{"id":113759,"date":"2023-08-16T14:49:00","date_gmt":"2023-08-16T14:49:00","guid":{"rendered":"https:\/\/learnexams.com\/blog\/?p=113759"},"modified":"2023-08-16T14:49:03","modified_gmt":"2023-08-16T14:49:03","slug":"hesi-med-surg-iii-final-exam-2023-study-bundle-pack-solution-verified-answers","status":"publish","type":"post","link":"https:\/\/www.learnexams.com\/blog\/2023\/08\/16\/hesi-med-surg-iii-final-exam-2023-study-bundle-pack-solution-verified-answers\/","title":{"rendered":"HESI MED SURG III FINAL EXAM 2023 STUDY BUNDLE PACK SOLUTION (Verified Answers)"},"content":{"rendered":"\n


2023 HESI Med Surg III Final Exam<\/p>\n\n\n\n

    \n
  1. The nurse is providing care to an older adult patient who is
    experiencing bradycardia. When educating the patient about this disorder,
    which age-re- lated cardiovascular change should the nurse include\u2714\u2714
    Reduced number of pacemaker cells in the SA node
    Rationale: A reduced number of pacemaker cells in the SA node
    causes the maximum heart rate to decrease with age, leading to
    bradycardia.<\/li>\n\n\n\n
  2. The nurse is providing care to an older adult patient who is diagnosed
    with congestive heart failure (CHF). When educating the patient about this
    disor- der, which age-related cardiovascular change should the nurse
    include\u2714\u2714 In- creased size of the left atrium
    Rationale: Left atrial enlargement causes a fourth heart sound to be
    auscultated and is also responsible for an increased risk for
    hypertension and congestive heart failure (CHF).<\/li>\n\n\n\n
  3. The nurse is providing care to an older adult patient who is diagnosed
    with atrial fibrillation. When educating the patient about this disorder,
    which age-related cardiovascular change should the nurse include\u2714\u2714
    1 \/<\/li>\n<\/ol>\n\n\n\n


    Decreased cardiac responsiveness to beta-adrenergic stimuli
    Rationale: Decreased cardiac responsiveness to beta-adrenergic
    stimuli increases the risk for arrhythmias, atrial fibrillation, and
    reduced heart rate control when exposed to stressors.<\/p>\n\n\n\n

      \n
    1. Which electrolyte imbalance should the nurse monitor an older adult
      patient for due to impaired renal diluting capacity and concentrating
      abili- ty\u2714\u2714 Hyponatremia
      Rationale: Sodium imbalances occur due to impaired renal diluting
      capacity and concentrating ability.<\/li>\n\n\n\n
    2. Which clinical manifestation does the nurse anticipate when providing
      care to an older adult patient diagnosed with failure to thrive (FTT)\u2714\u2714
      Skin that loses elasticity with poor turgor
      Rationale: Dehydration, manifested with decreased elasticity and
      turgor of the skin, supports the diagnosis of FTT.<\/li>\n\n\n\n
    3. The nurse is providing care to a patient who is diagnosed with acute
      respiratory distress syndrome (ARDS). Which clinical manifestation does
      the
      2 \/<\/li>\n<\/ol>\n\n\n\n


      nurse anticipate for this patient who is experiencing hypoxia as a result
      of the ARDS diagnosis\u2714\u2714 Dyspnea
      Rationale: Dyspnea is a clinical manifestation that patients
      experiencing hypoxia secondary to ARDS.<\/p>\n\n\n\n

        \n
      1. The nurse is providing care to a patient with an infected leg wound. The
        patient is exhibiting symptoms of a systemic infection and is receiving
        intravenous antibiotics. The patient states to the nurse, “I am having
        trouble breathing.” Based on this data, which does the nurse suspect the
        patient is experiencing\u2714\u2714 Acute respiratory distress syndrome
        Rationale: Sepsis is the most common cause of acute respiratory
        distress syn- drome (ARDS). The patient has a systemic infection,
        which is sepsis, and is complaining that it is getting hard to breathe.
        The nurse should suspect the patient is developing acute respiratory<\/li>\n\n\n\n
      2. A patient with a respiratory rate of eight breaths per minute has an
        oxygen saturation of 82%. Which nursing diagnosis is a priority for this
        patient\u2714\u2714 Im- paired Spontaneous Ventilation
        Rationale: A priority nursing diagnosis for a patient with a respiratory
        rate of eight breaths per minutes and an oxygen saturation of 82% is
        Impaired Spontaneous Ventilation. If the current pattern continues
        without intervention, the patient could experience respiratory arrest.<\/li>\n\n\n\n
      3. A patient with acute respiratory distress syndrome (ARDS) is being
        3 \/
        <\/li>\n<\/ol>\n\n\n\n


