HESI MED SURG Final Exam Preparations 2021 Top Grade Answers

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HESI MED SURG Final Exam Preparations Quality Questions & Answers Latest 2021 1. A home care nurse is preparing to visit a client with a diagnosis of Meniere’s disease. The nurse review’s the ph... ysician’s orders and expects to note that which of the following dietary measures will be prescribed? A. low fiber diet with decreased fluids B. low sodium diet and fluid restriction C. low carbohydrate diet and elimination of red meats D. low fat with restriction of citrus fruits 2. A nurse is assigned to care for a client who has just undergone eye surgery. The nurse plans to instruct the client that which of the following activities is permitted in the postoperative period? A. reading B. watching television C. bending over D. lifting objects 3. A nurse is instilling an otic solution into an adult client’s left ear. The nurse avoids doing which of the following as part of this procedure? A. warming the solution to room temperature B. placing the client in a side lying position with the ear facing up C. pulling the auricle backward and upward D. placing the tip of the dropper on the edge of the ear canal 4. A client has undergone surgery for glaucoma. The nurse provides which discharge instructions to the clients? A. wound healing usually takes 12 weeks B. expected the vision will be permanently impaired C. a shield or eye patch should be worn to protect the eye D. the sutures are removed after 1 week 5. Which assessment findings provide the best evidence that a client with acute angle-closure glaucoma is responding to drug therapy? A. swelling of the eyelids decreases B. redness of the sclera is reduced C. eye pain is reduced or eliminated D. peripheral vision is diminished 6. At the time of retinal detachment, a client most likely describes which symptoms? A. a seeing flashes of light B. being unable to see light C. feeling discomfort in light D. seeing poorly in daylight 7. The most important health teaching the nurse can provide to the client with conjunctivitis is to: A. eat a well balanced, nutritious diet B. wear sunglasses in bright light C. cease sharing towels and washcloths D. avoid products containing aspirin 8. When the nurse prepares the client or the myringotomy, the best explanation as to the purpose for the procedures is that it will: A. prevent permanent hearing loss B. provide a pathway for drainage C. aid in administering medications D. maintain motion of the ear bones 9. A nurse is reviewing the record of the client with a disorder involving the inner ear. Which of the following would the nurse expect to see documented as an assessment finding in this client? A. severe hearing loss B. complaints of severe pain in the affected ear C. complaints of burning in the ear D. complaints of tinnitus 10. A client with a conduction hearing loss asks the nurse how a hearing aid improves hearing. The nurse most accurately informs the client that a hearing aid: A. amplifies sound heard B. makes sounds sharper and clearer C. produces more distinct, crisp, speech D. eliminates garbled background sounds 11. Which nursing action is best for controlling the client’s nosebleed? A. have the client lay down slowly and swallow frequently B. have the client lay down and breathe through his mouth C. have the client lean forward and apply direct pressure D. have the client lean forward and clench his teeth Situation: Benjie 59 years old male was admitted to the hospital complaining of nausea, vomiting, weight loss of 20 lbs, constipation and diarrhea. A diagnosis of carcinoma of the colon was made. 12. A sigmoidoscopy was performed as a diagnostic measures. What position Benjie should assume for hi examination? A. knee-chest B. Sim’s C. Fowler’s D. Trendelenburg 13. As part of the preparation of the client for sigmoidoscopy the nurse should: A. explain to Benjie that he will swallow a chalk-like substance B. administer a cathartic the night before C. withhold fluids and foods on the day of examination D. administer cleansing enema in the morning of the examination 14. The doctor performed a colostomy, post operative nursing care include: A. keeping the skin around the opening clean and dry B. limiting visitors C. withholding D. limiting fluid intake 15. During the irrigation of the colostomy, Benjie complains of abdominal cramps, the nurse should: A. discontinue the irrigation B. clamp the catheter for a few minutes C. advance the catheter about one inch D. add color water 16. If colostomy irrigation is done, the height of the irrigator can must be how many inches above the stoma? A. 14-18 inches B. 18-20 inches C. 20-24 inches D. 10-14 inches 17. Which of the following gastrointestinal condition is known to predispose to Cancer of the colon? A. hemorrhoids B. intussusception C. islated colonic polyps D. pyloric stenosis Situation: Mr. J was brought to the ER complaining of pain located in the upper abdomen hematemesis and melena. Diagnosis is peptic ulcer. 