Hesi El Sevier Questions Med Surg Questions

Front 1

The nurse is providing instructions to a 68 year old client who is at high risk for development of coronary heart disease (CHD). Which intervention should the nurse include?

Back 1

Increase intake of soluble fiber to 10 to 25 grams per day.

Front 2

An Adult client is admitted to the hospital burn unit with second and third degree burns over 40% of the body surface area. In assessing the potential for skin regeneration, what should the nurse remember about thrid degree burns?

Back 2

Regenerative function of the skin is absent because the dermal layer has bbeen destroyed.

Front 3

Which description of symptoms is charcteristic of a client diagnosed with trigeminal neuralgia (Tic dououreux)?

Back 3

Sudden, stabbing, severe pain over the lip and chin.

Front 4

Prior to a cardiac catherization, which activity should the nurse have the client practice?

Back 4

Valsalva's manuever and coughing.

Front 5

A client is placed on respirator following a cerebral hemmorhage, and vecuronium bromide (Norcuron) .04mg/kg q 12h IV is prescribed. Which nursing diagnosis is the priority?

Back 5

Impaired communication related to paralysis of skeletal muscles.

Front 6

Which client should the nurse recognize as most likely to experience sleep apnea?

Back 6

Obese older male client with a short, thick neck.

Front 7

A client receiving cholestyramine (Questran) for hyperlipidemia should be evaluated for what vitamin deficency?

Back 7

Vit K (Thse drugs reduce the absorption of the fat soluble vitamins ADEK.

Front 8

The nurse identifies bright red drainage, about 6 cm in diameter, on the dresssing of a client who is one day post abdominal surgery. Which action should the nurse take next?

Back 8

Mark the drainage on the dressing and take vital signs.

Front 9

A client is admitted to the hospital with a diagnosis of severe acute diverticulitis. Which assessment finding should the nurse expect this client ot exhibit?

Back 9

Lower left quadrant pain an da low-grade fever. (sigmoid most common site)

Front 10

The nurse is assessing the lab results for a client who is admitted with renal failure and osteodystrophy. Which findings are consistent with this client's clinical picture?

Back 10

Serum Potassium of 5.5 mEq and total calcium of 6mg/dl.
Renal failure (hyperKalemia and Hypocalcemia)

Front 11

The nurse is assessing a client lab values following administration of chemotherapy. Which lab values leads the nurse to suspect that the client is experiencing tumor lysis syndrome?

Back 11

Serum calcium 5.0mg/dl.
TLS results in hyperkalemia, hypocalcemia, and hyperuricemia.

Front 12

A client who is HIV positive ask the nurse, "How will I know when I have Aids"? Which response is best for the nurse to provide?

Back 12

Aids is diagnosed when a specifc oppurtunistic infection is found in an other wise healthy individual.

Front 13

A splint is prescribed for nightitme use by a client with rhuematoid arthritis. Which statement by the nurse provides the most accurate explanation for use of the splints.

Back 13

Prevention of deformities.

Front 14

Then nurse is planning care for a client who has a right hemispheric stroke. Which nursing diagnosis should the nurse include in the plan of care?

Back 14

Risk for injury related to denial of deficits and impulsiveness. Right brain damage= difficulty in judgement and spatial perception. Left=speech issues and language deficits

Front 15

Then nurse knows that lab values sometimes vary for the older client. Which data should the nurse expect to find when reveiwing lab values of an 80 year old male?

Back 15

Increased protein in the urine, slightly increased serum glucose levels.

Front 16

The nurse is planning care to prevent complication for a client with multiple myeloma. Which intervention is most important for the nurse to include?

Back 16

Maintain a Fluid fo 3 to 4 l per day.
Malignant plasma cells that infiltrate bone casue demineralization>>>promote excretion of calcium

Front 17

The nurse is assessing a client with bacterial meningitis. Which assessment finding indicates the client may have developed septic emboli?

Back 17

Cyanosis of fingertips
Emboli lodge in small arterioles of extermities

Front 18

A client who is sexually active with several partners requests an IUD as a contraceptive method. Which information should the nurse provide?

Back 18

Using an IUD offers no protection against sexually transmitted diseases (STD), which increae the risk of pelvic inflammatory disease.

Front 19

In preparing a discharge plan for a 22 year old male client diagnosed with Buerger's disease (thromboangitis oblitrans), which referral is most important?

Back 19

Smoking cessation program.

Front 20

An 81 year old male client has emphysema. He lives at home with his cat and manages self care with no difficulty. When making a home visit, the nurse notices that his tongue is somewhat cracked and his eyeballs are sunken into his head. What nursing intervention is indicated?

Back 20

Help the client to determine ways to increase his fluid intake.

Front 21

Based on the analysis of the client's atrial fibrillation, the nurse should prepare for which treament protocol.

Back 21

Anticoagulant therapy.
THe nurse should prepare for anticoag therapy which is prescribed before rhythmn control.

Front 22

A client with cirrhosis develops increasing pedal edema and ascites. What dietary modification is most important for the nurse to teach this client?