        2023 HESI Med Surg III Final Exam<\/p>\n\n\n\n

          \n
        1. Diagnostic testing has revealed that a patient’s hepatocellular
          carcinoma (HCC) is limited to one lobe. The nurse should anticipate that
          this patient’s plan of care will focus on what intervention?
          a) Lobectomy
          b) Liver transplantation
          c) Cryosurgery
          d) Laser hyperthermia\u2714\u2714 a) Lobectomy<\/li>\n\n\n\n
        2. The nurse and physician are viewing a brain scan, which indicates
          bleed- ing at the point of impact to the skull and edema on the opposite
          side. The client is sleeping but can be aroused. The client has no memory
          of accident. The nurse provides all details to the next shift and is most
          accurate to report which type of injury?
          a) Coup injury
          1 \/ 33<\/li>\n\n\n\n
        3. <\/li>\n\n\n\n
        4. b) Contusion<\/li>\n\n\n\n
        5. c) Contrecoup injury<\/li>\n\n\n\n
        6. d) Head injury\u2714\u2714 c) Contrecoup injury<\/li>\n<\/ol>\n\n\n\n
            \n
          1. A client has undergone enucleation. What complication of
            enucleation should be addressed by the nurse?
            a) Hemorrhage
            b) Pneumonia
            c) Hypotension
            d) Nausea and vomiting\u2714\u2714 a) Hemorrhage
            2 \/ 33<\/li>\n\n\n\n
          2. <\/li>\n<\/ol>\n\n\n\n
              \n
            1. When caring for a client who is post intracranial surgery what is the
              most important parameter to monitor?
              a) Signs of infection
              b) Intake and output
              c) Nutritional status
              d) Body temperature\u2714\u2714 d) Body temperature<\/li>\n\n\n\n
            2. A client is diagnosed with keratitis. What advice should the nurse give
              this client?
              a) Use dark glasses.
              b) Frequently wash the face and hair.
              c) Use warm soaks frequently.
              d) Massage the surrounding area.\u2714\u2714 a) Use dark glasses.<\/li>\n\n\n\n
            3. A client is diagnosed with blepharitis. What symptoms should a
              nurse monitor in this client?
              a) Patchy flakes clinging to the eyelashes
              b) Redness
              c) A red pustule in the internal tissue of the eyelid
              d) A halo around the pupil\u2714\u2714 a) Patchy flakes clinging to the eyelashes<\/li>\n\n\n\n
            4. While cleaning gutters, a client reports getting debris in the eyes. On
              inspection, no obvious foreign object is noted. Which of the following
              diag- nostic evaluation techniques would be most beneficial for this
              client?
              3 \/ 33<\/li>\n<\/ol>\n\n\n\n


              a) Administer fluorescein dye.
              b) Obtain an x-ray for orbital fractures.
              c) Assess intraocular movements.
              d) Assess with tonometer.\u2714\u2714 a) Administer fluorescein dye.<\/p>\n\n\n\n

                \n
              1. The nurse is caring for a client who is scheduled for surgery to relieve
                pressure on a compressed nerve. The compression does not involve the
                spinal cord. What kind of spinal nerve root compression does the nurse
                know this is?
                a) Extramedullary
                b) Intramedullary
                c) Spinal
                d) Peripheral\u2714\u2714 a) Extramedullary
                4 \/ 33<\/li>\n<\/ol>\n\n\n\n