18. A frequent discomfort experience by Mr. J due to his peptic ulcer C. eructation A client diagnosed with IDDM becomes irritable and confused; the skin is cool and clammy and the pulse rate is 110. The first action of the nurse would be to: A. give a half-cup of orange juice B. check the serum glucose C. administer regular insulin D. call the physician A client with IDDM is recovering from DKA. Information of the serum level of the following substance will be very important to the nurse: A. sodium C. potassium B. calcium D. magnesium A 17-year-old client’s mother has been recently diagnosed with pulmonary tuberculosis. The nurse would expect the doctor to order which of the following tests initially? A. the mantoux C. a sputum culture B. an X-ray D. gram stain of the sputum The nurse injects 0.1 ml. of purified protein derivative (PPD) intradermally into the inner aspect of the forearm of a client. This nurse will interpret the reaction to this test as positive when the following is seen: A. redness greater than 5mm. B. swelling greater than 7mm. C. induration greater than 10mm. D. exudates covering more than 12mm A 29-year-old has been taking Prednisolone 60 mg. daily for an inflammatory condition for the past 6 months. The physician just wrote an order to discontinue the medication. The nurse should: A. stop the medication as ordered B. continue the medication until physician is available C. call the physician and question the order D. hold the medication until the physician is available A 55 year old has a chest tube connected to a Pleur Evac system to remove blood from the pleural cavity. While turning the client the nurse remembers to: A. keep the Pleur Evac below the level of the wound B. Remove the suction from the Pleur vac C. Clamp the tubing connected to the Pleur Evac D. drain the sterile water from the Pleur Evac A client on anti-neoplastic therapy has a platelet count of 20,000/cu.mm (N wbc 5,000 to 10,000). An appropriate intervention for the nurse to use would be: A. administering Vit. K IM B. massaging injection sites to avoid absorption C. encouraging the use of firm toothbrushes and vigorous flossing D. avoiding rectal temperatures and other rectal procedures 22. A nurse assumes responsibility for the care of the client at 7 A.M. NPH insulin is ordered for 7:30 A.M. Before giving the insulin, the nurse checks to see if the client will eat that day and for the: A. signs and symptoms of hypoglycemia B. previous sites of injection C. serum glucagons level D. serum glucose level A nurse is teaching a client to observe for signs of hypoxia. The nurse explains that cyanosis is not reliable indicator of the amount that tissues are receiving because the blue color is caused by: A. reduced hemoglobin B. a low partial pressure of oxygen in the blood C. inability of oxygen to enter the cell D. increased pH of the blood A client has ARDS. The lowest fraction of inspired oxygen possible for optimizing gas exchange is used. The nurse explains to the family that the reason for this precaution is to: A. avoid respiratory depression B. prevent oxygen toxicity C. increase lung compliance D. promote production of surfactant A client who is recovering from a myocardial infarction demonstrates that touching has been effective with the statements: A. “if my chest pain lasts for more than 5 minutes, I should get myself to the emergency room” B. “I just need to avoid salty foods and not add salt to my food” C. “I need to avoid constipation and all activities that have caused me chest pain in the past” D. “I need to get to the drugstore to get some medicine for my cold” A client is admitted to the hospital complaining of nervousness, heat intolerance and muscle weakness. Her pulse rate is 118 and she has exopthalmos. An essential part of her assessment will be: A. palpation of the thyroid gland B. evaluation of fluid and electrolyte balance C. evaluation of deep tendon reflexes D. use of the Glasgow Coma Scale A client is scheduled for thyroidectomy. The nurse