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BSN HESI 266 Med Surg Exam (100 out of 100) Questions and Answers (GRADED A)

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BSN HESI 266 Med Surg Exam (100 out of 100) Questions and Answers (GRADED A) Client is recovering from a transurethral prostatectomy. Which activity should be limited until after the first postoper... ative visit with the healthcare provider? Drink 3L A client with stage IV bone cancer is admitted to the hospital for a 1-10 scale. Which intervention should the nurse implement? Administer opioid and non-opioid medications simultaneously A client experiences an AOB incompatibility reaction after multiple blood transfusions. Which finding should the nurse report immediately to the health care provider? a. low back pain and hypotension b. rhinitis and nasal stuffiness c. delayed painful rash with urticarial d. arthritic joint changes and chronic pain a. low back pain and hypotension ANSWER: (A) LOW BACK PAIN AND HYPOTENSTION When conducting discharge teaching for a client diagnosed with diverticulosis, which diet instruction should the nurse include? a. Have small frequent meals and sit up for at least two hours after meals. b. Eat a bland diet and avoid spicy foods. c. Eat a high fiber diet and increase fluid intake. d. Eat a soft diet with increased intake of milk and milk products c. Eat a high fiber diet and increase fluid intake. ANSWER (C) EAT A HIGH-FIBER DIET AND INCREASE FLUID INTAKE The nurse observes an increased number of blood clots in the drainage tubing of a client with continuous bladder irrigation following a transurethral resection of the prostate (TURP). What is the best initial nursing action? a. Provide additional oral fluid intake b. Measure the client's intake and output. c. Increase the flow of the bladder irrigation d. Administer a PRN dose of an antispasmodic agent c. Increase the flow of the bladder irrigation ANSWER (C) Increase the flow of the bladder irrigation A client wit lung cancer who wears a subcutaneous morphine sulfate patch for pain is short of breath and difficult to arouse. When performing a head -to-toe assessment, the nurse discovers four analgesic patches on Remove all morphine patches Coming down the basement steps, a client is brought to the emergency room X-ray ... cast, which assessment finding warrants immediate Intervention by the nurse? Right foot pale with sluggish capillary refill An overweight, young adult who was recently Check finger stick glucose diagnosed with type 2 diabetes mellitus is admitted for a hernia repair. He tells the nurse that he is feeling very weak and jittery. Which actions should the nurse implement? (Select all that apply.) a. Check finger stick glucose b. Assess skin temperature and moisture c. Measure pulse and blood pressure a. Check finger stick glucose b. Assess skin temperature and moisture c. Measure pulse and blood pressure ANSWER: (CAM) A client who underwent cardiac stent placement four days ago arrives to the emergency department reporting a sudden onset of chest pressure and shortness of breath. Which action should the nurse take next? a. Listen for extra heart sounds, murmurs, and r hythm with the bell of the stethoscope. b. Evaluate upper and lower extremities for perfusion, pulse volume, and pitting edema. c. Verify troponin level assessments are scheduled every 3-6 hours for a series of three. d. Obtain a 12-lead electrocardiogram and begin continuous cardiac monitoring . d. Obtain a 12-lead electrocardiogram and begin continuous cardiac monitoring While completing a health assessment for a client with migraine headaches, the nurse assesses bilateral weakness in the clients hand grips. The client reports joint pain and trouble twisting a door knob due to weaknesses. Which action should the nurses take in response to these figures? a. Implement fall precautions to reduce the clients risk of injury. b. Explain that relief of the migraine pain will reduce related symptoms. c. Gather additional assessment data about the pain and weakness. d. Consult with the occupational therapist for a functional assessment c. Gather additional assessment data about the pain and weakness. The nurse is caring for a client diagnosed with psoriasis vulgaris who is receiving psoralen and ultraviolet A light (PUVA) treatment. Which assessment finding indicates that the client has been overexposed to the treatment? a. Thick skin plaques topped by silvery white scales b. Tenderness upon palpation and generalized erythema c. Brown, rough, greasy, wart-like papules on the face d. Requires sunglasses because sunlight hurts eyes b. Tenderness upon palpation and generalized erythema An adult client who had a gastric bypass surgery 2 weeks ago, is admitted with possible anastomosis leakage. The client's abdomen is tender to