HESI MED SURG 1 EXAM 2023 STUDY BUNDLE PACK SOLUTION (Verified Answers)HESI MED SURG 1 EXAM 2023 STUDY BUNDLE PACK SOLUTION (Verified Answers)

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HESI Med Surg 1 Practice Questions and Answers2023 (Verified Answers)

1. What instruction should the nurse include in the discharge teaching plan ofa client who had a cataract extraction today?
   a. sexual activities may be resumed upon return home
   b. light housekeeping is permitted but avoid heavy lifting
   c. use a metal eye shield on operative eye during the day
   d. administer eye ointment before applying eye drops ANS b. light
   housekeeping ispermitted but avoid heavy lifting
2. A male adult comes to the urgent care clinic 5 days after being diagnosed
   with influenza. He is short of breath, febrile, and coughing green colored
   sputum. Which intervention should the nurse implement first?
   a. Obtain a sputum sample for culture
   b. Check his oxygen saturation level
   c. Administer an oral antipyretic
   d. Auscultate bilateral lung sound ANS a. obtain a sputum sample for culture
3. An elder male client tells the nurse that he is loosing sleep because he hasto get up several times at night to go to the bathroom that he has trouble
   starting his urinary stream and that he does not feel like his bladder is ever

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completely empty. Which intervention should the nurse implement?
a. collect a urine specimen for culture analysis
b. obtain a fingerstick blood glucose level
c. palpate the bladder above the symphysis pubis
d. review the client fluid intake ANS c. palpate the bladder above the symphysis
pubis

4. An adult client is admitted with diabetic ketoacidosis (DKA) and a urinary
   tract infection (UTI) Prescriptions for intravenous antibiotics and insulin infusion are initiated.Which serum laboratory value warrants the most immediateintervention by the nurse?
   a. blood ph of 7.30
   b. glucose of 350 mg /dl
   c. white blood cell count of 15000mm
   d. potassium of 2.5 meq/l ANS d. potassium of 2.5 meq/l
5. A client with sickle cell anemia develops a fever during the last hour of
   administration of a unit of packed red blood cell.When notifying the healthcareprovider what information should the nurse provide first using the SBAR
   communication process?
   a. explain specific reason for urgent notification
   b. preface the report by stating the clients name and admitting diagnosis
   c. communicate the pre-transfusion temperatures
   d. optain prn prescription for acetaminophen for fever 101f ANS a. explain
   specificreason for urgent notification

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6. An adult male client is admitted for pneumocystis carinil pneumonia (PCP)secondary to aids. While hospitalized he receives IV pentamidine isethionatetherapy. In preparing this client for discharge what important aspect regardinghis medication therapy should the nurse explain?
   a. AZT therapy must be stopped when IV aerosol pentamine is being used.
   b. IV pentamine will be given until oral pentamine can be tolerated
   c. It will be necessary to continue prophylactic doses of IV or aerosol pentamine every month
   d. IV pentamine may offer protection to others aids related conditions such askaposis sarcoma ANS c. it will be necessary to continue prophylactic doses of IVor aerosol pentamine every month
7. A client subjective data includes dysuria, urgency, and urinary frequency.
   What action should the nurse implement next?
   a. collect a clean catch specimen
   b. palpate the suprapubic region
   c. instruct to wipe from front to back
   d. inquire about recent sexual activity ANS a. collect a clean catch specimen
8. A client tells the nurse that her biopsy results indicate that the cancer cellsare well differentiated How should the nurse respond?
   a. offer the client reassurance that this information indicates that the clients
   cancer cells are benign
   b. explain that these tissue cells often respond more effectively to radiation
   than to chemotherapy
   

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HESI Med Surg 1 Exam Questions and Answers 2023
(Verified Answers)

1. The nurse observes ventricular fibrillation on telemetry and, on entering theclient’s bathroom, finds the client unconscious on the floor. Which intervention should the nurse implement first?
   A.
   Administer an antidysrhythmic medication.
   B.
   Start cardiopulmonary resuscitation.
   C.
   Defibrillate the client at 200 J.
   D.
   Assess the client’s pulse oximetry.
   ANS : B.Start cardiopulmonary
   resuscitation.
   Rationale:
   Ventricular fibrillation is a life-threatening dysrhythmia, and CPR should be startedimmediately (B). (A and C) are appropriate, but CPR is the priority action. The clientis dying, and (D) does not address the seriousness of this situation.