explains that PTU or an iodine preparation is given prior to surgery in order to: A. increase the size of the thyroid gland B. render the parathyroid glands visible C. induce a euthyroid state in the body D. Separate the thyroid from the laryngeal nerve A client is being evaluated for the possibility of Grave’s disease. The nurse teaches that the best laboratory test for evaluating whether a client has hypothyroidism or hyperthyroidism is the serum level of: A. thyroxine (T4) C. TSH B. triiodothyroinine (T3) D. epinephrine 29. A client is taking Levothyroxine (synthroid) for hypothyroidism. The nurse teaches the client to: A. monitor the pulse regularly B. restrict sodium in the diet C. take the drug with meals D. measure urinary output A client with NIDDM is admitted to the hospital. The client is confused and has dry mucus membranes and poor skin turgor. The serum sodium is 149; the blood pressure 90/60 mmHg; the pulse is 118; and the serum glucose 465 mg/dl. The nurse anticipates that insulin and the following will be needed: A. a potassium drip C. intravenous fluids B. sodium bicarbonate D. calcium gluconate A nurse is teaching a diabetic client how to attain the optimal level of health. When assessing for other risk factors stroke and heart attack, this nurse looks for: A. hypervolemia C. proteinuria B. hypokalemia D. hypertension A nurse stops at the sight of a motor vehicle accident to find a young woman slumped over the wheel. She is breathing with a regular rhythm at a rate of 22; ventilation efforts normal. Her pulse rate is 110. The nurse’s next action would be: A. check the level of consciousness B. immobilize the spine C. call the rescue squad D. check for bleeding A 57-year-old client is being prepared for discharge following a myocardial infarction. The nurse knows that her teaching has been understood when she hears: A. “I guess my sex life is over” B. “depression is bad for me. I must stay happy and optimistic” C. “ the best way to know the amount of exercise I should take is to watch my pulse” D. “the injured area will be replaced with a new heart tissue” A client with IDDM has just been admitted to the ER after hitting a telephone pole with her car. Bystanders said she acted as if she has been drinking. Her temperature is 37.4 degrees Celsius, pulse 80, resp. 44 and deep. She complained of headache and acted confused. A fruity odor was noted on her breath. Her ABG report read= pH= 7.32, pCO2= 36, and bicarbonate= 18. The nurse prepared for the treatment of: A. metabolic acidosis C. respiratory acidosis B. metabolic alkalosis D. respiratory alkalosis A client with peptic ulcer is taking Maalox, Amoxicillin and Famotidine. The nurse teaches the client to take the Maalox: A. 1-2 hours before meals C. ½ hour before meals B. with meals D. 1-2 hours after meals A client with varicose veins tells the nurse, “I am afraid they will burst while I am walking.” Which response by the nurse would be the BEST? A. “the only way to prevent rupture is to have surgery” B. “you must find another job, one that requires less walking” C. “if that happens, you could bleed to death” D. “rupture of varicose veins rarely occur” A client asks why is it important to check the pupils. The nurse replies that changes in the pupils are a reflection of how well the following area of the nervous system is functioning: A. spinal cord C. midbrain B. brain stem D. cerebellum A 32-year-old client is being evaluated in the clinic today for possible Addison’s disease. The nurse knows that the most common cause of the disease is attributed to: A. autoimmune response C. disseminated tuberculosis B. blastomycosis D. diabetes mellitus The nurse knows that the recommended diet for a client with Addison’s disease includes: A. 1 mg. Na C. low fat, low cholesterol B. 3 gms. Na D. high potassium, high cholesterol A 36-year-old client with a history of Cushing’s disease is being seen in the ER for complaints of anorexia, vomiting, weakness and muscle cramps for the past 24 hours. The nurse recognizes that these clinical findings are a result of: A. hypernatremia C. hyperglycemia B. hypoglycemia D. hypokalemia When teaching a patient about home care related to outpatient corticosteroid therapy, the nurse emphasizes that side effects of corticosteroid therapy include: A. hyperglycemia and weight loss B. hyponatremia and hypotension C. hypoglycemia and gastric ulcers D. hyperglycemia and weight gain Additional teaming to a newly diagnosed diabetic client related to the effects of regular insulin