{"id":125475,"date":"2023-11-22T08:04:08","date_gmt":"2023-11-22T08:04:08","guid":{"rendered":"https:\/\/learnexams.com\/blog\/?p=125475"},"modified":"2023-11-22T08:04:09","modified_gmt":"2023-11-22T08:04:09","slug":"bsn-266-hesi-med-surg-practice-exam-version-1-2023-2024-update-questions-and-verified-answers-with-rationales100-correct-grade-a-nightingale","status":"publish","type":"post","link":"https:\/\/www.learnexams.com\/blog\/2023\/11\/22\/bsn-266-hesi-med-surg-practice-exam-version-1-2023-2024-update-questions-and-verified-answers-with-rationales100-correct-grade-a-nightingale\/","title":{"rendered":"BSN 266 HESI Med Surg Practice Exam Version 1 (2023\/ 2024 Update) Questions and Verified Answers with Rationales|100% Correct| Grade A- Nightingale"},"content":{"rendered":"\n

BSN 266 HESI Med Surg Practice Exam Version 1 (2023\/ 2024 Update) Questions and Verified Answers with Rationales|100% Correct| Grade A- Nightingale<\/p>\n\n\n\n

BSN 266 HESI Med Surg Practice Exam
(2023\/ 2024 Update) Questions and Verified
Answers with Rationales|100% Correct|
Grade A- Nightingale
Q: The client admitted with peripheral vascular disease (PVD) asks the nurse why
her legs hurt when she walks. The nurse bases a response on the knowledge that the
main characteristic of PVD is:<\/p>\n\n\n\n

    \n
  1. Decreased blood flow.<\/li>\n\n\n\n
  2. Increased blood flow.<\/li>\n\n\n\n
  3. Slow blood flow.<\/li>\n\n\n\n
  4. Thrombus formation.
    Answer:
    1
    Decreased blood flow is a common characteristic of all PVD. When the
    demand for oxygen to the working muscles becomes greater than the supply, pain is the
    outcome. Slow blood flow throughout the circulatory system may suggest pump failure.
    Thrombus formation can result from stasis or damage to the intima of the vessels.
    Q: The nurse is planning care for a client who is diagnosed with peripheral vascular
    disease (PVD) and has a history of heart failure. The nurse should develop a plan of
    care that is based on the fact that the client may have a low tolerance for exercise
    related to:<\/li>\n\n\n\n
  5. Decreased blood flow.<\/li>\n\n\n\n
  6. Increased blood flow.<\/li>\n\n\n\n
  7. Decreased pain.<\/li>\n\n\n\n
  8. Increased blood viscosity.
    Answer:
    1
    A client with PVD and heart failure will experience decreased blood flow. In
    this situation, low exercise tolerance (oxygen demand becomes greater than the oxygen
    supply) may be related to less blood being ejected from the left ventricle into the<\/li>\n<\/ol>\n\n\n\n

    systemic circulation. Decreased blood supply to the tissues results in pain. Increased
    blood viscosity may be a component, but it is of much less importance than the disease
    processes.
    Q: When assessing the lower extremities of a client with peripheral vascular
    disease (PVD), the nurse notes bilateral ankle edema. The edema is related to:<\/p>\n\n\n\n

      \n
    1. Competent venous valves.<\/li>\n\n\n\n
    2. Decreased blood volume.<\/li>\n\n\n\n
    3. Increase in muscular activity.<\/li>\n\n\n\n
    4. Increased venous pressure.
      Answer:
      4
      In PVD, decreased blood flow can result in increased venous pressure. The
      increase in venous pressure results in an increase in capillary hydrostatic pressure,
      which causes a net filtration of fluid out of the capillaries into the interstitial space,
      resulting in edema. Valves often become incompetent with PVD. Blood volume is not
      decreased in this condition. Decreased muscular action would contribute to the
      formation of edema in the lower extremities.
      Q: The nurse is obtaining the pulse of a client who has had a femoral-popliteal
      bypass surgery 6 hours ago. (See below) Which assessment provides the most accurate
      information about the client’s postoperative status?<\/li>\n\n\n\n
    5. radial pulse<\/li>\n\n\n\n
    6. femoral pulse<\/li>\n\n\n\n
    7. apical pulse<\/li>\n\n\n\n
    8. dorsalis pedis pulse
      Answer:
      4
      The presence of a strong dorsalis pedis pulse indicates that there is circulation to
      the extremity distal to the surgery indicating that the graft between the femoral and
      popliteal artery is allowing blood to circulate effectively. Answer 1 shows the nurse
      obtaining the radial pulse; answer 2 shows the femoral pulse, which is proximal to the
      surgery site and will not indicate circulation distal to the surgery site. Answer 3 shows
      the nurse obtaining an apical pulse.<\/li>\n<\/ol>\n\n\n\n

