HESI MEDSURG 2020 EXAM- UPDATED STUDY GUIDE

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HESI MEDSURG 2020 EXAM- UPDATED STUDY GUIDE HESI MEDSURG 2020 EXAM- LATEST STUDY GUIDE 1. The nurse empties the nasogastric suction collection canister of a client who had a bowel resection the prev... ious day and note that 1000 ml of gastric secretions were collected in the last 4 hours. a. Metabolic alkalosis b. Hyperkalemia c. Metabolic acidosis d. Hypoglycemia 2. A young client who is being taught to use an inhaler for symptoms of asthma tells the nurse the intention to use the inhaler but, plans to continue smoking cigarettes in evaluating the client’s response, what is the best initial action by the nurse? a. Inform the health care provider of this statement made by the client. b. Explain that denial of illness can interfere with the treatment regimen. c. Revise the plan of care based on the client’s plans to continue smoking. d. Review factors surrounding client’s beliefs about smoking cessation. 3. A client with sudden onset of big toe joint pain and swelling is diagnosed with gout. Which pathophysiologic process is producing the symptoms of gout? a. An immune complex and autoantibody deposition in connective tissue results in inflammation. b. Chondrocyte injury destroys joint cartilage, producing osteophytes and joint inflammation. c. An autoimmune inflammation involving IgG response to an antigen causes joint destruction. d. Deposition of crystals in the synovial space of the joint produce inflammation and irritation. 4. An older female client has normal saline infusing at 45ml/hour. She complains of pain the insertion site of the IV catheter. There is no redness or edema around the IV site. Which action should the nurse take? a. Determine what IV medications have recently been administered. b. Explain that without redness or edema, there is no need to re-start the IV. c. Consult with the healthcare provider about the best localization to start a new IV. d. Convert the IV to a saline lock and continue to monitor the site. 5. While assessing a female client who is chronically fatigued and was recently diagnosed with adrenal insufficiency, the client tells the nurse that she is very nervous that her hospitalization will cause her to lose her job. Which intervention should the nurse implement first? a. Teach client about risk for infection. b. Offer support and care measure to reduce anxiety and stress. c. Encourage the client to rest quietly to reduce fatigue. d. Place a referral to social service to discuss financial options. 6. The nurse is collecting information from a client with chronic pancreatitis who report persistent gnawing abdominal pain. To help the client manage the pain. Which assessment data is most important for the nurse to obtain? a. Color and consistency of feces. b. Eating patterns and dietary intake. c. Presence and activity of bowel sounds. d. Level and amount of physical activity. 7. A young adult client, admitted to the Emergency Department following a motor vehicle collision, is transfused with 4 unit of PRBCs (packed red blood cells). The client’s pretransfusion hematocrit is 17%. Which hematocrit value should the nurse expect the client to have after all the PRBCs have been transfused? a. 19% b. 9% c. 39% d. 29% 8. A client admitted with left-sided heart failure has a heart rate of 110 beats per minute and is becoming increasing dyspneic. Which additional assessment finding by the nurse support the client’s admitting diagnosis? a. An enlarged, distended abdomen. b. Crackles in the bases of both lungs. c. Jugular vein distension. d. Peripheral edema. 9. When planning care for a client newly diagnosed with open angle glaucoma, the nurse identifies a priority nursing problem of “visual sensory/perceptual alterations”. This problem is based on which etiology? a. Blurred distance vision. b. Limited eye movement. c. Decreased peripheral vision d. Photosensitivity. 10. A postoperative client report incisional pain. The client has two prescriptions for PRN analgesia that accompanied the client from the post anesthesia unit. Before selecting which medication to administer, which action should the nurse implement? a. Determine which prescription will have the quickest onset of action. b. Compare the client’s pain scale rating with the prescribed dosing. c. Ask the client to choose which medication is needed for the pain. d. Document the client’s report of pain in the electronic medical record. 