Med-Surg II HESI Exam 2023 Study Guide, Answered 100% Correct {All Answers Verified + Rationale}

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Med-Surg II HESI Exam 2023 Study Guide, Answered 100% Correct {All Answers Verified + Rationale} A nurse is collecting data from a client who has emphysema. Which of the following findings should t... he nurse expect? (Select all that apply.) 1. Dyspnea 2. Barrel chest 3. Clubbing of the fingers 4. Shallow respirations 5. Bradycardia Answer:- 1, 2, 3, 4 A nurse is caring for a client who has Cushing's syndrome. Which of the following clinical manifestations should the nurse expect to observe? (Select all that apply.) 1. Buffalo hump 2. Purple striations 3. Moon face 4. Tremors 5. Obese extremities Answer:- 1, 2, 3 A nurse is assisting with the care of a client immediately following a lumbar puncture. Which of the following actions should the nurse take? (Select all that apply.) 1. Encourage fluid intake. 2. Monitor the puncture site for hematoma. 3. Insert a urinary catheter. 4. Elevate the client’s head of bed. 5. Apply a cervical collar to the client. Answer:- 1, 2, A nurse is reinforcing pre-operative teaching for a client who is scheduled for surgery and is to take hydroxyzine preoperatively. Which of the following effects of the medication should the nurse include in the teaching? (Select all that apply.) 1. Decreasing anxiety 2. Controlling emesis 3. Relaxing skeletal muscles 4. Preventing surgical site infections 5. Reducing the amount of narcotics needed for pain relief Answer:- 1, 2, 5 A nurse is reinforcing teaching with a client who has type 2 diabetes mellitus. The nurse determines that teaching has been effective when the client identifies which of the following manifestations of hypoglycaemia? (Select all that apply.) 1. Polyuria 2. Blurry vision 3. Tachycardia 4. Polydipsia 5. Sweating Answer:- 2, 3, 5 A nurse is collecting data from a client who has an exacerbation of gout. Which of the following findings should the nurse expect? (Select all that apply.) 1. Edema 2. Erythema 3. Tophi 4. Tight skin 5. Symmetrical joint pain Answer:- 1, 2, 3, 4 A nurse is assisting in the plan of care for a client who had surgery for a bowel obstruction. The client has a nasogastric tube in place. Which of the following actions should the nurse include in the client's plan of care? (Select all that apply.) 1. Perform leg exercises every 2 hr. 2. Encourage hourly use of an incentive spirometer while awake. 3. Document the colour, consistency, and amount of nasogastric drainage. 4. Irrigate the nasogastric tube every 4 to 8 hr. 5. Maintain bed rest for 48 hr following surgery. Answer:- 1, 2, 3 A nurse is assisting with discharge teaching for a client who is postoperative following a laryngectomy. Which of the following instructions should the nurse include in the teaching? (Select all that apply.) 1. To aid in swallowing food, tip the chin before swallowing. 2. Avoid using liquid supplements. 3. Include warm foods in your diet because they are easier to swallow. 4. Swallow twice after each bite. 5. Take a sip of water with each bite of food. Answer:- 1, 4 A nurse is assisting with discharge teaching for a client who is postoperative from a mastectomy including the removal of axillary lymph nodes. Which of the following instructions should the nurse include? (Select all that apply.) 1. Use talcum powder instead of deodorant on the affected side for the first two weeks after surgery. 2. Perform range-of-motion exercises of the affected arm. 3. Avoid lifting arm above shoulder level on the affected side. 4. Wait 72 hr before consuming a regular diet. 5. Elevated the affected arm on a pillow when resting in bed. Answer Rationale: 2, 5 A client who is postoperative returns to the unit in skeletal traction. When collecting data from the client, the nurse should expect which of the following findings? (Select all that apply.) 1) Redness at the pin sites 2) Warmth at the pin sites 3) Movement of the pins at the insertion sites 4) No drainage from the pin sites 5) Tenting of the skin around the pin sites Answer Rationale: 1, 2, [Show More]

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