Back 22

Restrict salt and fluid intake.

Front 23

Which reaction should the nurse identify in a client who is responding to stimulatiion of the sympathetic nervous system?

Back 23

Increased Heart rate

Front 24

Thenurse is preparing a teaching plan for a client who is newly diagnosed with Type 1 diabetes mellitus. Which signs and symptoms should the nurse describe when teaching the client about hypoglycemia?

Back 24

Sweating, trembling, tachycardia
Hyper: Poly uria, dipsia, phagia, fruity breath tachypnea

Front 25

A client who is receiving chemotherapy asks the nurse, "Why is so much of my hair falling out each day"? WHich response by the nurse best explains the reason for alopecia?

Back 25

Chemotherapy affects the cells of the body that grow rapidly, both normal and malignant.

Front 26

Which finding should the nurse identify as most significant for a client diagnosed with polycystic disease?

Back 26

3+ bacteria in urine

Front 27

A female client receiving IV vasopressin (Pitressin) for esophageal varice rupture reports to the nurse that she feels substernal tightness and pressure across her chest. Which PRN protocol should the nurse initiate?

Back 27

Start an IV nitro infusion

Front 28

The nurse is assessing a client with Chronic Renal Failre. Which finding is most important for the nurse to respond to first?

Back 28

Potassium 6.0 mEQ>

Front 29

A male client receives a local anesthetic during surgery. During the post-operative assessment, the nurse notices the client is slurring his speech. Which action should the nurse take?

Back 29

Evaluate his blood pressure, pulse, and respiratory status.

Front 30

Which assessment finding by the nurse during a client's clinical breast exam requires follow-up?

Back 30

A newly retracted nipple.

Front 31

A client is being admitted to the medical unit from teh emergency dept after having a chest tube inserted. What equipment should be brought to his client's room?

Back 31

Rubber tipped clamp (assesses air leaks)

Front 32

Which information should thenurse give a client with chronic renal failure (CRF)?

Back 32

Avoid salt subsitutes

Front 33

A client who is one week postoperative after an aortic valve replacemnt suddenly develops severe pain in the left leg. On assessment, the nurse determines that the client's leg is pale and cool, and no pulses are palpable in the left leg. After notifying the healthcare provider, which action should the nurse take?

Back 33

Keep client in bed in the supine position (anti-coagulan therapy & rest)

Front 34

After the fourth dose of gentamicin sulfate (Garamycin) IV, the nurse plans to draw blood samples to determine peak and trough levels. When are the best times to draw these samples?

Back 34

5 m,inutes before and 30 minutes after the next dose.

Front 35

When teaching diaphragmatic breathing to a client with chronic obstructive pulmonary (COPD), which information should the nurse provide?

Back 35

Place a small book or magazine on the abdomen and make it rise while inhaling deeply

Front 36

A client taking a thiazide diuretic for the past six months has a serum potassium level of 3. The nurse anticipates which change in prescription for the client?

Back 36

A potassiium supplement will be prescribed.

Front 37

A 20 year old female client calls the nurse to report alump she found in her breast. Which response is the best for the nurse to provide?

Back 37

Most lumps are benign, but it is always best to come in for an examination.

Front 38

Which intervention should the nurse implement for a female client diagnosed with pelvic relaxation disorder?

Back 38

Encourage the client to perform Kegel exercises 10 times daily.

Front 39

During a health fair, a 72 year odl male client tells the nurse that he is experiencing shortness of breath. Auscultation reveals crackles and wheezing in both lungs. Suspecting that the client might have chronic bronchitis, which classic symptom should the nurse expect this clien to have?"

Back 39

productive cough with grayish-white sputum.

Front 40

A client has taken steroids for 12 years to help manage chronic obstructive pulmonary (COPD). When making a home visit, which nursing function is of greatest importnace to this client? Assess the client's

Back 40

C Temperature over skin color and turgor
steroids and infection

Front 41

A client has undergone insertion of a permanent pacemaker. When developing a discharge teaching plan, the nurse writes a goal of, "The client will verbalize symptoms of pacemaker failure. "Which symptom are the most important to teach the client?

Back 41

Feelings of dizziness

Front 42

In assessing a client diagnosed with primary hyperaldosteronism, the nurse expects the lab test results to indicate a decreased serum level of which substance?

Back 42

Potassium

Front 43

The healthcare provider prescribes aluminum and magnesium hydroxde (maalox, 1 tablet PO PRN, for a client with chronic renal failure who is complaining of indigestion. What intrevention should the nurse implement?

Back 43

Question the healthcare provider prescription.
(it can casue hypermagnesium)

Front 44

An elderly client is admitted with a diagnosis of bacterial pnuemonia. The nurse's assessment of the client is most likely to reveal which sign and symptom?

Back 44

Confusion and tachcardia

Front 45

A 67 year old woman who lives alone is admitted after tripping on a rug in her home and fractures her hip. WHic predisposing factor probably led to the fracture in the proximal end of her femur?

Back 45

Osteoporosis