeletal Traction
A client with a fracture of the right femur has had skeletal traction applied to
maintain bone alignment and promote healing. The nurse understands that
skeletal traction involves pins inserted directly into the bone, creating a risk for
complications that require ongoing monitoring. Which intervention should the
nurse include in the client's nursing care plan?
a. assess the pin sites for signs of infection.
b. administer pain medication at designated intervals around the clock.
c. assess the pulse proximal to the fracture site.
d. Remove traction every provide skin care.
HESI RN
MEDSURG V2
(NGN-STYLE QUESTIONS & CASE
“SCENARIOS”)
QUESTIONS AND VERIFIED ANSWERS|
100% CORRECT| GRADED A+
EXAM COVER SHEET
PROGRAM: RN Nursing Program
COURSE NAME: Medical-Surgical Nursing
EXAM NAME: HESI RN Medical-Surgical Exam Version 2
3 FULL SET EXAMS
,Table of Contents
HESI MEDSURG V2 EXAM SET 1.................................. 2
HESI MEDSURG V2 EXAM SET 2................................ 34
HESI MEDSURG V2 EXAM SET 3................................ 57
HESI MEDSURG V2 EXAM SET 1
Contraindication to Peritoneal Dialysis
A client with chronic kidney disease (CKD) is preparing to begin dialysis therapy.
The healthcare team is evaluating whether the client is a candidate for
peritoneal dialysis (PD) or hemodialysis. During the review of the client's
medical history, the nurse identifies several conditions that may affect the
choice of dialysis modality. Which condition should the nurse recognize as a
contraindication to peritoneal dialysis?
a. Nephrotic syndrome history
b. Crohn's disease with colectomy
c. Diabetes Mellitus
d. Latent Hepatitis C
b. Crohn's disease with colectomy
Rationale: Peritoneal dialysis uses the peritoneal membrane within the abdomen
as a filter to remove waste products and excess fluid from the body. Clients with
Crohn's disease, a history of major abdominal surgery, colectomy, severe
inflammatory bowel disease, adhesions, or other significant abdominal disorders
,may not be suitable candidates for peritoneal dialysis. These conditions can
interfere with the effectiveness of the dialysis process and increase the risk of
complications such as infection, poor dialysate flow, leakage, and impaired
peritoneal membrane function. Therefore, a history of Crohn's disease with
colectomy is considered a contraindication to peritoneal dialysis.
Assessing for Excessive Levothyroxine Dosage
A client is admitted to the hospital for treatment of a simple goiter and has
been prescribed levothyroxine sodium. The nurse understands that
levothyroxine is a synthetic thyroid hormone used to replace or supplement
thyroid hormone levels. Because the medication dosage must be carefully
adjusted, the nurse monitors the client for signs of overmedication. Which
symptoms indicate that the prescribed dosage may be too high?
a. Palpitations and shortness of breath
b. Bradycardia and constipation
c. Muscle cramping and dry, flushed skin
d. Lethargy and lack of appetite
a. Palpitations and shortness of breath
Rationales: Levothyroxine replaces thyroid hormone and increases the body's
metabolic activity. When the dosage is too high, the client may develop
symptoms similar to hyperthyroidism, including palpitations, tachycardia,
shortness of breath, nervousness, tremors, increased sweating, insomnia, and
weight loss. These symptoms indicate excessive thyroid hormone levels and may
place the client at risk for serious cardiovascular complications. The nurse should
report these findings promptly so the dosage can be evaluated and adjusted if
necessary.
, Mechanism of Edema and Ascites in Cirrhosis
A nurse is assessing a client with cirrhosis of the liver and notes 4+ pitting
edema in both lower extremities and massive ascites. The nurse understands
that liver dysfunction affects the body's ability to regulate fluid balance. To
provide appropriate care, the nurse must understand the underlying mechanism
responsible for the development of edema and ascites in clients with cirrhosis.
Which mechanism contributes to these findings?
a. Decreased portacaval pressure with greater collateral circulation.
b. Hyperaldosteronism causing an increased sodium reabsorption in renal
tubules.
c. Decreased renin-angiotensin response related to an increase in renal
bloodflow.
d. Hypoalbuminemia that results in a decreased colloidal oncotic pressure.
d. Hypoalbuminemia that results in a decreased colloidal oncotic pressure.
Rationale: In Cirrhosis, liver damaged leads to decreased synthesis of albumin.
Albumin plays a crucial role in maintaining colloidal oncotic pressure, and when it
is decreased (hypoalbuminemia), fluid is more likely to leak out of blood vessels,
resulting in anemia. The same mechanism contributes to the development of
ascities in the abdominal cavity.
Nursing Care for a Client in Skeletal Traction
A client with a fracture of the right femur has had skeletal traction applied to
maintain bone alignment and promote healing. The nurse understands that
skeletal traction involves pins inserted directly into the bone, creating a risk for
complications that require ongoing monitoring. Which intervention should the
nurse include in the client's nursing care plan?
a. assess the pin sites for signs of infection.
b. administer pain medication at designated intervals around the clock.
c. assess the pulse proximal to the fracture site.
d. Remove traction every provide skin care.
