HESI RN Case Studies Med Surg Practice
Exam(Rationales) Questions and Answers
100% Correct [Grade A]– Chamberlain
Which client should the nurse recognize as most likely to experience sleep apnea?
A. Middle-aged female who takes a diuretic nightly.
B. Obese older male client with a short, thick neck.
C. Adolescent female with a history of tonsillectomy.
D. School-aged male with a history of hyperactivity disorder. - correct answer B.
Obese older male client with a short, thick neck.
Sleep apnea is characterized by lack of respirations for 10 seconds or more during
sleep and is due to the loss of pharyngeal tone which allows the pharynx to collapse
during inspiration and obstructs air flow through the nose and mouth. Risk factors
which increase the condition of sleep apnea include: excessive weight, increases the
risk 4 times more than normal weighing individuals; neck circumference, thicker necks
have narrower airways; individuals with inherited narrower airways; males in general
are more prone to sleep apnea; females risk increase with being overweight and post-
menopausal; increased age (geriatrics); family history; use of alcohol, sedatives or
tranquilizers; smokers and those who suffer from nasal allergies.
Which milestone indicates to the nurse successful achievement of young adulthood?
A. Demonstrates a conceptualization of death and dying.
B. Completes education and becomes self-supporting.
C. Creates a new definition of self and roles with others.
D. Develops a strong need for parental support and approval. - correct answer B.
Completes education and becomes self-supporting.
Transitioning through young adulthood is characterized by establishing independence
as an adult, and includes developmental tasks such as completing education, beginning
a career, and becoming self-supporting.
A client who has heart failure is admitted with a serum potassium level of 2.9 mEq/L
(2.9 mmol/L). Which action is most important for the nurse to implement?
A. Give 20 mEq of potassium chloride.
B. Initiate continuous cardiac monitoring.
C. Arrange a consultation with the dietician.
D. Teach about the side effects of diuretics. - correct answer B. Initiate continuous
cardiac monitoring.
Hypokalemia (normal 3.5 to 5 mEq/L [3.5 to 5 mmol/L]) causes changes in myocardial
irritability and ECG waveform, so it is most important for the nurse to initiate
continuous cardiac monitoring to identify ventricular ectopy or other life-threatening
,HESI RN Case Studies Med Surg Practice
Exam(Rationales) Questions and Answers
100% Correct [Grade A]– Chamberlain
dysrhythmias. After cardiac monitoring is initiated, then the potassium chloride should
be given so that the effects of potassium replacement on the cardiac rhythm can be
monitored.
Which postmenopausal client's complaint should the nurse refer to the healthcare
provider?
A. Breasts feel lumpy when palpated.
B. History of white nipple discharge.
C. Episodes of vaginal bleeding.
D. Excessive diaphoresis occurs at night. - correct answer C. Episodes of vaginal
bleeding.
Postmenopausal vaginal bleeding may be an indication of endometrial cancer, which
should be reported to the healthcare provider.
The nurse is teaching a female client about the best time to plan sexual intercourse in
order to conceive. Which information should the nurse provide?
A. Two weeks before menstruation.
B. Vaginal mucous discharge is thick.
C. Low basal temperature.
D. First thing in the morning. - correct answer A. Two weeks before menstruation.
Ovulation typically occurs 14 days before menstruation begins during a typical 28 day
cycle. Sexual intercourse should occur within 24 hours of ovulation for an increase
chance of conception to occur. High estrogen levels occur during ovulation and
increase the vaginal mucous membrane characteristics to become more "slippery" and
stretchy, along with a rise in basal temperature. The timing during the day is not as
significant in determining conception as the day before and after ovulation.
A postmenopausal client asks the nurse why she is experiencing discomfort during
intercourse. Which response is best for the nurse to provide?
A. Estrogen deficiency causes the vaginal tissues to become dry and thinner.
B. Infrequent intercourse results in the vaginal tissues losing their elasticity.
C. Dehydration from inadequate fluid intake causes vulva tissue dryness.
D. Lack of adequate stimulation is the most common reason for dyspareunia. - correct
answer A. Estrogen deficiency causes the vaginal tissues to become dry and thinner.
