HESI Med-Surg 1

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Sample questions from HESI Med-Surg 1

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A client with COPD is receiving oxygen by nasal cannula at 2 L/min. The client becomes drowsy, and the respiratory rate decreases from 18 to 10/min. What should the nurse do first?

   • A.Remove the oxygen and reassess in 15 minutes
   • B.Assess respiratory status and oxygen saturation, then notify the provider
   • C.Increase oxygen to 6 L/min
   • D.Encourage the client to drink fluids

   Rationale: A decreased respiratory rate and new drowsiness may indicate worsening ventilation, so assess airway, breathing, and oxygenation promptly and report the change. Removing oxygen can worsen hypoxemia, while increasing the flow without assessment may also be unsafe. Fluids do not address the immediate respiratory concern; titrate oxygen only according to the prescription or protocol.

2. 2.A client with asthma is wheezing and has difficulty speaking in full sentences. Which prescribed medication should the nurse administer first?

   • A.Inhaled albuterol
   • B.Oral montelukast
   • C.Inhaled fluticasone
   • D.Oral prednisone

   Rationale: Inhaled albuterol is a rapid-acting bronchodilator used for acute bronchospasm. Montelukast and inhaled fluticasone are controller therapies and do not provide immediate relief. Prednisone may be prescribed for an exacerbation, but it does not act as quickly as a rescue bronchodilator.

3. 3.A client with suspected pulmonary tuberculosis is admitted to the hospital. Which action should the nurse take?

   • A.Place the client in a positive-pressure room
   • B.Use droplet precautions and a surgical mask
   • C.Place the client in an airborne infection isolation room and wear a fit-tested respirator
   • D.Use contact precautions and a gown

   Rationale: Pulmonary tuberculosis spreads through airborne particles, so the client needs an airborne infection isolation room and staff need a fit-tested respirator. Positive-pressure rooms are used to protect selected immunocompromised clients, not to contain infectious particles. Droplet and contact precautions alone do not provide adequate protection from tuberculosis.

4. 4.A client with heart failure reports increasing shortness of breath and has crackles in both lung bases. Which position should the nurse use first?

   • A.Flat with legs elevated
   • B.High-Fowler's with legs dependent
   • C.Trendelenburg position
   • D.Side-lying with knees flexed

   Answer and rationale are in the full material.

5. 5.A client with heart failure takes furosemide daily. Which laboratory result is most important for the nurse to report?

   • A.Potassium 3.0 mEq/L
   • B.Sodium 138 mEq/L
   • C.Hemoglobin 13 g/dL
   • D.Calcium 9.2 mg/dL

   Answer and rationale are in the full material.