2023 HESI MED-SURG TEST BANK REAL EXAM 450
QUESTIONS AND CORRECT DETAILED ANSWERS (100%
CORRECT AND VERIFIED ANSWERS) |ALREADY GRADED
A+ (LATEST TEST BANK!!)
- Which of the following statements made by a patient with COPD indicates a
need for further education regarding the use of an ipratropium inhaler?
A. “I should rinse my mouth following the two puffs to get rid of the bad taste.”
B. “I should wait at least 1 to 2 minutes between each puff of the inhaler.”
C. “If my breathing gets worse, I should keep taking extra puffs of the inhaler until
I can breathe more easily.”
D. “Because this medication is not fast-acting, I cannot use it in an emergency if
my breathing gets worse. – ANSWER- C. “If my breathing gets worse, I should
keep taking extra puffs of the inhaler until I can breathe more easily.” The patient
should not take extra puffs of the inhaler at will to make breathing easier.
Excessive treatment could trigger paradoxical bronchospasm, which would worsen
the patient’s respiratory status. - When assessing a patient’s sleep-rest pattern related to respiratory health, the
nurse would ask if the patient: (Select all that apply.)
A. Has trouble falling asleep
B. Awakens abruptly during the night
C. Sleeps more than 8 hours per night
D. Has to sleep with the head elevated – ANSWER- A,B,D The patient with sleep
apnea may have insomnia and/or abrupt awakenings. Patients with cardiovascular
disease (e.g., heart failure that may affect respiratory health) may need to sleep
with the head elevated on several pillows (orthopnea). Sleeping more than 8 hours
per night is not indicative of impaired respiratory health. - A patient is being discharged from the emergency department after being treated
for epistaxis. In teaching the family first aid measures in the event the epistaxis
would recur, which of the following measures would the nurse suggest? (Select all
that apply.)
A. Tilt patients head backwards
B. Apply ice compresses to the nose
C. Pinch the entire soft lower portion of the nose
D. Partially insert a small gauze pad into the bleeding nostril – ANSWER- B,C,D
First aid measures to control epistaxis includes placing the patient in a sitting
position, leaning forward. Tilting the head back does not stop the bleeding, but
rather allows the blood to enter the nasopharynx, which could result in aspiration
or nausea/vomiting from swallowing blood. All of the other options are appropriate
first aid treatment of epistaxis.
- To promote airway clearance in a patient with pneumonia, the nurse instructs the
patient to do which of the following? (Select all that apply.)
A. Splint the chest when coughing
B. Maintain a semi-Fowler’s position
C. Maintain adequate fluid intake
D. Instruct patient to cough at end of exhalation – ANSWER- A,C,D The nurse
should instruct the patient to splint the chest while coughing. This will reduce
discomfort and allow for a more effective cough. Maintaining adequate fluid intake
liquefies secretions, allowing easier expectoration. Coughing at the end of
exhalation promotes a more effective cough. The patient should be positioned in an
upright sitting position (high-Fowler’s) with head slightly flexed. - During admission of a patient diagnosed with non-small cell carcinoma of the
lung, the nurse questions the patient related to a history of which of the following
risk factors for this type of cancer? (Select all that apply.)
A. Asbestos exposure
B. Cigarette smoking
C. Exposure to uranium
D. Chronic interstitial fibrosis – ANSWER- A,B,C Non-small carcinoma is
associated with cigarette smoking and exposure to environmental carcinogens,
including asbestos and uranium. Chronic interstitial fibrosis is associated with the
development of adenocarcinoma of the lung. - When admitting a 45-year-old female with a diagnosis of pulmonary embolism,
the nurse will assess the patient for which of the following risk factors? (Select all
that apply.)
A. Obesity
B. Pneumonia
C. Hypertension
D. Cigarette smoking – ANSWER- A,C,D Research has demonstrated an increased
risk of pulmonary embolism in women associated with obesity, heavy cigarette
smoking, and hypertension. Other risk factors include immobilization, surgery
within the last 3 months, stroke, history of DVT, and malignancy. - When admitting a patient with the diagnosis of asthma exacerbation, the nurse
will assess for which of the following potential triggers? (Select all that apply.)
