Fundamental and Med-Surg HESI Study Guide

Free preview · Original latest version

Sample questions from Fundamental and Med-Surg HESI Study Guide

This material has 24 questions with answers and rationales. Here are the first 5.

1. 1.A client returns from thyroid surgery. Thirty minutes later, the nurse hears inspiratory stridor and observes increasing respiratory effort. Which action has priority?

   • A.D. Reassess the incision in 30 minutes.
   • B.A. Obtain a complete pain history.
   • C.B. Activate emergency assistance and support the airway.
   • D.C. Encourage the client to drink cool fluids.

   Rationale: B is correct because stridor suggests upper airway obstruction and requires immediate airway support and emergency assistance. A delays treatment of a potentially fatal problem. C creates aspiration risk and does not correct obstruction. D is unsafe because the client is actively deteriorating.

2. 2.The RN is caring for four clients. Which task is most appropriate to delegate to experienced assistive personnel?

   • A.D. Determine whether chest pain improved after nitroglycerin.
   • B.C. Measure intake and output for a stable client.
   • C.B. Teach a client how to use a new walker.
   • D.A. Evaluate new confusion in a client with pneumonia.

   Rationale: C is correct because routine measurement and recording for a stable client is generally delegable with clear instructions. A requires assessment and interpretation. B involves initial teaching and evaluation of safe technique. D requires nursing evaluation of a potentially unstable symptom and medication response.

3. 3.A client with COPD has an oxygen saturation of 81%, marked dyspnea, and difficulty speaking. What should the nurse do first?

   • A.B. Withhold oxygen until an arterial blood gas is available.
   • B.C. Ask the client to walk to improve ventilation.
   • C.D. Restrict oxygen because all clients with COPD depend on hypoxia to breathe.
   • D.A. Apply oxygen and obtain urgent assistance.

   Rationale: A is correct because severe hypoxemia requires immediate oxygen and urgent evaluation. Oxygen can then be titrated using the appropriate target and blood gases. B delays necessary treatment. C increases oxygen demand during severe distress. D reflects an unsafe oversimplification and can cause preventable hypoxic injury.

4. 4.A client taking spironolactone has new muscle weakness. Laboratory testing shows potassium 6.3 mEq/L. Which action is most appropriate?

   • A.D. Hold potassium-raising medications pending urgent review and initiate cardiac assessment.
   • B.C. Recheck the potassium level at the next monthly visit.
   • C.A. Administer the scheduled potassium supplement.
   • D.B. Encourage potassium-containing salt substitutes.

   Answer and rationale are in the full material.

5. 5.A client with diabetes is alert, can swallow, and has a glucose of 54 mg/dL. Which intervention should the nurse perform first?

   • A.C. Give a meal high in fat and wait one hour.
   • B.D. Withhold treatment until a venous glucose is available.
   • C.B. Give approximately 15 g of rapid-acting carbohydrate.
   • D.A. Administer the scheduled rapid-acting insulin.

   Answer and rationale are in the full material.