Estrogen deprivation decreases the moisture-secreting capacity of vaginal cells, so
vaginal tissues tend to become thinner, drier, and the rugae become smoother which
reduces vaginal stretching that contributes to dyspareunia. The discomfort during
, HESI RN Case Studies Med Surg Practice
Exam(Rationales) Questions and Answers
100% Correct [Grade A]– Chamberlain
intercourse, primary cause can be contributed to the decrease in estrogen hormone
levels.
Which discharge instruction is most important for a client after a kidney transplant?
A. Weigh weekly.
B. Report symptoms of secondary Candidiasis.
C. Use daily reminders to take immunosuppressants.
D. Stop cigarette smoking. - correct answer C. Use daily reminders to take
immunosuppressants.
After a renal transplantation, acute rejection is a high risk for several months. The
organ recipient will have to take immunosuppressive therapy for the rest of their lives,
such as corticosteroids and azathioprine, to prevent organ transplant rejection.
Discharge instructions include measures such as daily reminders to ensure the client
takes these medications regularly to prevent organ rejection from occurring.
The nurse is assessing a client with chronic kidney disease (CKD). Which finding is
most important for the nurse to respond to first?
A. Potassium 6.0 mEq.
B. Daily urine output of 400 ml.
C. Peripheral neuropathy.
D. Uremic fetor. - correct answer A. Potassium 6.0 mEq.
When assessing a client with chronic kidney disease (CKD), hyperkalemia (normal
serum level, 3.5 to 5.5 mEq) is a serious electrolyte disorder that can cause fatal
arrhythmias, so the elevation of the potassium level is a nursing priority.
Which finding should the nurse identify as most significant for a client diagnosed with
polycystic kidney disease (PKD)?
A. Hematuria.
B. 2 pounds weight gain.
C. 3+ bacteria in urine.
D. Steady, dull flank pain. - correct answer C. 3+ bacteria in urine.
Urinary tract infections (UTI) for a client with polycystic kidney disease (PKD) require
prompt antibiotic therapy to prevent renal damage and scarring which may cause
further progression of the disease so bacteria in the urine would be significant finding.
Exam(Rationales) Questions and Answers
100% Correct [Grade A]– Chamberlain
Which client should the nurse recognize as most likely to experience sleep apnea?
A. Middle-aged female who takes a diuretic nightly.
B. Obese older male client with a short, thick neck.
C. Adolescent female with a history of tonsillectomy.
D. School-aged male with a history of hyperactivity disorder. - correct answer B.
Obese older male client with a short, thick neck.
Sleep apnea is characterized by lack of respirations for 10 seconds or more during
sleep and is due to the loss of pharyngeal tone which allows the pharynx to collapse
during inspiration and obstructs air flow through the nose and mouth. Risk factors
which increase the condition of sleep apnea include: excessive weight, increases the
risk 4 times more than normal weighing individuals; neck circumference, thicker necks
have narrower airways; individuals with inherited narrower airways; males in general
are more prone to sleep apnea; females risk increase with being overweight and post-
menopausal; increased age (geriatrics); family history; use of alcohol, sedatives or
tranquilizers; smokers and those who suffer from nasal allergies.
Which milestone indicates to the nurse successful achievement of young adulthood?
A. Demonstrates a conceptualization of death and dying.
B. Completes education and becomes self-supporting.
C. Creates a new definition of self and roles with others.
D. Develops a strong need for parental support and approval. - correct answer B.
Completes education and becomes self-supporting.
Transitioning through young adulthood is characterized by establishing independence
as an adult, and includes developmental tasks such as completing education, beginning
a career, and becoming self-supporting.
A client who has heart failure is admitted with a serum potassium level of 2.9 mEq/L
(2.9 mmol/L). Which action is most important for the nurse to implement?
A. Give 20 mEq of potassium chloride.
B. Initiate continuous cardiac monitoring.
C. Arrange a consultation with the dietician.
D. Teach about the side effects of diuretics. - correct answer B. Initiate continuous
cardiac monitoring.
