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

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ted Upright,
HESI Med Surg 1 Final Exam Study Guide
Questions and Answers 2023 (Verified Answers)

2. thoracentesis?: the surgical puncture of the chest wall with a needle to obtain
   fluid from the pleural cavity
3. What should the nurse expect for a client who has unstable Angina who hada cardiac catheter?: Thorocentesis
4. Metabolic Acidosis Respirations: Kussmaul respirations
5. Kussmaul breathing: gasping, labored breathing, also called air hunger
   A sign of acidosis
6. *Thoracentesis.What position would you place them in?: Sea
   leaning over table
   Rationale: To increase lung expansion

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6. *Wheezing (expiratory): Wheezing is a short, high pitched sound made on
   expiratory
7. *Abnormal Breathe sounds: used to describe bronchial or bronchovesicular
   sounds heard in the peripheral lung fields.
8. *Adventitous sounds?: extra and abnormal breath sounds.
9. *Bronchoscopy nurse priority and aftercare?: Keep pt NPO until gag reflux
   returns.
10. bronchoscopy?: A visual examination of the bronchi
11. Bronchoscopy procedure: Bronchoscopy is a procedure that allows your doctor to look at your airway through a thin viewing instrument called a bronchoscope.During a bronchoscopy , your doctor will examine your throat, larynx , trachea , andlower airways. Can get a specifimen collection, do biopsy, suction mucous plugs and
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    remove foreign objects.
12. What to report with a Bronchoscopy?: monitor for: bloody sputum.
    complications include: bronchospasm or bronchial perforation. (facial or neck crepitus, dysrhythmias, hemorrhage, hypoxemia, and pneumothorax)
    (Saunders N-CLEX Review)
13. What test do you use to verify pulmonary embolus?: CT
14. Normal Arterial Blood Gases: pH 7.35-7.45,
    PaO2 80-100mm Hg,
    SaO2 >95%,
    PaCO2 32-48 mm Hg,
    HCO3- 22-26 mEq/L
    

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

1. Four days after abdominal surgery a client has not passed flatus and
   there are no bowel sounds. Paralytic ileus is suspected. What does the nurseconclude is the most likely cause of the ileus ANS Impaired neural functioning
   Paralytic ileus occurs when neurologic impulses are diminished as a result of
   anesthesia, infection, or surgery. Interference in blood supply will result in necrosis
   of the bowel. Perforation of the bowel will result in pain and peritonitis. Obstruction
   of the bowel initially will cause increased peristalsis and bowel sounds.
2. A nurse is caring for a client with cirrhosis of the liver.Which laboratory testshould the nurse monitor that, when abnormal, might identify a client who maybenefit from neomycin enemas ANS Ammonia level
   Increased ammonia levels indicate that the liver is unable to detoxify protein by-products. Neomycin reduces the amount of ammonia-forming bacteria in the intestines.Culture and sensitivity testing is unnecessary; cirrhosis is an inflammatory, not
   infectious, process. Increased white blood cell count may indicate infection; however,this will have no relationship to the need for neomycin enemas. ALT, also called
   serum glutamic-pyruvic transaminase (SGPT), assesses for liver disease but has
   no relationship to the need for neomycin enemas.

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3. Name the characteristics that support chronic persistent stage of Lyme
   disease: Arthritis
   Chronic fatigue
   R: Systemic infectious disease caused by Spirochete Borrelia Burgdorferi.
4. symptoms of Prodomal stage w/inhalation of anthrax.: Fatigue
   Mild chest pain
   dry cough
   R:The manifestations include low-grade fever; fatigue; mild chest pain; and a dry,
   harsh cough. Inhalation anthrax is a two-stage illness, prodromal and fulminant.Theprodromal stage is the early stage and is difficult to distinguish from influenza or
   pneumonia. A special feature of inhalation anthrax is that it is not accompanied by
   upper respiratory manifestations of sore throat or rhinitis.
5. Which are examples of a type IV hypersensitivity reaction ANS Sarcoidosisandpoison ivy
   In type IV hypersensitivity, the inflammation is caused by a reaction of sensitized Tcells with the antigen and the resultant activation of macrophages due to lymphokinerelease. Myasthenia gravis is an example of a type II or cytotoxic hypersensitivity

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reaction. Rheumatoid arthritis and systemic lupus erythematosus are examples of
type III immune complex-mediated reactions.