touch, and the vital signs are temperature 101 F (38 3 C). heart rate 130 beats/minute, Respiratory rate 26 breaths/minute, and blood pressure 100/50 mmHg. Which intervention is most important for the nurse to include in the client's plan of care? a. Encourage regular turning. b. Monitor skin for breakdown. c. Strict IV fluid replacement d. Assess wound drainage daily c. Strict IV fluid replacement A client who was recently diagnosed with Raynaud's disease is concerned about pain management. Which nursing instructions should the nurse provide? a. Painful areas should be rubbed gently until the pain subsides. b. Return appointments will be needed for IV pain medications. c. Enrolling in a pain clinic can provide relief alternatives. d. Wearing gloves when handling cold items guards against painful spasms. d. Wearing gloves when handling cold items guards against painful spasms. A client with newly diagnosed Crohn's disease asks the nurse about dietary restrictions. How should the nurse respond? a. Explain that the need to restrict fluids is the primary limitation. b. Advise the client to limit foods that are high in calcium and iron. c. Instruct the client to avoid foods with gluten, such as wheat bread. d. Describe the use of an elimination diet to find trigger foods d. Describe the use of an elimination diet to find trigger foods The nurse is obtaining a health history from a new client who has a history of kidney stones. Which statement by the client indicates an increased risk for renal calculi.? a. Jogs more frequently than usual daily routine. b. Eats a vegetarian diet with cheese 2 to 3 times a day. c. Experiences additional stress since adopting a child. d. Drinks several bottles of carbonated water daily b. Eats a vegetarian diet with cheese 2 to 3 times a day. An older male client tells the nurse that he is losing sleep because he has to get up several times at night to go to the bathroom, that he has trouble starting his urinary system, and that he does not feel like his bladder is ever completely empty. Which intervention should the nurse implement? a. Review the client's fluid intake prior to bedtime. b. Obtain a finger stick blood glucose level. c. Palpate the bladder above the symphysis pubis. d. Collect a urine specimen for culture analysis c. Palpate the bladder above the symphysis pubis. A client is diagnosed with chronic kidney disease and needs to begin dialysis. Which condition entered on the client's medical record should the nurse recognize as a contraindication for peritoneal dialysis? a. Nephrotic syndrome history. b. Latent hepatitis C. c. Crohn's disease with colectomy. d. Type 2 diabetes mellitus c. Crohn's disease with colectomy. When providing care for an unconscious client who has seizures. Which nursing intervention is most essential? a. Maintain the client in a semi-Fowler's position. b. Keep the room at a comfortable temperature. c. Ensure oral suction is available. d. Provide frequent mouth care c. Ensure oral suction is available. A client presents to the emergency department reporting chest pain that is radiation to the left arm, shortness of breath, and diaphoresis. Which medication should the nurse anticipate being prescribed by the healthcare provider? a. Fentanyl. b. Hydromorphone. c. Oxycodone. d. Morphine d. Morphine An adult who was recently diagnosed with glaucoma tells the nurse, "It feels like I am driving through a tunnel." The client expresses great concern about going blind. Which nursing instruction is most important for the nurses to provide this client? a. Maintain prescribed eye drop regimen b. Eat a diet high in carotene. c. Wear prescription glasses. d. Avoid frequent eye pressure measurement. a. Maintain prescribed eye drop regimen Which information should the nurse include on the teaching plan of a client diagnosed with gastroesophageal reflux disease (GERD)? a. Adjust food intake to three full meals per day and no snacks. b. Sleep without pillows at night to maintain neck alignment. c. Minimize symptoms by wearing loose, comfortable clothing. d. Avoid participation in any aerobic exercise programs c. Minimize symptoms by wearing loose, comfortable clothing. We have an expert-written solution to this problem! A client arrives to the emergency department reporting an intermittent fever and night sweats for the past 3 weeks and has developed a productive cough containing small amounts of blood. Which intervention should the nurse prioritize? a. Move into airborne isolation b. Collect specimens for blood cultures. c. Arrange transport for radiographic imaging. d. Obtain a sputum sample a. Move into airborne isolation A client receives a prescription for 1 liter of Ringer's intravenously to be infused over 6 hours. How many mL/hr should the nurse program the infusion pump to deliver? (Enter numerical value only. If rounding is required, round to the nearest whole number.) 