      Q: The nurse is teaching a client about risk factors associated with atherosclerosis
      and how to reduce the risk. Which of the following is a risk factor that the client is not
      able to modify?<\/p>\n\n\n\n

        \n
      1. Diabetes.<\/li>\n\n\n\n
      2. Age.<\/li>\n\n\n\n
      3. Exercise level.<\/li>\n\n\n\n
      4. Dietary preferences
        Answer:
        2
        Age is a nonmodifiable risk factor for atherosclerosis. The nurse instructs the
        client to manage modifiable risk factors such as comorbid diseases (eg, diabetes),
        activity level, and diet. Controlling serum blood glucose levels, engaging in regular
        aerobic activity, and choosing a diet low in saturated fats can reduce the risk of
        developing atherosclerosis.
        Q: The nurse is assessing the lower extremities of the client with peripheral
        vascular disease (PVD). During the assessment, the nurse should expect to find which of
        the following clinical manifestations of PVD? Select all that apply.<\/li>\n\n\n\n
      5. Hairy legs.<\/li>\n\n\n\n
      6. Mottled skin.<\/li>\n\n\n\n
      7. Pink skin.<\/li>\n\n\n\n
      8. Coolness.<\/li>\n\n\n\n
      9. Moist skin.
        Answer:
        2,4
        Reduction of blood flow to a specific area results in decreased oxygen and
        nutrients. As a result, the skin may appear mottled. The skin will also be cool to the
        touch. Loss of hair and dry skin are other signs that the nurse may observe in a client
        with PVD of the lower extremities.
        Q: The nurse is unable to palpate the client’s left pedal pulses. Which of the
        following actions should the nurse take next?<\/li>\n\n\n\n
      10. Auscultate the pulses with a stethoscope.<\/li>\n\n\n\n
      11. Call the physician.<\/li>\n\n\n\n
      12. Use a Doppler ultrasound device.<\/li>\n\n\n\n
      13. Inspect the lower left extremity<\/li>\n<\/ol>\n\n\n\n

        Answer:
        3
        When pedal pulses are not palpable, the nurse should obtain a Doppler
        ultrasound device. Auscultation is not likely to be helpful if the pulse isn’t palpable.
        Inspection of the lower extremity can be done simultaneously when palpating, but the
        nurse should first try to locate a pulse by Doppler. Calling the physician may be
        necessary if there is a change in the client’s condition.
        Q: Which of the following lipid abnormalities is a risk factor for the development
        of atherosclerosis and peripheral vascular disease?<\/p>\n\n\n\n

          \n
        1. Low concentration of triglycerides.<\/li>\n\n\n\n
        2. High levels of high-density lipid (HDL) cholesterol.<\/li>\n\n\n\n
        3. High levels of low-density lipid (LDL) cholesterol.<\/li>\n\n\n\n
        4. Low levels of LDL cholesterol.
          Answer:
          3
          An increased LDL cholesterol concentration has been documented as a risk
          factor for the development of atherosclerosis. LDL cholesterol is not broken down in
          the liver but is deposited into the intima of the blood vessels. Low triglyceride levels
          are desirable. High HDL and low LDL levels are beneficial and are known to be
          protective for the cardiovascular system.
          Q: When assessing an individual with peripheral vascular disease, which clinical
          manifestation would indicate complete arterial obstruction in the lower left leg?<\/li>\n\n\n\n
        5. Aching pain in the left calf.<\/li>\n\n\n\n
        6. Burning pain in the left calf.<\/li>\n\n\n\n
        7. Numbness and tingling in the left leg.<\/li>\n\n\n\n
        8. Coldness of the left foot and ankle
          Answer:
          4
          Coldness in the left foot and ankle is consistent with complete arterial
          obstruction. Other expected findings would include paralysis and pallor. Aching pain, a
          burning sensation, or numbness and tingling are earlier signs of tissue hypoxia and
          ischemia and are commonly associated with incomplete obstruction.
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