is necessary when the client asks, “if I take my regular insulin at 8 A.M., when might I experience signs of low blood sugar reaction? A. 8:30 am B. 11 am C. 1:30 pm D. 4 pm The nurse recognizes which of the following as signs of early hypoxia? A. bradycardia, hypotension, facial flushing B. confusion, bradycardia, headache C. hypotension, tachypnea, lethargy D. restlessness, yawning, tachycardia A 68-year-old client has a new colostomy and is being treated today at the clinic for diarrhea. When discussing diet with the client, the nurse explains to him that the one food that caused this problem was: A. cabbage C. tapioca B. eggs D. fried chicken The nurse is caring for a client with folic acid deficiency. The nurse recalls that one of the most frequent causes of folic acid deficiency is: A. poor nutritional intake due to alcoholism B. lack of absorption of the intrinsic factor C. a diet that consists of vegetables only and no meat D. a complicated pregnancy during the second trimester When planning care for a patient who is pancytopenic, the major goal should be: A. prevent hemorrhage and infection B. administering an oral iron preparation C. preventing fatigue and fluid overload D. encouraging consumption of a neutropenic diet when explaining different effects of chemotherapy to students, the nurse correctly identifies which group of chemotherapy drugs that does not affect DNA synthesis to kill tumor cells? A. hormones C. antimetabolites B. vinca alkalosis D. alkylating agents The nurse evaluates the client’s ability to self-monitor blood glucose level at home. What information BEST indicates the average degree of diabetes control during the past 2 to 4 months? A. serum glycosylated hemoglobin B. postprandial blood glucose level C. a written record of daily blood glucose levels D. a written record of daily double voided urine glucose levels Which of the findings would the nurse most likely note during an Addisonian crisis? A. serum potassium of 3 mEq/L, BP=158/72 mmHg B. serum potassium of 5.8 mEq/L, BP=62/48 mmHg C. serum sodium of 150 mEq/L, BP= 158/72 D. serum sodium of 135 mEq/L, BP=62/48 Propanolol (Inderal) is commonly prescribed for clients with hyperthyroidism to: A. block formation of the thyroid hormone B. decrease the vascularity of the thyroid gland C. inhibit peripheral conversion of T4 and T3 D. decrease CNS stimulation The client with cancer is receiving chemotherapy and develops thrombocytopenia. Which goal should be given the highest priority in the NCP? A. ambulation tree times a day B. monitoring temperature C. monitoring hemoglobin and hematocrit D. monitoring for pathologic fractures The nurse assesses the oral cavity of a client with cancer and notes white patches on the mucous membranes. The nurse determines that this occurrence: A. is common B. is characteristic of thrush infection C. indicates that oral hygiene need to be improved D. suggests that the client is anemic The nurse is monitoring the laboratory results of a client preparing to receive chemotherapy. The nurse determines that the WBC count is normal if which of the following results is present? A. 3,000 to 8,000/cu.mm. B. 4,000 to 9,000/cu.mm. C. 7,000 to 15,000/cu.mm. D. 2,000 to 5,000/cu. Mm. The client suspected of having an abdominal tumor is scheduled for a CT scan with dye injection. Which of the following is an accurate description of the scan? A. the test maybe painful B. the dye injected may cause a warm, flushing, sensation C. fluids will be restricted following the test D. the test takes approximately 2 hours The client is diagnosed as having a bowel tumor. Several diagnostic test are prescribed. Which of the following test will confirm the diagnosis of the malignancy? A. MRI C. abdominal ultrasound B. CT scan D. biopsy of the tumor The oncology nurse is preparing to administer chemotherapy to the client with Hodgkin’s disease. A multiagent medication regimen known as MOPP is prescribed. The medications included in the therapy are: 1. The most important nursing measure in the immediate postoperative period will be A. encouragement of isometric exercises B. cleansing of the area around the Steinmann pin C. CAREFUL OBSERVATION OF VITAL SIGNS D. massage of pressure areas 2. After Mr. Lee returns to his room, he complains of pain in his right arm. The initial action of the nurse should be to A. administer analgesics as ordered B. CHECK HIS FINGERS C. notify his physician immediately D. pad the edges of the cast 3. To maintain proper alignment and immobilization of