167 mL 1000mL/6(hours) =166.6=167mL The nurse is caring for a client with chronic pancreatitis who reports persistent gnawing abdominal pain. To help the client manage the pain, which assessment data is most important for the nurse to obtain? a. Activity level of bowel sounds. b. Eating patterns of dietary intake. c. Level and amount of physical activity d. Color and consistency of feces b. Eating patterns of dietary intake. An older adult client with a long hist ory of chronic obstructive pulmonary disease (COPD) is admitted with progressive shortness of breath and a persistent cough. The client is anxious and is complaining of a dry mouth. Which intervention should the nurse implement? a. Apply a tight flow venturi mask. b. Encourage client to drink water. c. Assist client to an upright position. d. Administer a prescribed sedative c. Assist client to an upright position. Which action should the nurse implement to reduce the risk of vesicant extravasation in the client who is receiving intravenous chemotherapy? a. Monitor the client's intravenous site hourly during the treatment b. Keep the head of the bed elevated until the treatment is completed. c. Instruct the client to drink plenty of fluids during the treatment. d. Administer an antiemetic before starting the chemotherapy a. Monitor the client's intravenous site hourly during the treatment The home health nurse provides teaching about self injection to a client who was recently diagnosed with diabetes mellitus. When the client begins to perform a return demonstration of an insulin injection into the abdomen as seen in the video, which instruction should the nurse provide? (Please view the video to select the opt ion that applies. To repeat the video, click the play button again.) a. Continue with the insulin injection. b. Keep the skin flat rather than bunched. c. Lie down flat for better skin exposure. d. Select a different injection site a. Continue with the insulin injection. An older client who is agitated, dyspneic, orthopneic, and using accessory muscles to breathe is admitted for further treatment. Initial assessment includes a heart rate 128 beats/minute and irregular, respirations 38 breathe/minute. blood pressure 168/100 mmHg, wheezes, and crackles in all lung fields. An hour after the administration of furosemide 60 mg IV. Which assessments should the nurse obtain to determine the client's response to treatment? Select at that apply. a. Oxygen saturation b. Pain scale c. Lung sounds d. Urinary output e. Skin elasticity a. Oxygen saturation c. Lung sounds d. Urinary output (LOU) While caring for a client with a full thickness burn covering 40% of the body, the nurse observes purulent drainage at the wound Before reporting this finding to the healthcare provider, the nurse should review which of the client's laboratory values? a. White blood cell (WBC) count b. Hematocrit. c. Platelet count. d. Blood pH level a. White blood cell (WBC) count The nurse assesses a client with petechiae and ecchymosis scattered across the arms and legs. Which laboratory result should the nurse review? a. Red blood cell count. b. Platelet count. c. White blood cell count. d. Hemoglobin levels. b. Platelet count. A client arrives to the medical-surgical unit 4 hours after a transurethral resection of the prostate. A triple-lumen catheter for the continuous bladder irrigation with normal saline is infused and the nurse observes dark-pink tinged outflow with blood clots in the tubing collection bag. Which action should the nurse take? a. Monitoring catheter drainage (pic one says this) b. irrigation the catheter manually. c. Decreasing the flow rate. d. Discounting infusing solution. a. Monitoring catheter drainage (pic one says this) The nurse is preparing a client for surgery who was admitted to the emergency center following a motor vehicle collision. The client has an open fracture of the femur and is bleeding moderately from the bone protrusion site. During the preoperative assessment, the nurse determines that the client currently receives heparin sodium 5,000 units subcutaneously daily. What is the priority nursing action? a. Notify the healthcare provider of the client's medication history. b. Observe the heparin injections sites for signs of bruising. c. Have the client sign the surgical and transfusion permits. d. Ensure that the potential for bleeding is explained to the client a. Notify the healthcare provider of the client's medication history. An obese client with emphysema who smokes at l east a pack of cigarettes daily is admitted after experiencing a sudden increase in dyspnea and activity intolerance. Oxygen therapy is initiated and its determined that the client will be discharged with oxygen. Which information is most important for the nurse to emphasize in the discharge teaching plan? a. Approaches to conserve energy. b. Guidelines for oxygen use. c. Methods for weight loss. d. Strategies for smoking cessation b. Guidelines for oxygen use. The healthcare provider prescribes penicillin 200,000 units intramuscularly for a client with pneumonia. The available vial is labeled, "Penicillin 500,000 units/mL". How many mL should the nurse administer to this client? (Enter numerical value only. If rounding is required, round the nearest tenth.) 