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2. The nurse assesses a client who has been prescribed furosemide (Lasix)
   for cardiac disease.Which electrocardiographic change would be a concern
   for a client taking a diuretic?
   A.
   Tall, spiked T waves
   B.
   A prolonged QT interval
   C.
   A widening QRS complex
   D.
   Presence of a U wave
   ANS : D .Presence of a U
   wave
   Rationale:
   A U wave (D) is a positive deflection following the T wave and is often present with
   hypokalemia (low potassium level). (A, B, and C) are all signs of hyperkalemia.
3. A 43-year-old homeless, malnourished female client with a history of alcoholism is transferred to the ICU. She is placed on telemetry, and the rhythm
   strip shown is obtained.The nurse palpates a heart rate of 160 beats/min, andthe client’s blood pressure is 90/54 mm Hg. Based on these findings, which IVmedication should the nurse administer?
   A.

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Amiodarone (Cordarone)
B.
Magnesium sulfate
C.
Lidocaine (Xylocaine)
D.
Procainamide (Pronestyl)
ANS : B.Magnesium sulfate
Rationale:
Because the client has chronic alcoholism, she is likely to have hypomagnesemia.
(B) is the recommended drug for torsades de pointes, which is a form of polymorphicventricular tachycardia (VT) usually associated with a prolonged QT interval that
occurs with hypomagnesemia. (A and D) increase the QT interval, which can
cause the torsades to worsen. (C) is the antiarrhythmic of choice in most cases of
drug-induced monomorphic VT, not torsades.

4. When developing a discharge teaching plan for a client after the insertion
   of a permanent pacemaker, the nurse writes a goal of “The client will verbalizesymptoms of pacemaker failure.” Which behavior indicates that the goal hasbeen met?
   A.
   The client demonstrates the procedures to change the rate of the pacemakerusing a magnet.
   B.
   The client carries a card in his wallet stating the type and serial number of the
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   pacemaker.
   C.
   The client tells the nurse that it is important to report redness and tendernessat the insertion site.
   D.
   The client states that changes in the pulse and feelings of dizziness are
   significant changes. ANS : D .
   The client states that changes in the pulse and feelings of dizziness are significant
   changes.
   Rationale:
   Changes in pulse rate and/or rhythm may indicate pacer failure. Feelings of dizzinessmay be caused by a decreased heart rate, leading to decreased cardiac output
   (D). The rate of a pacemaker is not changed by a client, although the client may
   

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HESI Med Surg 1 Exam Questions and Answers
2023 (Verified Answers)

1. The nurse obtains a fingerstick glucose level utilizing bedside lancet/glucose meter equipment from a client with prescribed sliding scale insulin protocol.The meter indicates 56 mg/dl (3.12 mmol/l). At this time which interventionshould the nurse implement first?
   A. Collect a blood specimen by venipuncture to send to the laboratory for
   serum glucose analysis.
   B. Prepare the prescribed dose of rapid acting insulin from the sliding scale
   instructions.
   C. Give the client six ounces of non-diet carbonated soda and instruct to drinkit entirely.
   D. Document the glucose reading in the electronic medical record as the onlyaction needed. ANS C
2. To achieve maximum mobility and independence for a client with multiple
   sclerosis (MS), which intervention is most important for the nurse to implement?

