2020 Hesi Med Surg Correct Answers from Rationale.

1. Carpal tunnel – assess • Carpal tunnel is evaluated by the Tinel’s sign and Phalen test. • Phalen test: client flex wrist 90° for 1 minute to see if the pain is elicited in this position. • Tinel’s Sign: tapping o ...

1. Carpal tunnel – assess • Carpal tunnel is evaluated by the Tinel’s sign and Phalen test. • Phalen test: client flex wrist 90° for 1 minute to see if the pain is elicited in this position. • Tinel’s Sign: tapping over the carpal tunnel and seeing numbness and tingling when this nerve is tapped. 2. Inflammatory bowel disease – no enema • Either Crohn’s disease or ulcerative colitis. • Avoid Enemas – Notify the healthcare provider about the prescription of a barium enema. • Treatments o Antimicrobials treat infection o 5-aminosalicylates decrease GI inflammation o Corticosteroids o Immunomodulators • Diet recommended is Low-fiber (low-residue) diet o White bread o Cooked cereals o Cooked potatoes o White rice o Pasta 3. Diabetes Mellitus – weakness • Feeling weak and jittery may indicate an adrenalin response to anxiety or to hypoglycemia. • The nurse should conduct an assessment. Changes in the client’s blood pressure and glucose levels can cause weakness. • Changes in the client’s skin temperature and moisture could be related to possible changes in glucose levels or anxiety 4. Meniere’s disease – vertigo • Antihistamines are often prescribed to reduce the symptoms of vertigo and tinnitus that a client with Meniere’s disease experiences during and following an acute attack. 2020 Hesi RN Medical Surgical Correct Rationales after taking the Hesi Medical Surgical Specialty Exam 2 5. Muscular Dystrophy – diminished breath sounds • Due to diminished breath sounds, oxygenation assessment is the first priority intervention 6. Cushing Syndrome – after surgery • When assessing a client after surgery who has Cushing syndrome, an irregular pulse may indicate an electrolyte imbalance, which can create capsular irritability leading to life-threatening arrhythmias. • Client’s diagnosed with Cushing Syndrome may experience serum irregularities with potassium due to the cortisol effect. 7. Reflux-bed blocks • Raising the head of the bed with blocks prevents an upright position for sleep that reduces the risk of gastroesophageal reflux 8. Athlete’s foot- antifungal • Athlete’s foot (tinea pedis) is an infection that affects the feet and causes cracking of the skin between the toes and on the soles of the feet. • The feet should be well ventilated, dried well after bathing, and clean socks should be placed on the feet after bathing. • Antibiotic ointment is the preferred treatment of a fungal infection. 9. Blurred vision – BP • A client who is reporting blurred vision is likely experiencing complications related to cardiovascular disease. • The client’s daily blood pressure will be less than 140/80 mmHg this month is an outcome statement in their plan of care that is client-centered, measurable, and has a time frame. 10. Testicular cancer – AFP • Alpha-fetoprotein (AFP) is elevated in testicular cancer, and a reduction indicates that chemotherapy treatment has the desired effect. • The normal range is <40 mcg/L with a half-life. 11. Lower Left Lobe Pulmonary Lung abscess – Left Lateral position • The client should be positioned with the affected left lung down to prevent infection. 2020 Hesi RN Medical Surgical Correct Rationales after taking the Hesi Medical Surgical Specialty Exam 3 12. Altered Mental – respiratory • A change in the mental status of a client being treated for respiratory illness such as pneumonia is often a sign of hypoxia. • Obtaining a new set of vital signs, oxygen saturation will give the healthcare provider an idea of this is occurring. 13. Heberden’s Node – pain control • Heberden’s nodes are one of the manifestations of the bony changes associated with degenerative joint disease. • If painful → chronic pain management → using analgesic therapy. 14. STEMI – postthrombolysis lidocaine • Lidocaine is an antiarrhythmic that reduces myocardial and decreases ventricular irritability. • A therapeutic response to lidocaine is a decrease in premature ventricular contractions and ventricular tachycardia. 15. Shingles – pain • Herpes zoster may remain dormant along the dorsal root ganglia in individuals previously exposed to the virus. • The pain and itching along the path of the herpes zoster (shingles) lesions are most likely affecting the client’s sleep patterns. 16. External Fixation device – perfusion Damage to major vessels around a long bone fracture can compromise distal circulation. The nurse should first assess perfusion by checking the peripheral pulses. 17. ALS – priority finding • ALS results in progressive muscular atrophy, and as the muscle weakens, the airway becomes compromised. • A weakened cough is a critical sign that the weakness has progressed and is affecting the airway. • Weakened cough effort warrants immediate intervention by the nurse. 2020 Hesi RN Medical Surgical Correct Rationales after taking the Hesi Medical Surgical Specialty Exam 4 18. Pneumonia – HAP action • Blood culture should be obtained before initiating antibiotic therapy to identify the infectious organism and to evaluate the organism’s sensitivity to antibic therapy