6. A client was diagnosed with ulcerative colitis. Two months after the diagnosis, the client is readmitted for an exacerbation of the illness. The client is
   weak, thin, and irritable.The client states, “I am now ready for surgery to createan ileostomy.” Which nursing intervention will best meet the client’s priority
   need ANS Replace the Pt’s fluid and electrolytes
   R:Fluid and electrolyte replacement is a life-saving strategy; it must be done beforesurgery is performed. Helping the client regain former body weight is not the
   priority at this time. The client is neither physically nor cognitively ready to learn thepsychomotor skill of how to manage an ileostomy. The client is not demonstrating areadiness for contact with other persons with ileostomies at this time
7. A nurse discovers the condition depicted in the image upon assessment ofa client.Which organism may lead to this condition ANS Human herpes virus8
   The client in the image has Kaposi’s sarcoma (KS). The risk for KS appears to
   be related to co-infection with human herpes virus-8. KS is the most common
   acquired immune deficiency syndrome-related malignancy. Cytomegalovirus may
   lead to retinitis, encephalitis, pneumonitis, adrenalitis, hepatitis, and disseminated
   infection.Varicella-zoster virus causes chicken pox and shingles. Human papillomavirus causes multiple types of malignancies such as cervical and anal cancer.
   

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

1. A client with a productive cough has obtained a sputum specimen for
   culture as instructed. What is the best initial nursing action?
   A. Administer the first dose of antibiotic therapy
   B. Observe the color, consistency, and amount of sputum
   C. Encourage the client to consume plenty of warm liquids
   D. Send the specimen to the lab for analysis ANS B. Observe the color,
   consistency,and amount of sputum
2. A client is brought to the ED by ambulance in cardiac arrest with cardiopulmonary resuscitation (CPR) in progress.The client is intubated and is
   receiving 100% oxygen per self-inflating (ambu) bag. The nurse determines
   that the client is cyanotic, cold, and diaphoretic. Which assessment is most
   important for the nurse to obtain?
   A. Breath sounds over bilateral lung fields.
   B. Carotid pulsation during compressions
   C. Deep tendon reflexes
   D. Core body temperature ANS A. Breath sounds over bilateral lung fields.

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3. After a hospitalization for Syndrome of Inappropriate Antidiuretic Hormone(SIADH), a client develops pontine myselinolysis. Which intervention should
   the nurse implement first?
   A. Reorient client to his room
   B. Place a patch on one eye
   C. Evaluate client’s ability to swallow
   D. Perform range of motion exercises ANS A. Reorient client to his room
4. A male client with heart failure (HF) calls the clinic and reports that he cannot put his shoes on because they are too tight.Which additional informationshould the nurse obtain?
   A. What time did he take his last medications?
   B. Has his weight changed in the last several days?
   C. Is he still able to tighten his belt buckle?
   D. How many hours did he sleep last night? ANS B. Has his weight changed
   in thelast several days?
5. An older adult woman with a long history of chronic obstructive pulmonarydisease (COPD) is admitted with progressive shortness of breath and a persistent cough. She is anxious and is complaining of a dry mouth. Which
   intervention should the nurse implement?

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A. Administer a prescribed sedative
B. Encourage client to drink water
C. Apply a high-flow venturi mask
D. Assist her to an upright position ANS D. Assist her to an upright position

6. A client with a history of asthma and bronchitis arrives at the clinic with
   shortness of breath, productive cough with thickened tenacious mucous, andthe inability to walk up a flight of stairs without experiencing breathlessnessWhich action is most important for the nurse to instruct the client about
   self-care?
   A. Increase the daily intake of oral fluids to liquefy secretions
   B. Avoid crowded enclosed areas to reduce pathogen exposure
   C. Call the clinic if undesirable side effects of mediations occur
   D.Teach anxiety reduction methods for feelings of suffocation ANS A.
   Increase thedaily intake of oral fluids to liquefy secretions
7. A cardiac catherterization of a client with heart disease indicates the following blockages ANS 95% proximal left anterior descending (LAD), 99%
   proximalcircumflex, and ? % proximal right coronary artery (RCA).The client
   later asksthe nurse “what does all this mean for me?”What information shouldthe nurseprovide?
   A. Blood supply to the heart is diminished by artherosclerotic lesions, which
   necessitate lifestyle changes.

