HESI MED SURG A & B EXAM PRACTICE – LATEST 2022
MED SURG A
Which procedures are done for curative purposes (select all that apply)?
a. Gastroscopy
b. Rhinoplasty
c. Tracheotomy
d. Hysterectomy
e. Herniorrhaphy
ANS
- d, e. Gastroscopy is for the purpose of diagnosis.
Rhinoplasty i...
hesi med surg a amp b exam practice – latest 2022 med surg a
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HESI MED SURG A & B EXAM PRACTICE –
LATEST 2022
MED SURG A
Which procedures are done for curative purposes (select all that apply)?
a. Gastroscopy
b. Rhinoplasty
c. Tracheotomy
d. Hysterectomy
e. Herniorrhaphy
ANS
- d, e. Gastroscopy is for the purpose of diagnosis.
Rhinoplasty is done for a cosmetic improvement. A
tracheotomy is palliative
A patient is scheduled for a hemorrhoidectomy at an ambulatory day-surgery center. An
advantage of performing
surgery at an ambulatory center is a decreased need for
a. laboratory tests and perioperative medications.
b. preoperative and postoperative teaching by the nurse.
c. psychologic support to alleviate fears of pain and discomfort.
d. preoperative nursing assessment related to possible risks and complications.
ANS
- a. Ambulatory surgery is usually less expensive and more
convenient, generally involving fewer laboratory tests,
fewer preoperative and postoperative medications, less
psychologic stress, and less susceptibility to hospitalacquired
infections. However, the nurse is still responsible
for assessing, supporting, and teaching the patient who
is undergoing surgery, regardless of where the surgery is
performed.
A patient who is being admitted to the surgical unit for a hysterectomy paces the floor,
repeatedly saying, "I just
want this over." What should the nurse do to promote a positive surgical outcome for the
patient?
a. Ask the patient what her specific concerns are about the surgery.
b. Reassure the patient that the surgery will be over soon and she will be fine.
c. Redirect the patient's attention to the necessary preoperative preparations.
d. Tell the patient she should not be so anxious because she is having a common, safe
surgery.
ANS
- a. Excessive anxiety and stress can affect surgical recovery
and the nurse's role in psychologically preparing the patient
for surgery is to assess for potential stressors that could
negatively affect surgery. Specific fears should be identified
and addressed by the nurse by listening and by explaining
,planned postoperative care. Falsely reassuring the patient,
ignoring her behavior, and telling her not to be anxious are
not therapeutic.
Many herbal products that are commonly taken cause surgical problems. Which herbs listed
below should the
nurse teach the patient to avoid before surgery to prevent an increase in bleeding for the
surgical patient (select
all that apply)?
a. Garlic
b. Fish oil
c. Valerian
d. Vitamin E
e. Astragalus
f. Ginkgo biloba
ANS
- a, b, d, f. Valerian may cause excess sedation. Astragalus
may increase blood pressure before and during surgery.
Priority Decision: When the nurse asks a preoperative patient about allergies, the patient
reports a history of seasonal
environmental allergies and allergies to a variety of fruits. What should the nurse do next?
a. Note this information in the patient's record as hay fever and food allergies.
b. Place an allergy alert wristband that identifies the specific allergies on the patient.
c. Ask the patient to describe the nature and severity of any allergic responses experienced
from these agents.
d. Notify the anesthesia care provider (ACP) because the patient may have an increased risk
for allergies to
anesthetics.
ANS
- c. Risk factors for latex allergies include a history of
hay fever and allergies to foods such as avocados, kiwi,
bananas, potatoes, peaches, and apricots. When a patient
identifies such allergies, the patient should be further
questioned about exposure to latex and specific reactions
to allergens. A history of any allergic responsiveness
increases the risk for hypersensitivity reactions to drugs
used during anesthesia but the hay fever and fruit allergies
are specifically related to latex allergy. After identifying
the allergic reaction, the anesthesia care provider (ACP)
should be notified, the allergy alert wristband should be
applied, and the note in the record will include the allergies
and reactions as well as the nursing actions related to the
allergies.
During a preoperative review of systems, the patient reveals a history of renal disease. This
finding suggests the need
for which preoperative diagnostic tests?
a. ECG and chest x-ray
b. Serum glucose and CBC
, c. ABGs and coagulation tests
d. BUN, serum creatinine, and electrolytes
ANS
- d. BUN, serum creatinine, and electrolytes are used to
assess renal function and should be evaluated before
surgery. Other tests are often evaluated in the presence
of diabetes, bleeding tendencies, and respiratory or heart
disease.
During a preoperative physical examination, the nurse is alerted to the possibility of
compromised respiratory
function during or after surgery in a patient with which problem?
a. Obesity
b. Dehydration
c. Enlarged liver
d. Decreased peripheral pulses
ANS
- a. Obesity, as well as spinal, chest, and airway deformities,
may compromise respiratory function during and after
surgery. Dehydration may require preoperative fluid therapy
and an enlarged liver may indicate hepatic dysfunction that
will increase perioperative risk related to glucose control,
coagulation, and drug interactions. Weak peripheral pulses
may reflect circulatory problems that could affect healing.
What type of procedural information should be given to a patient in preparation for
ambulatory surgery (select all
that apply)?
a. How pain will be controlled
b. Any fluid and food restrictions
c. Characteristics of monitoring equipment
d. What odors and sensations may be experienced
e. Technique and practice of coughing and deep breathing, if appropriate
ANS
- a, b, e. Procedural information includes what will or should
be done for surgical preparation, including what to bring and
what to wear to the surgery center, length and type of food
and fluid restrictions, physical preparation required, pain
control, need for coughing and deep breathing (if appropriate),
and procedures done before and during surgery (such as vital
signs, IV lines, and how anesthesia is administered). The other
options are sensory and process information (see Table 18-6).
The nurse asks a preoperative patient to sign a surgical consent form as specified by the
surgeon and then signs the
form after the patient does so. By this action, what is the nurse doing?
a. Witnessing the patient's signature
b. Obtaining informed consent from the patient for the surgery
c. Verifying that the consent for surgery is truly voluntary and informed
d. Ensuring that the patient is mentally competent to sign the consent form
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