                Hesi Med Surg III Final Exam<\/p>\n\n\n\n

                  \n
                1. what type of stroke is when blood supply to a part of the brain is
                  suddenly interrupted\u2714\u2714 ischemic<\/li>\n\n\n\n
                2. what are ischemic strokes caused by?\u2714\u2714 thrombus or
                  embolus most commonly due to atherosclerosis<\/li>\n\n\n\n
                3. what type of ischemic stroke is caused by a blood clot that
                  obstructs arterial blood flow to an area of the brain?\u2714\u2714 thrombotic
                  stroke<\/li>\n\n\n\n
                4. how does a thrombotic stroke appear?\u2714\u2714 slowly<\/li>\n\n\n\n
                5. wha type of ischemic stroke is caused by a blood clot that travels from
                  its original site and becomes lodged in an artery that feeds the brain?\u2714\u2714
                  embolic stroke<\/li>\n\n\n\n
                6. how does an embolic stroke appear?\u2714\u2714 suddenly, causing
                  immediate neuro- logic deficits<\/li>\n\n\n\n
                7. what is a type of ischemic stroke in which brief episodes of focal neurologic deficits appear that usually resolve in a few minutes or hours, and
                  do not cause permaent damage\u2714\u2714 TIA<\/li>\n\n\n\n
                8. what might precede a stroke?\u2714\u2714 TIA<\/li>\n\n\n\n
                9. what is a warning of an impending stroke?\u2714\u2714 TIA
                  1 \/ 11<\/li>\n<\/ol>\n\n\n\n

                  <\/p>\n\n\n\n

                    \n
                  1. how does a TIA appear?\u2714\u2714 brief
                    usually resolve in a few minutes or
                    hours does not cause permanent
                    damage<\/li>\n\n\n\n
                  2. what type of stroke is when bleeding into the brain tissue or cranial
                    vault appear?\u2714\u2714 hemorrhagic<\/li>\n\n\n\n
                  3. how does a hemorrhagic stroke appear?\u2714\u2714
                    suddenly, varies based on location<\/li>\n\n\n\n
                  4. who is a hemorrhagic stroke more common in?\u2714\u2714 older adult with
                    HTN<\/li>\n\n\n\n
                  5. what are the three types of ischemic strokes?\u2714\u2714
                    thrombotic embolic
                    TIA<\/li>\n\n\n\n
                  6. what are the two types of hemorrhagic strokes?\u2714\u2714 intracerebral
                    hemorrhage subarachnoid hemorrhage<\/li>\n\n\n\n
                  7. what type ofhemorrhagic stroke is due to trauma or rupture of
                    an aneurysm and is an EMERGENCY!!\u2714\u2714 subarachnoid
                    hemorrhage<\/li>\n\n\n\n
                  8. what is weakening and dilation of the vessel wall?\u2714\u2714 aneurysm<\/li>\n<\/ol>\n\n\n\n

                    1 \/ 7
                    HESI Med Surg III REVIEW Questions and Answers
                    2023 (Verified Answers)<\/p>\n\n\n\n

                      \n
                    1. increasing temperature has what effect on the body’s metabolism?
                      what can fever cause?: increasing temp increases the body’s demand for nutrientsand oxygen\u2026
                      fever can cause dehydration r\/t excessive fluid loss d\/t diaphoresis<\/li>\n\n\n\n
                    2. why is hydration important w\/ PNA?: thins out mucus trapped in bronchioles\/alveoli–facilitates expectoration
                      replacement of fluid lost by lungs through evaporation<\/li>\n\n\n\n
                    3. early s\/s of cerebral hypoxia?: irritability and restlessness<\/li>\n\n\n\n
                    4. preventing PNA: flu shot\/pneumovax vaccine
                      avoid sick people, indoor pollutants, no smoking
                      adequate nutrition\/fluids
                      if comatose–elevate HOB when before and after feeding, turn pt frequently<\/li>\n<\/ol>\n\n\n\n