the femur, the physician has ordered skeletal traction with a Thomas splint. While caring for Mr. Lee, the nurse should explain to him that he A. cannot turn or sit up B. cannot turn but can sit up C. can turn but cannot sit up D. CAN TURN AND CAN SIT UP 4. In dealing with the weights that are applying the traction, the nurse should A. ALLOW THEM TO HANG FREELY IN PLACE B. hold them up if the patient is shifting position in bed C. remove them if the patient is being moved up in bed D. lighten them for short periods if the patient complains of pain 5. Mr. Lee has a Thomas knee splint in place. In addition to the usual measures for a patient in traction, it will be important that the nurse observe A. THE GROIN AREA FOR PRESSURE B. for constipation C. his skin for sings of decubiti D. for signs of hypostatic pneumonia 6. If Mr. Lee should show an increase in blood pressure and signs of confusion and increased restlessness, the nurse should suspect A. a concussion B. impending shock C. FAT EMBOLI D. anxiety 7. Because of the nature of Mr. Lee’s wound and the insertion of a Steinmann pin, it is especially important that the nurse observe for A. A FOUL ODOR B. foot drop C. pulmonary congestion D. fecal impaction 8. Mr. Lee develops an acute localized osteomyelitis. He is placed on intravenous antibiotic therapy. The wound is incised and drained, and neomycin irrigations are ordered four times a day. It is important that these irrigations be performed A. WITH STRICT ASEPTIC TECHNIQUES B. with a warm solution C. for at least 5 minutes D. at equal time intervals Situation: Maria Alfredo is a 30-year old married woman who has systemic lupus erythematosus (SLE). 9. While doing as nursing history on Mrs. Alfredo, the nurse should recognize that the most common initial symptoms of SLE are A. petechiae in the skin, nosebleeds, and pallor B. hematuria, increased blood pressure, and edema C. tachycardia, tremors, and loss of weight D. PAINFUL MUSCLES AND JOINTS, STIFFNESS, AND INFLAMMATION OF JOINTS 10. Mrs. Afredo is instituted on long-term prednisone therapy. Her daily maintenance dose is 5 mg/day. In the instructions to Mrs. Alfredo, the nurse should emphasize that A. once the symptoms of SLE subside, the medication will be discontinued gradually B. a weight gain 2 pounds per week should be reported to the physician C. THE MAINTENANCE DOSE WILL BE THE LOWEST DOSE THAT CONTROLS SYMPTOMS D. if adrenal atrophy occurs, adrenocorticotropic hormone (ACTH) will have to be prescribed 11. Mrs. Alfredo questions the nurse about family planning and birth control. Which of the following choices should the nurse include in her answer? A. ORAL CONTRACEPTIVES CAN PRECIPITATE AN ACUTE EXACERBATION OF YOUR CONDITION B. Intrauterine devices are the recommended brithcontrol measures C. there are no contraindications for pregnancy, as long as the disease is being treated D. studies indicate that the corticosteroids produce fetal damage 12. The nursing care plan states, “Observe for signs of Raynaud’s phenomenon.” The nurse should recognize that this phenomenon A. occurs as a side effect of prednisone B. IS AGGRAVATED BY SMOKING C. is relieved by application of cold compresses to the hands D. is the priority care 13. Although many abnormal laboratory findings are found in SLE, there is no one specific diagnostic test. The test that is positive in over 95 percent of all patients with SLE is the blood test for A. the lupus erythematosus (LE) factor B. the rheumatoid factor C. ANTINUCLEAR ANTIBODIES (ANA) D. C-reactive protein (CRP) 14. The teaching program for Mrs. Alfredo planned by the nurse should include emphasis on which of the following? A. once the symptoms are controlled, the corticosteroids will be discontinued B. if hair loss occurs, it is irreversible C. OVEREXPOSURE TO THE SUN CAN PRODUCE AN EXACERBATION OF SYMPTOMS D. a low-potassium, low-protein diet is recommended 15. Mrs. Alfredo tells the nurse that she has had black, tarry stools. The nurse should A. reassure the patient that this is a minor side effect of prednisone B. tell the patient that if she takes the prednisone with milk, black, tarry stools will be avoided C. tell the patient that she will ask the physician to prescribe aluminum hydroxide D. NOTIFY THE PHYSICIAN BECAUSE BLACK, TARRY STOOLS CAN BE AN INDICATION OF BLEEDING PEPTIC ULCER 16. Mrs. Alfredo calls the physician’s office and complains that she has chills, a fever, and a cough. The nurse should A. advise that she remain in bed, drink extra fluids, and take aspirin