A. Exercise
B. Allergies
C. Emotional stress
D. Decreased humidity – ANSWER- A,B,C Although the exact mechanism of
asthma is unknown, there are several triggers that may precipitate an attack. These
include allergens, exercise, air pollutants, respiratory infections, drug and food
additives, psychologic factors, and GERD. - A person complains of fatigue and malaise and has a slight temperature
elevation for 2 days before symptoms of influenza (fever, chest congestion, and
productive cough) become noticeable. During the time immediately before the
illness is diagnosed, the patient
A. could avoid contracting the disease if treatment is begun with antibiotics.
B. is unable to spread the disease because it is still in the incubation period.
C. is in the prodromal stage and is highly contagious and able to spread the disease.
D. has a nosocomial infection, which affects approximately two million individuals
a year. – ANSWER- C. is in the prodromal stage and is highly contagious and able
to spread the disease. The prodromal stage is a short period of time (hours to
several days) immediately preceding the onset of an illness during which the
patient is very contagious. Antibiotics are not effective against viral illnesses. The
incubation period is the time from entry of the organism to the onset of symptoms
and, in some viral illnesses, may be contagious. Nosocomial infections are those
acquired in a hospital, and this scenario does not suggest the source of the
infection. - In older adults, infection after exposure to respiratory illness is most likely to
A. result in similar rates of infection as in the younger adult.
B. be easily prevented with the use of antibiotics after being exposed.
C. result in serious lower respiratory infection related to weakened respiratory
muscles and fewer cilia.
D. be less serious because the older adult has less contact with younger children
who are most likely to carry serious infections. – ANSWER- C. result in serious
lower respiratory infection related to weakened respiratory muscles and fewer cilia.
Changes in the older adult respiratory system make older adults more susceptible
to infections that can be very serious and life threatening. Use of antibiotics to
“prevent” lung infections is not recommended and is ineffective for viral
infections. - If a nurse is caring for an 80-year-old patient with a temperature of 100.4° F,
crackles at the right lung base, pain with deep inspiration, and dyspnea, which of
the following orders is the nurse’s priority?
A. Sputum specimen for culture and sensitivity
B. Codeine 15 mg orally every 6 hours as needed
C. Incentive spirometer every 2 hours while awake
D. Amoxicillin (Amoxil) 500 mg orally 4 times a day – ANSWER- A. Sputum
specimen for culture and sensitivity The patient presents with signs of a respiratory
infection. To initiate the most effective therapy, the health care prescriber must
know the pathogen causing the infection. Therefore, the sputum specimen is the
nurse’s priority. If the antibiotic is administered before the specimen is obtained,
the results of the culture might not be as accurate and could impair the
effectiveness of therapy. After the specimen is obtained, the nurse can administer
codeine for coughing and begin the incentive spirometry to mobilize secretions and
improve the patient’s ability to expectorate the secretions. - When assessing a patient’s respiratory status, which of the following
nonrespiratory data are most important for the nurse to obtain?
A. Height and weight
B. Neck circumference
C. Occupation and hobbies
D. Usual daily fluid intake – ANSWER- C. Occupation and hobbiesMany
respiratory problems occur as a result of chronic exposure to inhalation irritants.
Common occupational sources of inhalation irritants include mines, granaries,
farms, lawn care companies, paint, plastics and rubber manufacture, and building
remodeling. Hobbies associated with inhalation irritants include woodworking,
metal finishing, furniture refinishing, painting, and ceramics. Daily fluids, height,
and weight are more related to respiratory problems secondary to cardiac issues. - If a nurse is assessing a patient whose recent blood gas determination indicated
a pH of 7.32 and respirations are measured at 32 breaths/min, which of the
following is the most appropriate nursing assessment?
A. The rapid breathing is causing the low pH.
B. The nurse should sedate the patient to slow down respirations.
C. The rapid breathing is an attempt to compensate for the low pH.
D. The nurse should give the patient a paper bag to breathe into to correct the low
pH. – ANSWER- C. The rapid breathing is an attempt to compensate for the low
pH. The respiratory system influences pH (acidity) through control of carbon
dioxide exhalation. Thus, rapid breathing increases the pH. Breathing into a paper