0.4 The nurse is caring for a client in the post anesthesia care unit (PACU) who underwent a thoracotomy two hours ago. The nurse observes the following vital signs; heart rate 140 beats/minute, respirations 26 breaths/minute, and blood pressure 140/90 mmHg. Which intervention is most important for the nurse to implement? a. Apply oxygen at 10 L via non-rebreather mask and monitor pulse oximeter. b. Medicate for pain and monitor vital signs according to protocol. c. Administer intravenous fluid bolus as prescribed by the healthcare provider. d. Encourage the client to splint the incision with a pillow to cough and deep breathe b. Medicate for pain and monitor vital signs according to protocol. While assessing a client with degenerative joint disease, the nurse observes Heberden's nodes, large prominences on the client's fingers that are reddened. The client reports that the nodes are painful. Which action should the nurse take? a. Assesses the client's radical pulses and capillary refill time. b. Discuss approaches to chronic pain control with the client. c. Notify the healthcare provider of the finding immediately. d. Review the client's dietary intake of high- protein foods b. Discuss approaches to chronic pain control with the client. We have an expert-written solution to this problem! A client with draining skin lesions of the lover extremity is admitted with possible Methicillin-Resistant Staphylococcus Aureus (MRSA). Which nursing interventions should the nurse i include in the plan of care? (Select all that apply.) a. Explain the purpose of a low bacteria diet. b. Monitor the client's white blood cell count. c. Send wound drainage for culture and sensitivity d. Use standard precautions and wear a mask e. Institute contact precautions for staff and visitors b. Monitor the client's white blood cell count. c. Send wound drainage for culture and sensitivity e. Institute contact precautions for staff and visitors (MIS) The nurse is preparing to obtain a rapid coronavirus (COVID-19) test for a client who was exposed to the virus eight days ago. The client is experiencing fever, cough and shortness of breath. Which action is most important for the nurse to take? a. Counsel family members to monitor for illness symptoms for 2 weeks after last contact with patient. b. Move the client to a private room, keep the door closed, and initiate droplet precautions. c. Start an intravenous infusion for antiviral drug to be administered for positive COVID-19 test results. d. Assist the client to recall everyone possibly exposed since onset symptoms. b. Move the client to a private room, keep the door closed, and initiate droplet precautions A client with multiple sclerosis has urinary retention related to sensorimotor details. Which action should the nurse include in the client's plan of care? a. Remind the client to practice pelvic floor (Kegel) exercises regularly. b. Provide a bedside commode for immediate use in the client's discomfort. c. Explain the need to limit intake of oral fluids to reduce client discomfort. d. Teach the client techniques for performing intermittent catheterization. d. Teach the client techniques for performing intermittent catheterization A client who has a history of hypothyroidism was initially with lethargy and confusion. Which additional finishing warrants finding warrants the most immediate action by the nurse? a. Facial puffiness and periorbital edema. b. Further decline in level consciousness. c. Hematocrit of 30% (0.30). d. Cold and dry skin. b. Further decline in level consciousness. The nurse is caring for a client with human immunodeficiency virus (HIV) who has developed oral thrush and is experiencing burning and soreness in the south, Which intervention should the nurse implement first. a. Cleanse the mouth with swabs. b. Encourage frequent mouth care. c. Obtain a soft diet for the client. d. Administer a topical analgesic d. Administer a topical analgesic The healthcare provider prescribes diagnostic tests for a client whose chest ray indicates pneumonia. Which diagnostic test should the nurse review for implementation in the most therapeutic treatment of the pneumonia? a. Sputum culture and sensitivity. b. Arterial blood gases (ABG). c. Computerized tomography (CT) of the chest. d. Blood cultures. a. Sputum culture and sensitivity. The