every 4 hours B. recommended that she increase her dose of prednisone until her temperature is normal C. RECOMMENDED THAT SHE COME TO THE OFFICE TO BE EXAMINED BY THE PHYSICIAN D. tell Mrs. Alfredo to call for an appointment when she is feeling better Situation: Irene P is being treated in the emergency room for an acute attack of Meniere’s syndrome 17. The nurse should recognize that the triad of symptoms associated with Meniere’s syndrome is A. nystagmus, arthralgia, and vertigo B. nausea, vomiting, and arthralgia C. syncope, headache, and hearing loss D. HEARING LOSS, VERTIGO, AND TINNITUS 18. Patient teaching for Mrs. P includes helping her to recognize that A. Meniere’s syndrome is psychogenic and is brought on by stress B. most patients can be successfully treated with a low-salt diet and diuretics C. acute infection can precipitate an attack D. a labyrinthectomy is the preferred treatment for relieving symptoms and restoring hearing 19. Nursing intervention during an acute attack includes A. encouraging the patient to walk B. placing the patient in a semi-Fowler’s position C. HAVING THE PATIENT LIE FLAT D. placing the patient in Trendelenburg’s position Situation: Mrs. C, 30 years old, has symptoms of diplopia, fatigue, slight vertigo, and a lack of coordination. After a neurological work- up she is diagnosed as having multiple sclerosis. 20. The main goal of nursing care for Mrs. C during the acute phase of the disease should be to A. PROMOTES REST B. prevent constipation C. maintain normal functioning D. encourage activities of daily living 21. Mrs. C is note d to be having mood swings. In deciding what approach to use with her, the nursing staff should recognize that this A. is probably the result of an underlying mental disorder B. indicates that Mrs. C is having difficulty accepting her diagnosis C. MAY BE A RESULT OF PATHOLOGY AND INVOLVEMENT OF THE LIMBIC SYSTEM IN THE DISEASE D. indicates that Mrs. C’s intellectual capacity has been compromised 22. Mrs. C questions the nurse concerning the usual course of multiple sclerosis. Which would be the best reply by the nurse? A. each individual is very different; we cannot tell what will happen B. I know you are worried, but it is too soon to predict what will happen C. usually, acute episodes like this are followed by remissions, which may last a long time D. the future will take care of itself; let’s concentrate on the present 23. As Mrs. C’s condition improves, it is most important that she be given guidance in A. developing a program of exercise B. LEARNING TO HANDLE STRESSFUL SITUATIONS C. seeking vocational rehabilitation D. limiting her activities to those that are absolutely necessary Situation: Barbara is a 23-year-old woman who lives with her mother, sister, and brother in a private residence. She is attending the neurological out-patient clinic for the first time. Her health history includes two grand mal seizures./ A diagnosis of idiopathic epilepsy has been made. The physician has ordered an electroencephalogram (EEG) and phenytoin sodium (Dilantin), 300 mg/day 24. While doing a nursing history on Barbara, the nurse should recognize that A. persons with idiopathic epilepsy have a lower intelligence level B. GRAND MAL SEIZURES DO NOT CAUSE MENTAL DETERIORATION C. a common characteristic of idiopathic epilepsy is committing acts of violence D. idiopathic epilepsy is a form of mental illness 25. To prepare Barbara for EEG, the nurse should explain that A. during the test she will experience small electric shocks that feels like pin pricks B. the test measures mental status as well as electrical brain waves C. DURING THE HYPERVENTILATION PORTION OF THE TEST, SHE MAY EXPERIENCE DIZZINESS D. she will be unconscious during the test 26. Health teaching for Barbara includes ensuring that she understands that A. PROPER PROPHYLACTIC MEDICATION CAN CONTROL THE INCIDENCE OF SEIZURES B. moderate use of alcohol is permitted C. forcing fluids helps to reduce the incidence of seizures D. the incidence of seizures is related to hyperglycemia 27. During a follow-up clinic visit, Barbara tells the nurse that her urine has had a reddish-brown color. The nurse should A. REASSURE BARABARA THAT THIS IS A HARMLESS SIDE EFFECT OF PHENYTOIN SODIUM (DILANTIN) B. tell Barbara that this is a sign of hepatic toxicity C. recommend that Barbara go to the laboratory for a serum Dilantin concentration test D. notify the physician that Barbara has hematuria [Show More]

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