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A. Provide a walker for ambulation
B. Frequently assist the client to the bathroom
C. Apply alternating patches over eyes
D.Teach strengthening exercises ANS D

3. A client is admitted to the hospital with symptoms consistent with a right
   hemisphere stroke.Which neurovascular assessment requires immediate intervention by the nurse?
   A. Pupillary changes to ipsilateral dilation
   B. Orientation to person and place only
   C. Left- sided drooping and dysphagia
   D. Unequal bilateral hand grip strengths ANS C
4. The nurse is teaching a client with glomerulonephritis about self care.Whichdietary recommendations should the nurse encourage the client to follow?
   A. Limit oral fluid intake to 500 ml per day
   B. Restrict protein intake by limiting meats and other high-protein foods
   C. Increase intake of potassium-rich foods such as bananas and cantaloupe.D. Increase intake of high fiber foods such as bran cereal ANS B
5. The nurse is caring for a client with Herpes zoster who reports painful, redblisters that align from the back along the chest’s curvature to the anterior
   chest.Which intervention is the highest priority for the nurse?

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A. Place the client on contact precautions
B. Administer antiviral medications
C. Place wet compresses to ruptured vesicles
D. Administer narcotic analgesics ANS B

6. A young adult who suffered a severe brain injury in an automobile collisionhas been mechanically ventilated for the past three days and has no spontaneous respiratory effort. After serial electroencephalograms (EEG) reveal nobrain activity, the healthcare provider discusses end-of-life options with the
   family who agree to discontinue life support. Which intervention should the
   nurse implement?
   A. Ask the family if they wish to remain at the bedside during withdrawal
   B. Request a living will be placed in the clients medical record
   C. Discuss the withdrawal procedure with the family and offer support
   D.Turn off mechanical ventilator and note time of death ANS C
7. Following a transurethral resection of the prostate (TURP), a client is discharged from the hospital with an indwelling urinary catheter. which instruction is important for the nurse to include in the discharge teaching plan?
   A. Eliminate all spicy foods from your diet
   B. Drink 3 liters of water each day
   C. Clamp the catheter when taking a shower
   D. Avoid driving a car for 2 weeks ANS B
   

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HESI Med Surg 1 Exam Questions and Answers 2023 (Verified Answers)

1. The nurse is providing care to a client after a percutaneous transluminal coronary angioplasty (PTCA).What actions will the nurse include in the
   client’s plan of care? (Select all that apply.) ANS A.Frequent vital signs.
   B.Determine if the client is allergic to aspirin.
   D.Offer fluids of choice.
   F.Monitor infusion of IV nitroglycerine.
2. In assessing a client diagnosed with primary aldosteronism, the nurse
   expects the laboratory test results to indicate a decreased serum level of
   which substance? ANS C.Potassium
   Clients with primary aldosteronism exhibit a profound decline in serum levels of
   potassium; hypokalemia; hypertension is the most prominent and universal sign.
3. The nurse is providing care for a client diagnosed with trigeminal neuralgia(tic douloureux).Which symptoms will the nurse be looking for in the focusedassessment related to this condition? (Select all that apply.) ANS A.Facial
   musclespasms
   B.Sudden facial pain
   Trigeminal neuralgia is characterized by paroxysms of pain, similar to an electric

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shock, in the area innervated by one or more branches of the trigeminal nerve
(cranial V).

4. A 74-year-old male client is admitted to the intensive care unit (ICU) with adiagnosis of respiratory failure secondary to pneumonia. Currently, the clientis ventilator-dependent, with settings of tidal volume (VT) of 750 mL and an
   intermittent mandatory ventilation (IMV) rate of 10 breaths/min. Arterial bloodgas (ABG) results are as follows pH, 7.48; PaCO2, 30 mm Hg; PaO2, 64 mm
   Hg; HCO3, 25 mEq/L; and FiO2, 0.80. Which action should the nurse take
   first? ANS D.Add 5 cm positive end-expiratory pressure (PEEP)
   Adding PEEP helps improve oxygenation while reducing FiO2 to a less toxic level
5. The clinic nurse is providing post-operative teaching for a client scheduledfor a myringoplasty. Which client statements indicate to the nurse that the
   teaching has been effective? (Select all that apply.) ANS B.”I will avoid forcefulanddeep coughing until my post-op checkup.
   C.”I must lay flat on my non-operative side for the first 12 hours after surgery.”
   D.”My hearing may be less or muffled until the packing comes out.”
   The client must keep the ear bandage clean and dry until the packing is removed.
   Showering and hair washing is discouraged.
6. During the shift report, the charge nurse informs a nurse of a reassignmentto another unit for the day. The nurse begins to sigh deeply and tosses abouther belongings when preparing to leave.What is the best immediate action forthe charge nurse to take? ANS A.
   