nurse reports that a client is at risk for a brain attack (stroke) based on which assessment finding? a. Carotid bruit. b. Jugular vein distention. c. Palpable cervical lymph node. d. Nuchal rigidity a. Carotid bruit. We have an expert-written solution to this problem! A client with gouty arthritis reports tenderness and swelling of the right ankle and great toe. The nurse observes the area of inflammation extends above the ankle area. The client receives prescriptions for colchicine and indomethacin. Which instruction should the nurse include in the discharge teaching? a. Eat high protein foods to achieve ideal body weight. b. Use electric heating pad when pain is at its worse. c. Encourage active range of motion to limit stiffness. d. Drink at least 8 cups (1920 mL) of water per day. d. Drink at least 8 cups (1920 mL) of water per day. A client with pheochromocytoma reports the onset of a severe headache. The nurse observes that the client is very diaphoretic. Which assessment data should the nurse obtain next? a. Capillary glucose. b. Oxygen saturation. c. Body temperature. d. Blood pressure d. Blood pressure 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 ascites in clients with cirrhosis? a. Hypoalbuminemia that results in a decreased colloidal onoctic pressure. b. Hyperaldosteronism causing an increased sodium reabsorption in renal tubules. c. Decreased renin-angiotensin response related to an increase in renal blood flow. d. Decreased portacaval pressure with greater collateral circulation a. Hypoalbuminemia that results in a decreased colloidal onoctic pressure. A client with a history of asthma reports having episodes of bronchoconstriction and increased mucous production while exercising. Which action should the nurse implement? a. Determine if the client is using an inhaler before exercising. b. Teach client to use pursed lip breathing when episodes occur. c. Review the client's routine asthma management prescriptions. d. Assess client for signs and symptoms of upper airway infection. a. Determine if the client is using an inhaler before exercising. Question about dry feet apply lotion to prevent cracks The nurse is evaluating a male client's understanding of diet teaching about the DASH eating plan. Which behavior indicates that the client is adhering to the eating plan? Low fat yogurt A client with operating room received succinylcholine. The client is experiencing muscle rigidity and has an extremely high temperature. Which action should the nurse implement? Prepare ice packs for placement in the client's axillary area We have an expert-written solution to this problem! The nurse is obtaining the ad mission history for a client with suspected peptic ulcer disease (PUD). Which subjective data reported by the client supports this medical diagnosis? Upper mid abdominal pain described as gnawing and burning An adult client is admitted with flank pain and is diagnosed with acute pyelonephritis. What is the priority nursing action? a. Administer IV antibiotics as prescribed A client who has developed acute kidney injury (AKI) due to aminoglycoside antibiotics 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. Uremic irritation of mucous membranes and skin surfaces. b. Hypovolemia and electrocardiographic (ECG) changes. C. Side effects of total parental nutrition (TPN) and Intralipids. d. Elevated creatinine and blood urea nitrogen (BUN) b. Hypovolemia and electrocardiographic (ECG) changes. The nurse is providing teaching to a client with Type 2 diabetes mellitus and peripheral neuropathy. Which information should the nurse provide? a. Aching feet may be soaked in lukewarm water for one hour or more. b. Shoes should be worn outside the house, but it is fine to be barefoot inside. c. Family members can help with regular foot exams. d. Heating pads are useful if on the lowest setting c. Family members can help with regular foot exams. Question about facial droop prepare for fiberlyntic therapy Client is hospitalized with Heart failure. What nursing interventions will be implemented for patient to improve ventilation and reduce venous return? Place in high fowlers Dialysis access bruit heard in R arm normal/ document math (drops question) 42 gtt/min TURP QUESTION decrease urinary output Assessment question Guillan Barre loss of sensation at T-8 Addison's question educate to take steroids Peritoneal dialysis can't be started on patient with necrotic syndrome post op w/ elevated temperature apply ice packs a client with type 2 diabetes mellitus arrives to the clinic reporting episodes of weakness and palpitations. Which finding should the nurse recognize as a possible complication? a. anxiety and sighing b. myalgia in wrists and hands c. hyperactive bowel sounds d. dark yellow urine b. myalgia in wrists and hands The nurse has conducted a cancer