11. The nurse is caring for a client that had a thyroidectomy 24 hours ago. The client reports experiencing numbness and tingling and tingling and tingling of the face. Which intervention should the nurse implement? a. Open and prepare the tracheostomy kit. b. Inspect the neck for increase in swelling. c. Monitor for presence of Chvostek’s sign. d. Assess lung sound for laryngeal stridor. 12. When conducting discharge teaching for a client diagnosed with diverticulosis, which diet instruction should the nurse include? a. Eat a high-fiber and increase fluid intake. b. Have small frequent meals and sit up for at least two hours after meal. c. Eat s bland diet and avoid spicy foods. d. Eat a soft diet with increased intake of milk and milk products. 13. An older female client with long term type 2 diabetes mellitus (DM) is seen in the client for a routine health assessment. To determine if the client is experiencing any long – term complications of DM, which assessments should the nurse obtain? (Select all that apply) a. Serum creatinine and blood urea nitrogen (BUN). b. Sensation in feet and legs. c. Skin condition of lower extremities. d. Signs of respiratory tract infection e. Visual acuity. 14. A client with chronic kidney disease missed dialysis yesterday to attend a funeral. The client’s wife the home health nurse and reports that her husband is lethargic and hard to arouse. Which instruction is most important for the nurse to provide? a. Apply the client’s home oxygen. b. Check for a thrill and bruit at the client’s dialysis access site. c. Ensure the client avoids salt intake for the rest of the day. d. Take client to emergency department (ED). 15. The healthcare provider writes several prescriptions for a client diagnosed with hospital-acquired pneumonia (HAP) that include a combination of broad- spectrum antibiotics. Which intervention should the nurse implement first? a. Monitor client’s metabolic panel results during course of antibiotic therapy. b. Review medical record for results of a chest x-ray obtained on admission. c. Schedule prescribed nebulizer treatments with respiratory therapy. d. Collect blood specimens for culture prior to starting antibiotic therapy. 16. The nurse provides dietary instructions about iron rich food to a client with iron deficiency anemia. Which food selection made by the client indicates a need for additional instructions? a. Liver. b. Kidney beans. c. Oranges. d. Leafy green vegetable. 17. A client who is experiencing respiratory distress is admitted with respiratory acidosis. Which pathophysiological process supports the client’s respiratory acidosis. a. Carbon dioxide is converted in the kidneys for elimination. b. Blood oxygen levels are stimulating the respiratory rate. c. Hyperventilation is eliminating carbon dioxide rapidly. d. High levels of carbon dioxide have accumulated in the blood 18. Methotrexate is prescribed for a client with rheumatoid arthritis (RA) who is also taking aspirin. What is the best explanation for the nurse to provide as to why a second medication has been added? a. Methotrexate slows the disease progression while aspirin controls the symptoms. b. Methotrexate has less harmful side effects than aspirin. c. Methotrexate helps to reduce the side effects of the aspirin therapy. d. Methotrexate enhances the effectiveness of the aspirin. 19. A client who has developed acute kidney injury (AKI) due to an aminoglycoside antibiotic has moved from the oliguric phase to the diuretic phase of AKI. Which parameters are most important for the nurse to plan to carefully monitor? a. Side effect of total parental nutrition (TPN) and Intralipids. b. Uremic irritation of mucous membranes and skin surfaces. c. Elevated creatinine and blood urea nitrogen (BUN). d. Hypovolemia and electrocardiographic (ECG) changes. 20. A woman with chronic osteoarthritis is complain of knee pain. Which pathophysiological process is contributing to her pain? a. Inflammation results from deposition of crystals in the synovial space of joints producing irritation. b. Joint destruction happens due to an autoimmune inflammation involving IgG response to an antigen. c. Joint inflammation occurs when chondrocyte injury destroys joint cartilage, producing osteophytes. d. Inflammation is caused by immune complex and autoantibody deposition in connective tissue. 