                      2 \/ 7<\/p>\n\n\n\n

                        \n
                      1. As COPD worsens, what happens to a patient’s O2\/CO2 levels in their bloodand what is the condition that results?
                        is this more of a problem for emphysema or chronic bronchitis?: as COPD
                        worsens, hypoxemia and hypercapnia result–leading to respiratory acidosis
                        emphysema leads more toward hypercapnia bc the alveoli are effected<\/li>\n\n\n\n
                      2. what bed position facilitates productive cough?: semi-fowler or high-fowler<\/li>\n\n\n\n
                      3. Emphysema vs. Chronic Bronchitis: CB: airway problem (chronically inflamed)—chronic sputum production, increased bronchial wall thickness–obstruction of airflow, chronic hypoxemia, cor pulmonale (s\/s RSHF)
                        —>blue bloater, cyanosis, RSHF—JVD, crackles\/expiratory wheezes
                        Emphysema–alveoli problem–air trapping, compensatory hyperventilation–barrel
                        chest
                        –>pink puffer–pursed lip breathers, diminished breath sounds<\/li>\n\n\n\n
                      4. tx for COPD: mucolytics
                        bronchodilators (SABA\/LABA–theophylline, albuterol, ipratropium)
                        anti-inflammatory drugs (fluticasone)
                        tripod position, pursed-lip breathing, diaphragmatic breathing
                        low FIO2 to prevent CO2 retention
                        monitor for s\/s of fluid overload
                        <\/li>\n\n\n\n
                      5. <\/li>\n\n\n\n
                      6. HESI Med Surg III Review<\/li>\n<\/ol>\n\n\n\n
                          \n
                        1. increasing temperature has what effect on the body’s metabolism?
                          what can fever cause\u2714\u2714 increasing temp increases the body’s demand
                          for nutri- ents and oxygen\u2026
                          fever can cause dehydration r\/t excessive fluid loss d\/t diaphoresis
                          2.why is hydration important w\/ PNA\u2714\u2714 thins out mucus trapped in
                          bronchi- oles\/alveoli–facilitates expectoration
                          replacement of fluid lost by lungs through evaporation
                          3.early s\/s of cerebral hypoxia\u2714\u2714 irritability and restlessness
                          4.preventing PNA: flu shot\/pneumovax
                          vaccine avoid sick people, indoor
                          pollutants, no smoking adequate
                          nutrition\/fluids
                          if comatose–elevate HOB when before and after feeding, turn pt
                          frequently
                          1 \/<\/li>\n\n\n\n
                        2. <\/li>\n<\/ol>\n\n\n\n
                            \n
                          1. As COPD worsens, what happens to a patient’s O2\/CO2 levels in
                            their blood and what is the condition that results?
                            is this more of a problem for emphysema or chronic bronchitis\u2714\u2714 as
                            COPD worsens, hypoxemia and hypercapnia result–leading to
                            respiratory acidosis
                            emphysema leads more toward hypercapnia bc the alveoli are effected
                            6.what bed position facilitates productive cough\u2714\u2714 semi-fowler or highfowler
                            7.Emphysema vs. Chronic Bronchitis: CB: airway problem (chronically
                            in- flamed)—chronic sputum production, increased bronchial wall
                            thickness–obstruc- tion of airflow, chronic hypoxemia, cor pulmonale
                            (s\/s RSHF)
                            —>blue bloater, cyanosis, RSHF—JVD, crackles\/expiratory wheezes
                            Emphysema–alveoli problem–air trapping, compensatory
                            hyperventilation–barrel chest
                            –>pink puffer–pursed lip breathers, diminished breath sounds
                            8.tx for COPD: mucolytics
                            bronchodilators (SABA\/LABA–theophylline, albuterol,
                            ipratropium) anti-inflammatory drugs (fluticasone)
                            2 \/<\/li>\n<\/ol>\n\n\n\n

                            Stuvia.com Stuvia.com — The Marketplace to Buy and Sell your Study The Marketplace to Buy and Sell your Study Material Material
                            tripod position, pursed-lip breathing, diaphragmatic breathing
                            low FIO2 to prevent CO2
                            retention monitor for s\/s of
                            fluid overload
                            3 \/
                            <\/p>\n\n\n\n

                            1 \/ 15
                            HESI Med Surg III Exam Questions and Answers 2023
                            (Verified Answers)<\/p>\n\n\n\n

                              \n
                            1. List four common symptoms of pneumonia the nurse might note on physical examination: – Tachypnea, shallow respirations with use of accessory muscles- abrupt onset of fever with shaking and chills (not reliable in older adults)<\/li>\n<\/ol>\n\n\n\n
                                \n
                              • productive cough with pleuritic pain<\/li>\n\n\n\n
                              • rapid, bounding pulse<\/li>\n<\/ul>\n\n\n\n
                                  \n
                                1. State four nursing interventions for assisting the client to cough productively: – deep breathing q2 hours (may use incentive spirometer)<\/li>\n<\/ol>\n\n\n\n
                                    \n
                                  • use humidity to loosen secretions (may be used with O2)<\/li>\n\n\n\n
                                  • suctioning the airway if necessary, also helps with coughing<\/li>\n\n\n\n
                                  • chest physiotherapy
                                    -increase fluids to 3L\/day<\/li>\n<\/ul>\n\n\n\n
                                      \n
                                    1. What symptoms of pneumonia might the nurse expect to see in an older
                                      client?: – confusion<\/li>\n<\/ol>\n\n\n\n
                                        \n
                                      • lethargy\/malaise<\/li>\n\n\n\n
                                      • anorexia<\/li>\n\n\n\n
                                      • rapid respiratory rate<\/li>\n\n\n\n
                                      • tachycardia<\/li>\n<\/ul>\n\n\n\n

