MED SURG 1 HESI 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 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 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 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
   

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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

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HESI Med Surg Test bank

1. The nurse assesses a patient with shortness of breath for evidence of
   long-standing hypoxemia by inspecting:
   A. Chest excursion
   B. Spinal curvatures
   C.The respiratory pattern
   D.The fingernail and its base: D. The fingernail and its base Clubbing, a sign of
   long-standing hypoxemia, is evidenced by an increase in the angle between the
   base of the nail and the fingernail to 180 degrees or more, usually accompanied byan increase in the depth, bulk, and sponginess of the end of the finger.
2. 2. The nurse is caring for a patient with COPD and pneumonia who has
   an order for arterial blood gases to be drawn. Which of the following is
   the minimum length of time the nurse should plan to hold pressure on the
   puncture site?
   A. 2 minutes
   B. 5 minutes
   C. 10 minutes
   D. 15 minutes: B. 5 minutes Following obtaining an arterial blood gas, the nurse

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should hold pressure on the puncture site for 5 minutes by the clock to be sure thatbleeding has stopped. An artery is an elastic vessel under higher pressure than
veins, and significant blood loss or hematoma formation could occur if the time is
insufficient.

3. 3. The nurse notices clear nasal drainage in a patient newly admitted with
   facial trauma, including a nasal fracture. The nurse should:
   A. test the drainage for the presence of glucose.
   B. suction the nose to maintain airway clearance.
   C. document the findings and continue monitoring.
   D. apply a drip pad and reassure the patient this is normal.: A. test the drainagefor the presence of glucose. Clear nasal drainage suggests leakage of cerebrospinafluid (CSF).The drainage should be tested for the presence of glucose, which wouldindicate the presence of CSF.
4. 4. When caring for a patient who is 3 hours postoperative laryngectomy, thenurse’s highest priority assessment would be:
   A. Airway patency
   B. Patient comfort
   C. Incisional drainage
   D. Blood pressure and heart rate: A. Airway patency Remember ABCs with
   prioritization. Airway patency is always the highest priority and is essential for a
   patient undergoing surgery surrounding the upper respiratory system.

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5. 5. When initially teaching a patient the supraglottic swallow following a
   radical neck dissection, with which of the following foods should the nurse
   begin?
   A. Cola
   B. Applesauce
   C. French fries
   D.White grape juice: A. ColaWhen learning the supraglottic swallow, it may be
   helpful to start with carbonated beverages because the effervescence provides
   clues about the liquid’s position. Thin, watery fluids should be avoided because
   they are difficult to swallow and increase the risk of aspiration. Nonpourable pureedfoods, such as applesauce, would decrease the risk of aspiration, but carbonated
   beverages are the better choice to start with.
6. 6. The nurse is caring for a patient admitted to the hospital with pneumoniaUpon assessment, the nurse notes a temperature of 101.4° F, a productive
   cough with yellow sputum and a respiratory rate of 20.Which of the followingnursing diagnosis is most appropriate based upon this assessment? A. Hyperthermia related to infectious illness
   B. Ineffective thermoregulation related to chilling
   C. Ineffective breathing pattern related to pneumonia
   D. Ineffective airway clearance related to thick secretions: A. Hyperthermia
   related to infectious illness Because the patient has spiked a temperature and hasa diagnosis of pneumonia, the logical nursing diagnosis is hyperthermia related to
   infectious illness. There is no evidence of a chill, and her breathing pattern is withinnormal limits at 20 breaths per minute. There is no evidence of ineffective airway

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clearance from the information given because the patient is expectorating sputum.7. 7. Which of the following physical assessment findings in a patient with
pneumonia best supports the nursing diagnosis of ineffective airway clearance? A. Oxygen saturation of 85%
B. Respiratory rate of 28
C. Presence of greenish sputum
D.Basilar crackles: D.Basilar crackles The presence of adventitious breath soundsindicates that there is accumulation of secretions in the lower airways. This would
be consistent with a nursing diagnosis of ineffective airway clearance because thepatient is retaining secretions.

8. 8. Which of the following clinical manifestations would the nurse expect tofind during assessment of a patient admitted with pneumococcal pneumonia?A. Hyperresonance on percussion
   B. Fine crackles in all lobes on auscultation
   C. Increased vocal fremitus on palpation D.Vesicular breath sounds in all