HESI RN MEDICAL SURGICAL PROCTORED EXAM
NAXLEX MOST TESTED EXAM QUESTIONS AND ANSWERS
GRADED A+ ASSURED SUCCESS
A client with Addison's disease started taking hydrocortisone in a
divided daily dose last week. It is most important for the nurse to
monitor which serum laboratory value?
A. Osmolarity
B. Platelets
C. Albumin
D. Glucose Correct Answers Correct Answer : D
Osmolarity is a measure of the concentration of solutes in the blood.
While it can be important in certain contexts, it is not the primary
concern when monitoring a client with Addison's disease who is on
hydrocortisone therapy.
Platelets are a component of blood involved in clotting. Monitoring
platelet count is important in certain conditions, but it is not the primary
focus for a client with Addison's disease on hydrocortisone therapy.
Albumin is a protein in the blood that helps maintain osmotic pressure
and transport substances. While it is important to monitor albumin
levels in some conditions, it is not the primary concern for a client with
Addison's disease on hydrocortisone therapy.
D. Glucose levels are crucial to monitor in clients with Addison's
disease on hydrocortisone therapy. Hydrocortisone can affect glucose
metabolism, potentially leading to hyperglycemia. Monitoring glucose
levels helps ensure that the client's blood sugar remains within a safe
range and allows for timely intervention if necessary.
,A client who is experiencing a first gouty arthritis attack reports
excruciating pain in the right great toe. The nurse inspects the inflamed
joint and administers ibuprofen 800mg PO as prescribed. Which
instruction should the nurse include in the discharge teaching?
A. Replace dietary table salt with salt substitutes.
B. Encourage active range of motion to limit stiffness.
C. Take prescribed pain medication after exercising joints.
D. Avoid the consumption of wine, beer, and coffee. Correct Answers
Correct Answer : D
D. Avoiding the consumption of wine, beer, and coffee is crucial for
managing gout. Alcohol, particularly beer and wine, contains high levels
of purines, which can increase uric acid production and exacerbate gout
symptoms. Alcohol also promotes dehydration, which can lead to higher
uric acid concentrations in the blood. Both of these factors can trigger
gout attacks. Coffee has mixed effects on gout; while some studies
suggest that moderate coffee consumption may not significantly impact
uric acid levels, it is generally advised to be cautious with its intake.
Educating the client to avoid or limit these beverages can help prevent
future gout attacks and manage symptoms more effectively. Dietary
modifications are a key component of gout management, and avoiding
high-purine foods and beverages is essential in reducing the frequency
and severity of gout attacks.
During a routine eye examination, an older client reports decreased
peripheral vision and is found to have elevated intraocular pressures.
Ophthalmic drops are prescribed for primary open-angle glaucoma
,(POAG). Which intervention(s) should the nurse include in this client's
plan of care? Select all that apply.
A. Review written and verbal instructions for a reduced sodium diet.
B. Teach strategies for aseptic administration of the eye drops.
C. Describe how the use of the eye drops will help improve peripheral
vision.
D. Teach to apply pressure over the inner eye corner after eye drops.
E. Explain the need to continue eye drops for the rest of their life.
Correct Answers Correct Answer: B,D,E
Choice B reason: Teaching strategies for aseptic administration of the
eye drops is a critical intervention for clients with POAG. Proper
administration of ophthalmic drops is essential to avoid contamination
and infection. Aseptic techniques include washing hands before
administering the drops, avoiding touching the dropper tip to any
surface (including the eye), and ensuring that the dropper cap is replaced
tightly after use. These measures help maintain the sterility of the
medication and prevent complications such as eye infections, which can
exacerbate the client's condition.
Choice D reason: Teaching the client to apply pressure over the inner
eye corner (punctal occlusion) after administering eye drops is an
important intervention. Punctal occlusion helps prevent the medication
from draining into the tear duct and being absorbed systemically. This
technique increases the contact time of the medication with the eye,
enhancing its effectiveness and reducing potential systemic side effects.
Clients should be instructed to gently press the inner corner of the eye
for a few minutes after instilling the drops to ensure maximum benefit.
, Choice E reason: Explaining the need to continue eye drops for the rest
of their life is essential for clients with POAG. Glaucoma is a chronic
condition that requires lifelong management to control intraocular
pressure and prevent progression of the disease. Discontinuing the
medication can lead to elevated intraocular pressures and irreversible
vision loss.
A client with oral cancer is receiving radiotherapy (RT) prior to surgery.
Which intervention should the nurse teach the client to implement in
managing mucositis related to RT?
A. Place chin down and tilt head for dyspahgia during meals.
B. Normal saline mouth rinses as swish and spit after meals and
bedtime.
C. Eat high caloric meals to prevent weight loss.
D. Use a commercial mouthwash for xerostomia. Correct Answers
Correct Answer : B
Normal saline mouth rinses as swish and spit after meals and bedtime is
an effective intervention for managing mucositis. Rinsing with saline
helps to keep the mouth clean, reduce bacterial load, and soothe
inflamed tissues. It can also help to remove food particles and debris,
reducing the risk of infection and promoting healing. Saline rinses are
gentle and do not contain irritating ingredients, making them ideal for
sensitive oral tissues affected by mucositis.