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B. Blood vessels supplying the pumping chamber have blockages indicatinga past heart attack.
C.Three main arteries have major blockages, with only 1 to 5% of blood flow
getting through to the heart muscle.
D.The heart is not receiving enough blood, so there is a risk of heart failure
and fluid retention. ANS C. Three main arteries have major blockages, with
only 1 to5% of blood flow getting through to the heart muscle.

8. A client who weighs 175 pounds is receiving IV bolus dose of heparin 80
   units/kg. The heparin is available in a 2 ml vial, labeled 10,000 units/ml. How
   many ml should the nurse administer? (Enter numeric value only. If roundingis required, round to the nearest tenth.) ANS 0.6 ml
9. What information should the nurse include in the teaching plan of a client
   diagnosed with gastroesophageal reflux disease (GERD)?
   A. Sleep without pillows at night to maintain neck alignment.
   

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

1. 1. A nurse is visiting a client who is receiving home health care, focusing
   on medication and dietary instructions and management of heart failure. Thenurse should reinforce which instruction?
   A.) If you feel tired and short of breath, lie down flat and prop up your feet.
   B.) Eating liver several times a week will help build up your strength.
   C.)Your daily dose of furosemide should be taken first thing in the morning.
   D.) The dose of enalapril will help prevent vasodilation from occurring.:
   Answer: C
2. 2. A nurse planning care for a client who has undergone transurethral
   resection of the prostate (TURP) remembers that the most common cause ofpostoperative pain is which factor?
   A.) Bladder spasms
   B.) Bleeding within the bladder

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C.) The location of the incision
D.) Tension on the Foley catheter: Answer: A

3. 3. A nurse assessing the skin of a client who is immobile notes this changein appearance of the skin in the sacral area:
   The nurse documents this finding in which way?
   A.) Stage I pressure ulcer
   B.) Stage II pressure ulcer
   C.) Stage III pressure ulcer
   D.) Stage IV pressure ulcer: Answer: A
4. 4. A nurse reinforces teaching given to a client with gastroesophageal refluxdisease (GERD) about measures to manage the disease.What does the nurseencourage the client to do to obtain relief of the symptoms?

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A.) Limit intake of coffee and tea.
B.) Eat three large, well-balanced meals per day.
C.) Rest in a supine position for 30 minutes after each meal.
D.) Elevate the head of the bed at least 6 to 8 inches for sleep.: Answer: D

5. 5. A nurse provides instructions to a client who is taking allopurinol for thetreatment of gout. Which statements by the client indicate an understanding
   of the medication?
   A.) “I need to take the medication 1 hour before I eat.”
   B.) “I need to drink at least 8 glasses of fluid every day.”
   C. “I’ll start taking a vitamin C supplement each morning.”
   D.) “I can use an antihistamine lotion if I get an itchy rash.”: Answer: B
6. 6. A client with phantom limb pain has decided to use transcutaneous
   electrical nerve stimulation (TENS) as prescribed by the health care providerThe nurse reinforces instructions regarding the use of the TENS unit. Which
   statements by the client indicate a need for further instruction regarding thispain-relief measure?
   A.) “I’m so glad this will help relieve the pain.”

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B.) “Now I won’t need to take so many pain medications.”
C.) “I need to put the electrodes on the areas that you marked.”
D.) “I’m not sure I’m going to like having those electrodes attached to my
skin.”: Answer: C

7. 7. A hospitalized client has just been found to have acute renal failure (ARF).The laboratory calls the nursing unit and reports that the client has a serum
   potassium level of 6.4 mEq/L. On the basis of this laboratory finding, the nurseshould first take which action?
   A.) Call the health care provider
   