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HESI Med Surg 1 Practice Questions and Answers 2023(Verified Answers)

1. The nurse is assessing a 48-year-old client with a history of smoking duringa
   routine clinic visit.The client, who exercises regularly, reports having pain in
   the calf
   during exercise that disappears at rest.Which of the following findings requires further
   evaluation?
2. Heart rate 57 bpm.
3. SpO2 of 94% on room air.
4. Blood pressure 134/82.
5. Ankle-brachial index of 0.65.: 4
   An Ankle-Brachial Index of 0.65 suggests moderate arterial vascular disease in
   a client who is experiencing intermittent claudication. A Doppler ultrasound is
   indicated for further evaluation. The bradycardic heart rate is acceptable in an
   athletic
   client with a normal blood pressure. The SpO2 is acceptable; the client has a
   smoking
   history.

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2. An overweight client taking warfarin (Coumadin) has dry skin due to decreased
   arterial blood flow.What should the nurse instruct the client to do? Select allthat apply.
3. Apply lanolin or petroleum jelly to intact skin.
4. Follow a reduced-calorie, reduced-fat diet.
5. Inspect the involved areas daily for new ulcerations.
6. Instruct the client to limit activities of daily living (ADLs).
   5.Use an electric razor to shave: 1,2,3,5
   Maintaining skin integrity is important in preventing chronic ulcers and
   infections.The client should be taught to inspect the skin on a daily basis.The clientshould reduce weight to promote circulation; a diet lower in calories and fat is
   appropriate. Because the client is receiving Coumadin, the client is at risk for
   bleeding
   from cuts. To decrease the risk of cuts, the nurse should suggest that the client usean
   electric razor.The client with decreased arterial blood flow should be encouraged toparticipate in ADLs. In fact, the client should be encouraged to consult an exercisephysiologist for an exercise program that enhances the aerobic capacity of the body.3. A client with peripheral vascular disease has undergone a right
   femoral-popliteal

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bypass graft. The blood pressure has decreased from 124/80 to 94/62. What
should the nurse assess first?

1. IV fluid solution.
2. Pedal pulses.
3. Nasal cannula flow rate.
4. Capillary refill: 2
   With each set of vital signs, the nurse should assess the dorsalis pedis and
   posterior tibial pulses. The nurse needs to ensure adequate perfusion to the lower
   extremity with the drop in blood pressure. IV fluids, nasal cannula setting, and
   capillary
   refill are important to assess; however, priority is to determine the cause of drop in
   blood pressure and that adequate perfusion through the new graft is maintained.
5. The nurse is caring for a client with peripheral artery disease who has
   recently
   been prescribed clopidogrel (Plavix).The nurse understands that more teaching is
   necessary when the client states which of the following:
6. “I should not be surprised if I bruise easier or if my gums bleed a little whenbrushing my teeth.”
7. “It doesn’t really matter if I take this medicine with or without food, whateverworks best for my stomach.”
8. “I should stop taking Plavix if it makes me feel weak and dizzy.”
9. “The doctor prescribed this medicine to make my platelets less likely to
   stick together and help prevent clots from forming.”: 3

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Weakness, dizziness, and headache are common adverse effects of Plavix and
the client should report these to the physician if they are problematic; in order to
decrease risk of clot formation, Plavix must be taken regularly and should not be
stopped or taken intermittently. The main adverse effect of Plavix is bleeding, whichoften occurs as increased bruising or bleeding when brushing teeth. Plavix is well
absorbed, and while food may help decrease potential gastrointestinal upset, Plavixmay
be taken with or without food. Plavix is an antiplatelet agent used to prevent clot
formation in clients who have experienced or are at risk for myocardial infarction,
ischemic stroke, peripheral artery disease, or acute coronary syndrome.

5. A client is receiving Cilostazol (Pletal) for peripheral arterial disease causing
   intermittent claudication.The nurse determines this medication is effective
   when the