The nurse obtains a fingerstick blood glucose level using a bedside
glucose meter from a client with a prescribed sliding scale insulin
NAXLEX MOST TESTED EXAM QUESTIONS AND ANSWERS
GRADED A+ ASSURED SUCCESS
A client with Addison's disease started taking hydrocortisone in a
divided daily dose last week. It is most important for the nurse to
monitor which serum laboratory value?
A. Osmolarity
B. Platelets
C. Albumin
D. Glucose Correct Answers Correct Answer : D
Osmolarity is a measure of the concentration of solutes in the blood.
While it can be important in certain contexts, it is not the primary
concern when monitoring a client with Addison's disease who is on
hydrocortisone therapy.
Platelets are a component of blood involved in clotting. Monitoring
platelet count is important in certain conditions, but it is not the primary
focus for a client with Addison's disease on hydrocortisone therapy.
Albumin is a protein in the blood that helps maintain osmotic pressure
and transport substances. While it is important to monitor albumin
levels in some conditions, it is not the primary concern for a client with
Addison's disease on hydrocortisone therapy.
D. Glucose levels are crucial to monitor in clients with Addison's
disease on hydrocortisone therapy. Hydrocortisone can affect glucose
metabolism, potentially leading to hyperglycemia. Monitoring glucose
levels helps ensure that the client's blood sugar remains within a safe
range and allows for timely intervention if necessary.
,A client who is experiencing a first gouty arthritis attack reports
excruciating pain in the right great toe. The nurse inspects the inflamed
joint and administers ibuprofen 800mg PO as prescribed. Which
instruction should the nurse include in the discharge teaching?
A. Replace dietary table salt with salt substitutes.
B. Encourage active range of motion to limit stiffness.
C. Take prescribed pain medication after exercising joints.
D. Avoid the consumption of wine, beer, and coffee. Correct Answers
Correct Answer : D
D. Avoiding the consumption of wine, beer, and coffee is crucial for
managing gout. Alcohol, particularly beer and wine, contains high levels
of purines, which can increase uric acid production and exacerbate gout
symptoms. Alcohol also promotes dehydration, which can lead to higher
uric acid concentrations in the blood. Both of these factors can trigger
gout attacks. Coffee has mixed effects on gout; while some studies
suggest that moderate coffee consumption may not significantly impact
uric acid levels, it is generally advised to be cautious with its intake.
Educating the client to avoid or limit these beverages can help prevent
future gout attacks and manage symptoms more effectively. Dietary
modifications are a key component of gout management, and avoiding
high-purine foods and beverages is essential in reducing the frequency
and severity of gout attacks.
During a routine eye examination, an older client reports decreased
peripheral vision and is found to have elevated intraocular pressures.
Ophthalmic drops are prescribed for primary open-angle glaucoma
,(POAG). Which intervention(s) should the nurse include in this client's
plan of care? Select all that apply.
A. Review written and verbal instructions for a reduced sodium diet.
B. Teach strategies for aseptic administration of the eye drops.
C. Describe how the use of the eye drops will help improve peripheral
vision.
D. Teach to apply pressure over the inner eye corner after eye drops.
E. Explain the need to continue eye drops for the rest of their life.
Correct Answers Correct Answer: B,D,E
Choice B reason: Teaching strategies for aseptic administration of the
eye drops is a critical intervention for clients with POAG. Proper
administration of ophthalmic drops is essential to avoid contamination
and infection. Aseptic techniques include washing hands before
administering the drops, avoiding touching the dropper tip to any
surface (including the eye), and ensuring that the dropper cap is replaced
tightly after use. These measures help maintain the sterility of the
medication and prevent complications such as eye infections, which can
exacerbate the client's condition.
Choice D reason: Teaching the client to apply pressure over the inner
eye corner (punctal occlusion) after administering eye drops is an
important intervention. Punctal occlusion helps prevent the medication
from draining into the tear duct and being absorbed systemically. This
technique increases the contact time of the medication with the eye,
enhancing its effectiveness and reducing potential systemic side effects.
Clients should be instructed to gently press the inner corner of the eye
for a few minutes after instilling the drops to ensure maximum benefit.
, Choice E reason: Explaining the need to continue eye drops for the rest
of their life is essential for clients with POAG. Glaucoma is a chronic
condition that requires lifelong management to control intraocular
pressure and prevent progression of the disease. Discontinuing the
medication can lead to elevated intraocular pressures and irreversible
vision loss.
A client with oral cancer is receiving radiotherapy (RT) prior to surgery.
Which intervention should the nurse teach the client to implement in
managing mucositis related to RT?
A. Place chin down and tilt head for dyspahgia during meals.
B. Normal saline mouth rinses as swish and spit after meals and
bedtime.
C. Eat high caloric meals to prevent weight loss.
D. Use a commercial mouthwash for xerostomia. Correct Answers
Correct Answer : B
Normal saline mouth rinses as swish and spit after meals and bedtime is
an effective intervention for managing mucositis. Rinsing with saline
helps to keep the mouth clean, reduce bacterial load, and soothe
inflamed tissues. It can also help to remove food particles and debris,
reducing the risk of infection and promoting healing. Saline rinses are
gentle and do not contain irritating ingredients, making them ideal for
sensitive oral tissues affected by mucositis.
The nurse obtains a fingerstick blood glucose level using a bedside
glucose meter from a client with a prescribed sliding scale insulin