                                        2 \/ 15<\/p>\n\n\n\n

                                          \n
                                        1. How does the nurse prevent hypoxia when suctioning?: oxygenate with 100%O2 for 1-2 minutes before and after suctioning<\/li>\n\n\n\n
                                        2. During mechanical ventilation, what are three major nursing interventions?-: – verify that the alarms are on<\/li>\n<\/ol>\n\n\n\n
                                            \n
                                          • maintain settings, and check often to ensure that they are specifically set as
                                            prescribed by the HCP<\/li>\n\n\n\n
                                          • verify functioning of ventilator at least q4 hours
                                            -keep airway clear by coughing and suctioning<\/li>\n<\/ul>\n\n\n\n
                                              \n
                                            1. When examining a client with emphysema, what physical findings is the
                                              nurse most likely to see?: – bronchospasm and dyspnea<\/li>\n<\/ol>\n\n\n\n
                                                \n
                                              • change in breathing pattern<\/li>\n\n\n\n
                                              • over inflation of lungs\u2026 barrel chest<\/li>\n\n\n\n
                                              • generalized cyanosis<\/li>\n\n\n\n
                                              • either dry or productive cough<\/li>\n\n\n\n
                                              • higher CO2 than average<\/li>\n\n\n\n
                                              • low O2, usually between 90-92%<\/li>\n\n\n\n
                                              • decreased breath sounds<\/li>\n\n\n\n
                                              • coarse crackles in lungs that tend to disappear after coughing<\/li>\n\n\n\n
                                              • orthopnea<\/li>\n\n\n\n
                                              • poor nutrition, weight loss<\/li>\n\n\n\n
                                              • activity intolerance
                                                -anxiety from not being able to breath<\/li>\n<\/ul>\n\n\n\n

                                                3 \/ 15<\/p>\n\n\n\n

                                                  \n
                                                1. What is the most common risk factor associated with lung cancer?: cigarettesmoking\/marijuana<\/li>\n\n\n\n
                                                2. describe why preop care is important for a pt going for a laryngectomy: –
                                                  involve family and client in manipulation of trach equipment before surgery<\/li>\n<\/ol>\n\n\n\n
                                                    \n
                                                  • plan acceptable communication methods<\/li>\n\n\n\n
                                                  • refer to speech pathologist<\/li>\n\n\n\n
                                                  • discuss rehab program<\/li>\n<\/ul>\n\n\n\n
                                                      \n
                                                    1. List 5 nursing interventions after chest tube insertion.: – keep all tubing
                                                      loosely coiled below chest level, ensure connections are tight and taped<\/li>\n<\/ol>\n\n\n\n
                                                        \n
                                                      • keep water seal and suction control at appropriate levels<\/li>\n\n\n\n
                                                      • monitor fluid drainage and mark times of measurement and the fluid level<\/li>\n\n\n\n
                                                      • observe for bubbling in water seal chamber<\/li>\n\n\n\n
                                                      • monitor clients clinical status<\/li>\n\n\n\n
                                                      • check position of chest drainage system<\/li>\n\n\n\n
                                                      • encourage client to deep breath periodically<\/li>\n\n\n\n
                                                      • do not empty collection chamber container of chest tube, replace whole unit whenfull<\/li>\n\n\n\n
                                                      • do not strip or milk chest tubes<\/li>\n\n\n\n
                                                      • chest tubes are not clamped, if drainage system breaks, place distal end of tube
                                                        in sterile water as an emergency water seal<\/li>\n\n\n\n
                                                      • maintain dry occlusive dressing
                                                        <\/li>\n<\/ul>\n\n\n\n

                                                        1 \/ 21
                                                        HESI Med Surg III Study Guide Questions and Answers
                                                        2023 (Verified Answers)<\/p>\n\n\n\n

                                                          \n
                                                        1. How much of our body weight consists of fluid?: 60%<\/li>\n\n\n\n
                                                        2. What affects Body fluids?: age, percent of body fat, gender<\/li>\n\n\n\n
                                                        3. Intracellular fluid: in the cell<\/li>\n\n\n\n
                                                        4. Extracellular Fluid: out of the cell<\/li>\n\n\n\n
                                                        5. What is Extracellular fluid made up of?: Intravascular
                                                          Interstitial
                                                          Transcellula<\/li>\n<\/ol>\n\n\n\n