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

1. The nurse is assessing a client’s laboratory values following administrationof chemotherapy.Which lab value leads the nurse to suspect that the client isexperiencing tumor lysis syndrome (TLS)?
   a. Serum PTT of 10 seconds.
   b. Serum calcium of 5 mg/dL.
   c. Oxygen saturation of 90%.
   d. Hemoglobin of 10 g/dL ANS B – Tumor lysis syndrome (TLS) results inhyperkalemia, hypocalcemia, hyperuricemia, and hyperphosphatemia. A serumcalcium level of 5,which is low, is an indicator of possible tumor lysis syndrome.
2. Which description of symptoms is characteristic of a client diagnosed withtrigeminal neuralgia (tic douloureux)?
   a.Tinnitus, vertigo, and hearing difficulties.
   b. Sudden, stabbing, severe pain over the lip and chin.
   c. Facial weakness and paralysis.
   d. Difficulty in chewing, talking, and swallowing. ANS B – Trigeminal neuralgia ischar- acterized by paroxysms of pain, similar to an electric shock, in the areainnervatedby one or more branches of the trigeminal nerve (5th cranial).Women are
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   more oftenafflicted with this condition and generally occurs in clients over the ageof 50 yearsold.
3. Which discharge instruction is most important for a client after a kidney
   transplant?
   a.Weigh weekly.
   b. Report symptoms of secondary Candidiasis.
   c. Use daily reminders to take immunosuppressants.
   d. Stop cigarette smoking. ANS C – After a renal transplantation, acute rejection is a high risk for several months. The organ recipient will have to take
   immunosuppres-sive therapy for the rest of their lives, such as corticosteroids and azathioprine, to prevent organ transplant rejection. Discharge instructions include
   measures such as daily reminders to ensure the client takes these medications
   regularly to preventorgan rejection from occurring.
4. The nurse is providing dietary instructions to a 68-year-old client who is athigh risk for development of coronary heart disease (CHD).Which informationshould the nurse include?
   a. Limit dietary selection of cholesterol to 300 mg per day.
   b. Increase intake of soluble fiber to 10 to 25 grams per day.
   c. Decrease plant stanols and sterols to less than 2 grams/day.
   d. Ensure saturated fat is less than 30% of total caloric intake. ANS B – To
   reduce risk factors associated with coronary heart disease, the daily intake of
   soluble fiber

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should be increased to between 10 and 25 grams per day.According to the AmericanHeart Association, soluble fibers helps reduce LDL cholesterol levels.

5. Two days postoperative, a male client reports aching pain in his left leg.Thenurse assesses redness and warmth on the lower left calf.Which interventionwould be most helpful to this client?
   a. Apply sequential compression devices (SCDs) bilaterally.
   b. Assess for a positive Homan’s sign in each leg.
   c. Pad all bony prominences on the affected leg.
   d. Advise the client to remain in bed with the leg elevated. ANS D – For a
   client exhibiting symptoms of deep vein thrombosis (DVT), a complication of
   immobility,the initial care includes bedrest and elevation of the extremity.
6. A middle-aged male client with diabetes continues to eat an abundance of
   foods that are high in sugar and fat. According to the Health Belief Model,
   which event is most likely to increase the client’s willingness to become
   compliant with the prescribed diet?
   a. He visits his diabetic brother who just had surgery to amputate an infectedfoot.
   b. He is provided with the most current information about the dangers of
   untreated diabetes.
   c. He comments on the community service announcements about preventingcomplications associated with diabetes.
   d. His wife expresses a sincere willingness to prepare meals that are within
   his prescribed diet. ANS A – The loss of a limb due to diabetes by a family

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member should be the strongest event or “cue to action” and is most likely to
increase theclient’s perceived seriousness of the disease.

7. A 58-year-old client who has been post-menopausal for five years is concerned about the risk for osteoporosis because her mother has the conditionWhich information should the nurse offer?
   a. Osteoporosis is a progressive genetic disease with no effective treatment.b. Calcium loss from bones can be slowed by increasing calcium intake and
   exercise.
   c. Estrogen replacement therapy should be started to prevent the progressionosteoporosis.
   d. Low-dose corticosteroid treatment effectively halts the course of osteoporosis. ANS B – Post-menopausal females are at risk for osteoporosis due to
   the cessation of estrogen secretion, but a regimen including calcium, vitamin D,
   andweight-bearing exercise can help prevent further bone loss.
8. The nurse notes that the only ECG for a 55-year-old male client scheduled
   for surgery in two hours is dated two years ago.The client reports that he has