21. An adult client who received partial thickness burns 40%bof the body in a house fire is admitted to the inpatient burn unit. Which fluid should the nurse prepare to administer during the client’s burn recovery? a. 5% dextrose in water. b. 5% dextrose in 0.25 normal saline. c. Total parenteral nutrition d. Lactate Ringer’s. 22. A client with partial thickness burns to the lower extremities is schedules for whirlpool therapy to debride the burned area. Which intervention should the nurse implement before transporting the client to the physical therapy department? a. Obtain supplies to re- dress the burn area. b. Verify the client’s signed consent form. c. Give a prescribed narcotic analgesic agent. d. Perform active range-of- motion exercise. 23. The nurse determines that an adult client who is admitted to the post anesthesia care unit (PACU) following abdominal surgery has a tympanic temperature of 94.6 F(34.8*C), a pulse rate of 88 beast/minute, a respiratory rate of 14 breaths/minute, and a blood pressure of 94/64 mmHg. Which action should the nurse implement? a. Take the client’s temperature using another method. b. Raise the head of the bed to 60 to 90 degrees. c. Ask the client to cough and deep breathe. d. Check the blood pressure every five minutes for one hour. 24. Based on this strip, what is the interpretation of this rhythm? a. First degree AV heart block. b. Sinus bradycardia. c. Junctional escape rhythm. d. Normal sinus rhythm. 25. An unlicensed assistive personnel (UAP) reports to the nurse that a client with a postoperative wound infection has a temperature of 103 F (39.89 C), blood pressure of 90/70, pulse of 124 beats/minute, and respirations of 28 breath/minute. When assesses the client, finding include mottled skin appearance and confusion. Which action should the nurse take first? a. Transfer the client to the ICU. b. Initiate an infusion of intravenous (IV) fluids. c. Assess the client’s core temperature. d. Obtain a wound specimen for culture. 26. Which institution should the nurse include in the discharge teaching plan for a client who has a cataract extraction today? a. Use a metal eye shield on operative eye during the day. b. Administer eye ointment prior to applying eye drops. c. Sexual activities may be resumed upon return home. d. Light housekeeping is sale to do but avoid heavy lifting. 27. The nurse assesses a client with cirrhosis and finds 4+ pitting edema of the feet and legs, and massive ascites. Which mechanism contributes to edema and cite in clients with cirrhosis? a. Decreased renin-angiotensin response to an increase in renal blood flow. b. Hyperaldosteronism causing an increased sodium reabsorption in renal tubules. c. Hypoalbuminemia that results in a decreased colloidal oncotic pressure. d. Decreased portacaval pressure with greater collateral circulation. 28. A client is admitted to the medical unit during an exacerbation of systemic lupus erythematosus (SLE). It is most important to report which assessment finding to the healthcare provider? a. Joint pain b. Low grade fever. c. Muscle atrophy. d. Hematuria. 29. Four hours following surgical repair of a compound fracture of the right ulna, the nurse is unable to palpate the client’s right radical pulse. Which action should the nurse take first? a. Notify the healthcare provider of the finding immediately. b. Complete a neurovascular assessment of the right hand. c. Elevate the client’s right hand on one or two pillows. d. Measure the client’s blood pressure and apical pulse rate. 30. A client’s laboratory finding indicate elevations in thyroxine and triiodothyronine hormones. The nurse suspects that the client may hyperthyroidism. Which assessment finding is most often associated with hyperthyroidism? a. Periorbital edema. b. Atrophied thyroid gland. c. Increased pulse rate. d. Diarrhea stools. 31. A young adult is burned when wearing a shirt that was splashed with lighter fluid and caught on fire white attempting to light a charcoal grill. The client ripped off the shirt immediately, without unbuttoning the sleeves, which caused circumferential burns to both wrists. When the client is admitted, which intervention should the nurse implement first? a. Monitor pulse intensity, b. Evaluate extremity sensation. c. Assess range of motion. d. Place sterile bandage on both wrists. 32. A client with rheumatoid arthritis has elevated serum rheumatoid factor. Which interpretation of this finding should the nurse make? a. Evidence of spread of the disease to the kidney. b. Confirmation of the autoimmune disease process. c. Representative of a decline in the client’s condition. d. Indication of the onset of joint degeneration. CONTINUED.........DOWNLOAD FOR BEST SCORES AND REVISION GUIDE [Show More]

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