                                                          2 \/ 21<\/p>\n\n\n\n

                                                            \n
                                                          1. What are the active chemicals used in electrolyte basics?: Cations (+) and
                                                            Anions (-)<\/li>\n\n\n\n
                                                          2. What are major Cations?: potassium
                                                            sodium
                                                            calcium
                                                            magnesium
                                                            hydrogen<\/li>\n\n\n\n
                                                          3. What are major Anions?: phosphate
                                                            chloride
                                                            Bicarbonate<\/li>\n\n\n\n
                                                          4. When someone gets a lab test drawn to see their electrolyte status what isit usually drawn on?
                                                            a-ICF
                                                            b- creatinine
                                                            c- BUN
                                                            d- ECF: d- ECF<\/li>\n<\/ol>\n\n\n\n

                                                            3 \/ 21<\/p>\n\n\n\n

                                                              \n
                                                            1. How do Solutes Move?: diffusion and active transport<\/li>\n\n\n\n
                                                            2. what is diffusion?: solutes move from higher to lower concentration<\/li>\n\n\n\n
                                                            3. what is active transport?: solutes move from low to high concentrations with
                                                              assistance from something like the sodium-potassium pump
                                                              (this requires energy)<\/li>\n\n\n\n
                                                            4. How does fluid move?: Osmosis
                                                              Capillary filtration<\/li>\n\n\n\n
                                                            5. How does Osmosis work?: movement of fluid from a lower solute concentration to an area of high solute concentration<\/li>\n\n\n\n
                                                            6. How does Capillary Filtration work?: site of exchange is at capillaries<\/li>\n\n\n\n
                                                            7. what is third spacing?: volume in capillary space goes into tissue<\/li>\n\n\n\n
                                                            8. When would Capillary Filtration occur?: people with HTN, urinary retention,
                                                              liver failure, edema<\/li>\n\n\n\n
                                                            9. Osmolarity: concentration of particle\/solutes per LITER of solution<\/li>\n\n\n\n
                                                            10. Osmolality: concentration of particles\/solutes per KILOGRAM<\/li>\n\n\n\n
                                                            11. Tonicity: osmolality of a solution in relation to normal plasma<\/li>\n<\/ol>\n\n\n\n

                                                              4 \/ 21<\/p>\n\n\n\n

                                                                \n
                                                              1. How is Fluid Balance Regulated?: Kidneys
                                                                Thirst Mechanism
                                                                Anti-Diuretic Hormone
                                                                Renin- Angiotensin Aldosterone System
                                                                Natriuritc Peptide<\/li>\n\n\n\n
                                                              2. How do Kidneys help with regulation?: filters 170 liters of plasma a day
                                                                excrete 1.5 liters of urine a day
                                                                regulates ECF
                                                                regulates electrolyte and acid-base balances
                                                                excretes toxic waste products<\/li>\n\n\n\n
                                                              3. How does the Thirst Mechanism work?: this is a sign of dehydration<\/li>\n\n\n\n
                                                              4. Purpose of ADH: stops diuresis and urination
                                                                causes kidneys to retain volume and water
                                                                urinary output decreased
                                                                reduce serum osmolality<\/em>
                                                                more volume less solute<\/em><\/li>\n\n\n\n
                                                              5. Renin Angiotensin Aldosterone System: -helps to urinate
                                                                -renin is released when there is a decrease renal perfusion
                                                                -activated angiotensin 1 which is a vasoconstrictor
                                                                <\/li>\n<\/ol>\n\n\n\n

                                                                Stuvia.com – The Marketplace to Buy and Sell your Study Material
                                                                2023 HESI Med Surg III Final Exam<\/p>\n\n\n\n

                                                                  \n
                                                                1. what is the amount of blood pumped by the heart each minute\u2714\u2714 CO<\/li>\n\n\n\n
                                                                2. all hemodynamic measurements are affected by what?\u2714\u2714 CO<\/li>\n\n\n\n
                                                                3. what is normal cardiac output?\u2714\u2714 4-8 L<\/li>\n\n\n\n
                                                                4. what is a more accurate measurement of CO by taking BSA into
                                                                  account?-
                                                                  \u2714\u2714 cardiac index<\/li>\n\n\n\n
                                                                5. what is normal cardiac index?\u2714\u2714 2.4-4<\/li>\n\n\n\n
                                                                6. what compensates for changes in CP by speeding up or slowing
                                                                  down\u2714\u2714 –
                                                                  heart rate<\/li>\n\n\n\n
                                                                7. what is the amount of blood ejected by each heartbeat?\u2714\u2714 stroke
                                                                  volume<\/li>\n\n\n\n
                                                                8. what is the presure exerted on the ventricular walls by the volume of
                                                                  blood filling the ventricle at the end of diastole?\u2714\u2714 preload
                                                                  1 \/ 11<\/li>\n<\/ol>\n\n\n\n