prevention community education program. In evaluating the participants' understanding of the carcinogens, which statement indicates an accurate understanding? a. Environmental factors such as sunlight and chemicals can cause cancer to spread. b. Carcinogens are substances that contain cancerous cells. c. Substances that change a cell so that it becomes cancerous are potential sources of cancer d. Carcinogens are in the environment and cannot be avoided. c. Substances that change a cell so that it becomes cancerous are potential sources of cancer A client with eczema is applying 10% urea cream onto the affected skin areas. Which finding reflects the expected therapeutic response? a. Hydration of affected dry skin areas b. Reduced pain in eczematous areas. c. Decreased weeping of ulcerations in affected areas. d. Healing with a return to normal skin appearance. a. Hydration of affected dry skin areas A client with hyperparathyroidism reports a sudden monster of severe flank pain. Which intervention should the nurse include in the client's plan of care? a. Implement seizure precautions. b. Initiate cardiac telemetry. c. Administer a PRN dose of a laxative. d. Begin straining all urine d. Begin straining all urine After falling down the basement steps, a client is brought to the emergency room. X-ray confirms that the client's right leg is fractured. Following application of a leg cast, which assessment finding warrants immediate intervention by the nurse? a. Circumferential edema of right foot. b. Complaint of throbbing right leg pain. c. Right foot pale with sluggish capillary refill. d. Increased temperature to lower extremity b. Complaint of throbbing right leg pain. A female college student comes to the school's health clinic complaining of urinary frequency and burning with right lower back pain. Which intervention should the nurse implement first? a. Palpate the right flank for tenderness. b. Test her urine for the presence of hematuria c. Evaluate the urine for a strong odor. d. Measure her temperature and pulse rate. d. Measure her temperature and pulse rate. The nurse is caring for a client who reports a sudden, severe headache, and facial numbness. The nurse asks the client to smile and observes an uneven smile with facial droop the right side and a hand grasp strength that is weaker on the right than the left. The client denies a recent history of headache or trauma. Which intervention should the nurse should perform in the immediate management of the client? a. Place an indwelling urinary catheter and measure strict output. b. Notify the stroke team to assist with acute assessment and management. c. Raise the head of the bed to 30 degrees keeping head and neck in neutral alignment. d. Begin continuous observation for transient episodes of neurologic dysfunction b. Notify the stroke team to assist with acute assessment and management. Four days following and abdominal aortic aneurysm repair, the client is exhibiting edema of both lower extremities, and pedal pulses are not palpable. Which action should the nurse implement first? a. Wrap the feet with warmed blankets. b. Elevate extremities on pillows. c. Assess pulses with a vascular Doppler. d. Evaluate edema for pitting c. Assess pulses with a vascular Doppler While car ing for a client with Amyotrophic Lateral Sclerosis (ALS), the nurse performs a neurological assessment every four hours. Which assessment finding warrants immediate intervention by the nurse? a. Inappropriate laughter. b. Weakened cough effort. c. Asymmetrical weakness. d. Increasing anxiety. b. Weakened cough effort. The nurse is performing the preoperative assessment for a client scheduled for a vertebroplasty of the cervical spine. Which finding should the nurse alert the healthcare provider prior to the procedure? a. Hemoglobin 12 g/dL (120 g/L). b. Platelet count 40,000 x109/pL (40,000 x107L). c. Hematocrit 38% (0.38). d. White blood cells 9,000/pL (9x109L) b. Platelet count 40,000 x109/pL (40,000 x107L). A client who had colon surgery 3 days ago is anxious and requesting assistance to reposition. While the nurse is turning the client, the wound dehiscence's and eviscerates. The nurse moistens an a available sterile dressing and places over the wound. Which intervention should the nurse implement next? a. Prepare the client to return to the operating room. b. Auscultate the abdomen for bowel sound activity. c. Obtain a sample fo the drainage to send to the lab. d. Bring additional sterile dressing supplies to the room d. Bring additional sterile dressing supplies to the room Meningitis test to anticipate lumbar puncture Athlete's feet clean and dry socks COPD doing HUFF cough Re-learn exercise Burn (brown yellow) Full thickness Colon & rectal diet Oatmeal/raisin [Show More]

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