HESI Med Surg 1 Final Exam Study Guide Questions and Answers 2023 (Verified Answers)
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HESI Med Surg 1 Final Exam Study Guide Questions and Answers 2023 (Verified Answers)
Four days after abdominal surgery a client has not passed flatus and there are no bowel sounds. Paralytic ileus is suspected. What does the nurse conclude is the most likely cause of the ileus?
Impaired neural ...
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HESI Med Surg 1 Final Exam Study Guide Questions and
Answers 2023 (Verified Answers)
Four days after abdominal surgery a client has not passed flatus and there are no
bowel sounds. Paralytic ileus is suspected. What does the nurse conclude is the
most likely cause of the ileus?
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.
A nurse is caring for a client with cirrhosis of the liver. Which laboratory test
should the nurse monitor that, when abnormal, might identify a client who may
benefit from neomycin enemas?
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.
Name the characteristics that support chronic persistent stage of Lyme disease
Arthritis
Chronic fatigue
R: Systemic infectious disease caused by Spirochete Borrelia Burgdorferi.
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. The
prodromal 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.
Which are examples of a type IV hypersensitivity reaction?
Sarcoidosis and poison ivy
In type IV hypersensitivity, the inflammation is caused by a reaction of sensitized T cells
with the antigen and the resultant activation of macrophages due to lymphokine release.
Myasthenia gravis is an example of a type II or cytotoxic hypersensitivity reaction.
, Rheumatoid arthritis and systemic lupus erythematosus are examples of type III
immune complex-mediated reactions.
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 create an
ileostomy." Which nursing intervention will best meet the client's priority need?
Replace the Pt's fluid and electrolytes
R:Fluid and electrolyte replacement is a life-saving strategy; it must be done before
surgery 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 the psychomotor
skill of how to manage an ileostomy. The client is not demonstrating a readiness for
contact with other persons with ileostomies at this time
A nurse discovers the condition depicted in the image upon assessment of a
client. Which organism may lead to this condition?
Human herpes virus-8
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 papilloma virus causes multiple
types of malignancies such as cervical and anal cancer.
The nurse instructs a client with a new colostomy to avoid foods and drinks that
produce a large amount of gas, specifically to avoid the intake of what?
Cabbage
R:Cabbage is a gas-producing food that can cause a client with a colostomy problems
with odor control and ballooning of the ostomy bag, which may break the device seal
and allow leakage. Milk, cheese, and coffee should not cause excessive gas problems
in moderation. The client with a new colostomy should slowly introduce new foods into
the diet to test toleration.
On the third postoperative day after a subtotal gastrectomy, a client reports
having severe abdominal pain. The nurse palpates the client's abdomen and
determines rigidity. What should be the nurse's first action?
Obtain the Pt's vitals
Rigidity and pain are hallmarks of bleeding from the suture line or of peritonitis; vital
signs provide supporting data. Ambulation is indicated if pain was the result of
flatulence; however, rigidity is associated with bleeding or peritonitis, and additional data
are needed. An analgesic may mask the symptoms, thereby delaying diagnosis.
Encouraging use of the incentive spirometer is unrelated to the symptoms presented.
A nurse is caring for a client who just had a liver biopsy. After the procedure, the
nurse should monitor for which common complication associated with the
biopsy?
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