                                                                  <\/p>\n\n\n\n

                                                                    \n
                                                                  1. if the preload is high, what do we see?\u2714\u2714 too much blood volume, fluid
                                                                    overload HF
                                                                    renal failure<\/li>\n\n\n\n
                                                                  2. if preload is low, what do we see?\u2714\u2714
                                                                    dehydration from diuretic<\/li>\n\n\n\n
                                                                  3. what is the resistance to ventricular contraction to pump the blod out?- \u2714\u2714 afterload<\/li>\n\n\n\n
                                                                  4. what is the pressure that the heart must overcome such as in MAP?\u2714\u2714
                                                                    af- terload<\/li>\n\n\n\n
                                                                  5. if we have a high afterload, what do we see?\u2714\u2714 aortic
                                                                    stenosis vasoconstriction<\/li>\n\n\n\n
                                                                  6. what is property of myocardial muscle fivers that allows them to
                                                                    short- en\u2714\u2714 contractility<\/li>\n\n\n\n
                                                                  7. how do we measure CO?\u2714\u2714 HR x Stroke volume<\/li>\n\n\n\n
                                                                  8. what are minimally invasive lines for cardiac?\u2714\u2714 central venous
                                                                    access arterial access<\/li>\n\n\n\n
                                                                  9. what are invasive lines for cardiac?\u2714\u2714 pulmonary artery catheter
                                                                    (swan ganz)
                                                                    2 \/ 11<\/li>\n<\/ol>\n\n\n\n

                                                                    <\/p>\n\n\n\n

                                                                      \n
                                                                    1. where is the central line normally placed?\u2714\u2714 subclavian
                                                                      vein jugular vein<\/li>\n\n\n\n
                                                                    2. why is central line good?\u2714\u2714 good way to give
                                                                      meds give fluids
                                                                      3 \/ 11
                                                                      <\/li>\n<\/ol>\n\n\n\n


                                                                      Hesi Med Surg III Final Exam 2023 Study Exam<\/p>\n\n\n\n

                                                                        \n
                                                                      1. A 79 year old patient has been admitted with BPH. What is most
                                                                        appropri- ate to include in the nursing plan of care
                                                                        a. Limit fluid intake to no more than 1000 ml\/day
                                                                        b. Leave a light on in the bathroom during the night
                                                                        c. Ask the patient to use a urinal so that urine can be measured
                                                                        d. Pad the patients bed to accommodate overflow incontinence\u2714\u2714 B
                                                                        The patient’s age and diagnosis indicate a likelihood of nocturia, so
                                                                        leaving the light on in the bathroom is appropriate. Fluids should be
                                                                        encouraged because dehydration is more common in older patients.
                                                                        The information in the question does not indicate that measurement of
                                                                        the patient’s output is necessary or that the patient has overflow
                                                                        incontinence.<\/li>\n\n\n\n
                                                                      2. A female patient with a suspected UTI is to provide a clean catch
                                                                        urine specimen for culture and sensitivity testing. To obtain the
                                                                        specimen, the nurse will
                                                                        a. Have the patient empty the bladder completely, then obtain the next
                                                                        urine specimen that the patient is able to void
                                                                        b.Teach the patient to clean the urethral area, void a small amount into
                                                                        the toilet, and then void into a sterile specimen cup
                                                                        1 \/ 59<\/li>\n<\/ol>\n\n\n\n

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                                                                        c. Insert a short sterile mini catheter attached to a collecting container into
                                                                        the urethra and bladder to obtain the specimen
                                                                        d. Clean the area around the meatus with a povidine-iodine (betadine)
                                                                        swab and then have the patient void into a sterile container\u2714\u2714 B
                                                                        This answer describes the technique for obtaining a clean-catch
                                                                        specimen. The answer beginning, “insert a short, small, ‘mini’ catheter
                                                                        attached to a collecting container” describes a technique that would
                                                                        result in a sterile specimen, but a health care provider’s order for a
                                                                        catheterized specimen would be required. Using Betadine before
                                                                        obtaining the specimen is not necessary, and might result in
                                                                        suppressing the growth of some bacteria. The technique described in
                                                                        the answer beginning “have the patient empty the bladder
                                                                        completely” would not result in a sterile specimen.<\/p>\n\n\n\n