Hypokalemia (normal 3.5 to 5 mEq/L [3.5 to 5 mmol/L]) causes changes in myocardial
irritability and ECG waveform, so it is most important for the nurse to initiate
continuous cardiac monitoring to identify ventricular ectopy or other life-threatening
,HESI RN Case Studies Med Surg Practice
Exam(Rationales) Questions and Answers
100% Correct [Grade A]– Chamberlain
dysrhythmias. After cardiac monitoring is initiated, then the potassium chloride should
be given so that the effects of potassium replacement on the cardiac rhythm can be
monitored.
Which postmenopausal client's complaint should the nurse refer to the healthcare
provider?
A. Breasts feel lumpy when palpated.
B. History of white nipple discharge.
C. Episodes of vaginal bleeding.
D. Excessive diaphoresis occurs at night. - correct answer C. Episodes of vaginal
bleeding.
Postmenopausal vaginal bleeding may be an indication of endometrial cancer, which
should be reported to the healthcare provider.
The nurse is teaching a female client about the best time to plan sexual intercourse in
order to conceive. Which information should the nurse provide?
A. Two weeks before menstruation.
B. Vaginal mucous discharge is thick.
C. Low basal temperature.
D. First thing in the morning. - correct answer A. Two weeks before menstruation.
Ovulation typically occurs 14 days before menstruation begins during a typical 28 day
cycle. Sexual intercourse should occur within 24 hours of ovulation for an increase
chance of conception to occur. High estrogen levels occur during ovulation and
increase the vaginal mucous membrane characteristics to become more "slippery" and
stretchy, along with a rise in basal temperature. The timing during the day is not as
significant in determining conception as the day before and after ovulation.
A postmenopausal client asks the nurse why she is experiencing discomfort during
intercourse. Which response is best for the nurse to provide?
A. Estrogen deficiency causes the vaginal tissues to become dry and thinner.
B. Infrequent intercourse results in the vaginal tissues losing their elasticity.
C. Dehydration from inadequate fluid intake causes vulva tissue dryness.
D. Lack of adequate stimulation is the most common reason for dyspareunia. - correct
answer A. Estrogen deficiency causes the vaginal tissues to become dry and thinner.
Estrogen deprivation decreases the moisture-secreting capacity of vaginal cells, so
vaginal tissues tend to become thinner, drier, and the rugae become smoother which
reduces vaginal stretching that contributes to dyspareunia. The discomfort during
, HESI RN Case Studies Med Surg Practice
Exam(Rationales) Questions and Answers
100% Correct [Grade A]– Chamberlain
intercourse, primary cause can be contributed to the decrease in estrogen hormone
levels.
Which discharge instruction is most important for a client after a kidney transplant?
A. Weigh weekly.
B. Report symptoms of secondary Candidiasis.
C. Use daily reminders to take immunosuppressants.
D. Stop cigarette smoking. - correct answer C. Use daily reminders to take
immunosuppressants.
After a renal transplantation, acute rejection is a high risk for several months. The
organ recipient will have to take immunosuppressive therapy for the rest of their lives,
such as corticosteroids and azathioprine, to prevent organ transplant rejection.
Discharge instructions include measures such as daily reminders to ensure the client
takes these medications regularly to prevent organ rejection from occurring.
The nurse is assessing a client with chronic kidney disease (CKD). Which finding is
most important for the nurse to respond to first?
A. Potassium 6.0 mEq.
B. Daily urine output of 400 ml.
C. Peripheral neuropathy.
D. Uremic fetor. - correct answer A. Potassium 6.0 mEq.
When assessing a client with chronic kidney disease (CKD), hyperkalemia (normal
serum level, 3.5 to 5.5 mEq) is a serious electrolyte disorder that can cause fatal
arrhythmias, so the elevation of the potassium level is a nursing priority.
Which finding should the nurse identify as most significant for a client diagnosed with
polycystic kidney disease (PKD)?
A. Hematuria.
B. 2 pounds weight gain.
C. 3+ bacteria in urine.
D. Steady, dull flank pain. - correct answer C. 3+ bacteria in urine.
Urinary tract infections (UTI) for a client with polycystic kidney disease (PKD) require
prompt antibiotic therapy to prevent renal damage and scarring which may cause
further progression of the disease so bacteria in the urine would be significant finding.