                                                                          \n
                                                                        1. Which statement made by a patient who had a cystoscopy the
                                                                          previous day should be reported immediately to the HCP?
                                                                          a. My urine looks pink
                                                                          b. My IV site is bruised
                                                                          c. My sleep was restless
                                                                          d. My temperature is 101\u2714\u2714 D
                                                                          The patient’s elevated temperature may indicate a bladder
                                                                          infection, a possible complication of cystoscopy. The health care
                                                                          provider should be notified so that
                                                                          2 \/ 59<\/li>\n<\/ol>\n\n\n\n

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                                                                          antibiotic therapy can be started. Pink-tinged urine is expected after a
                                                                          cystoscopy. The insomnia and bruising should be discussed further
                                                                          with the patient but do not indicate a need to notify the health care
                                                                          provider.<\/p>\n\n\n\n

                                                                            \n
                                                                          1. To determine possible causes, the nurse will ask a patient admitted
                                                                            with acute glomerulonephritis about
                                                                            a. Recent bladder infection
                                                                            b. History of kidney stones
                                                                            c. Recent sore throat and fever
                                                                            d. History of high blood pres\u2714\u2714 B
                                                                            Acute glomerulonephritis frequently occurs after a streptococcal
                                                                            infection such as strep throat. It is not caused by kidney stones,
                                                                            hypertension, or urinary tract infection (UTI).<\/li>\n\n\n\n
                                                                          2. The nurse will anticipate teaching a patient with nephrotic syndrome
                                                                            who develops flank pain about treatment with
                                                                            a. Antibiotics
                                                                            b. Antifungals
                                                                            c. Anticoagulants
                                                                            d. Antihypertensive\u2714\u2714 C
                                                                            Flank pain in a patient with nephrotic syndrome suggests a renal vein
                                                                            thrombosis, and anticoagulation is needed. Antibiotics are used to
                                                                            treat a patient with flank pain caused by pyelonephritis. Fungal
                                                                            pyelonephritis is uncommon and is treated with antifungals.
                                                                            Antihypertensives are used if the patient has high blood pressure
                                                                            3 \/ 59<\/li>\n<\/ol>\n\n\n\n

                                                                            Stuvia.com – The Marketplace to Buy and Sell your Study Material
                                                                            Stuvia.com – The Marketplace to Buy and Sell your Study Material
                                                                            Stuvia.com – The Marketplace to Buy and Sell your Study Material<\/p>\n\n\n\n

                                                                              \n
                                                                            1. The nurse will plan to teach a 27 year old woman who smokes two
                                                                              packs a day about the risk for
                                                                              a. Kidney stones
                                                                              b. Bladder cancer
                                                                              c. Bladder infection
                                                                              d. Interstitial cystitis\u2714\u2714 B
                                                                              Cigarette smoking is a risk factor for bladder cancer. The patient’s
                                                                              risk for devel- oping interstitial cystitis, urinary tract infection (UTI),
                                                                              or kidney stones will not be reduced by quitting smoking.<\/li>\n\n\n\n
                                                                            2. Following rectal surgery, a patient voids about 50 mL of urine every 30-
                                                                              60 minutes for the first 4 hours. Which nursing intervention is most
                                                                              appropriate?
                                                                              a. Monitor the patients intake and output overnight
                                                                              b. Have the patient drink small amounts of fluid frequently
                                                                              c. Use an ultrasound scanner to check the postvoid residual volume
                                                                              d. Reassure the patient that this is normal after anesthesia for rectal surgery\u2714\u2714 C
                                                                              4 \/ 59
                                                                              <\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

                                                                              2023 HESI Med Surg III Final Exam Decreased cardiac responsiveness to beta-adrenergic stimuliRationale: Decreased cardiac responsiveness to beta-adrenergicstimuli increases the risk for arrhythmias, atrial fibrillation, andreduced heart rate control when exposed to stressors. nurse anticipate for this patient who is experiencing hypoxia as a resultof the ARDS diagnosis\u2714\u2714 DyspneaRationale: Dyspnea is a clinical manifestation that […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[25],"tags":[],"class_list":["post-113759","post","type-post","status-publish","format-standard","hentry","category-exams-certification"],"_links":{"self":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/113759","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/comments?post=113759"}],"version-history":[{"count":0,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/113759\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/media?parent=113759"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/categories?post=113759"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/tags?post=113759"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}