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MED/SURG HESI PRACTICE QUESTIONS & ANSWERS
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MED/SURG HESI PRACTICE QUESTIONS & ANSWERS
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MED/SURG HESI PRACTICE QUESTIONS & ANSWERSThe nurse is planning to initiate a socialization group for older residents of a long-term
facility. Which information would be most useful to the nurse when planning activities for
the group?
A. The length of time each group member has resided at the nursing home.
B. A brief description of each resident's family life.
C. The age of each group member.
D. The usual activity patterns of each member of the group. - Answers -D
An older person's level of activity is a determining factor in adjustment to aging as
described by the Activity Theory of Aging. The most useful information initially would be
an assessment of each individual's adjustment to the aging process.
A client has taken steroids for 12 years to help manage chronic obstructive pulmonary
disease (COPD). When making a home visit, which nursing assessment is of greatest
importance to this client?
A. pulse rate, both apically and radially.
B. blood pressure, both standing and sitting.
C. temperature.
D. skin color and turgor. - Answers -C
Long term use of steroids by COPD clients is effective in suppressing inflammation in
their airways making it easier for them to breath, but at the same time suppresses the
immune system, placing the client at risk for infection, so it is very important to obtain
the client's temperature.
A client who is sexually active with several partners requests an intrauterine device
(IUD) as a contraceptive method. Which information should the nurse provide?
A. Using an IUD offers no protection against sexually transmitted diseases (STD), which
increase the risk for pelvic inflammatory disease (PID).
B. Getting pregnant while using an IUD is common and is not the best contraceptive
choice.
C. Relying on an IUD may be a safer choice for monogamous partners, but a barrier
method provides a better option in preventing STD transmission.
D. Selecting a contraceptive device should consider choosing a successful method
used in the past. - Answers -A
The use of an intrauterine device (IUD) provides the client with no protection from
sexually transmitted diseases (STD).
Which symptoms should the nurse expect a client to exhibit who is diagnosed with a
pheochromocytoma?
A. Numbness, tingling, and cramps in the extremities.
,B. Headache, diaphoresis, and palpitations.
C. Cyanosis, fever, and classic signs of shock.
D. Nausea, vomiting, and muscular weakness. - Answers -B
Pheochromocytoma is a catecholamine secreting non-cancerous tumor of the adrenal
medulla, and a headache, profuse sweating and palpitations is the typical triad of
symptoms depending upon the relative proportions of epinephrine and norepinephrine
secretion. Surgical removal of the tumor is the only treatment.
A middle-aged male client with diabetes continues to eat an abundance of foods that
are high in sugar and fat. According to the Health Belief Model, which event is most
likely to increase the client's willingness to become compliant with the prescribed diet?
A. He visits his diabetic brother who just had surgery to amputate an infected foot.
B. He is provided with the most current information about the dangers of untreated
diabetes.
C. He comments on the community service announcements about preventing
complications associated with diabetes.
D. His wife expresses a sincere willingness to prepare meals that are within his
prescribed diet. - Answers -A
The loss of a limb due to diabetes by a family member should be the strongest event or
"cue to action" and is most likely to increase the client's perceived seriousness of the
disease.
When preparing a client who has had a total laryngectomy for discharge, which
instruction is most important for the nurse to include in the discharge teaching?
A. Recommend that the client carry suction equipment at all times.
B. Instruct the client to have writing materials with him at all times.
C. Tell the client to carry a medic alert card stating that he is a total neck breather.
D. Tell the client not to travel alone. - Answers -C
It is imperative that total neck breathers carry a medic alert notice so, that if they have a
cardiac arrest, mouth-to-neck breathing can be done.
During an interview with a client planning elective surgery, the client asks the nurse,
"What is the advantage of having a preferred provider organization insurance plan?"
Which response is best for the nurse to provide?
A. Neither plan allows selections of healthcare providers or hospitals.
B. There are fewer healthcare providers to choose from than in an HMO plan.
C. An individual may select healthcare providers from outside of the PPO network.
D. An individual can become a member of a PPO without belonging to a group. -
Answers -C
The financial implication of selecting a provider from outside of the network is the
feature most relevant to the average consumer. The nurse must have knowledge about
preferred provider organizations (PPOs), which provides the option for the consumer to
,select a Healthcare Provider (HCP) from within the PPO network (in-network) at a
reduced cost versus a higher cost for selecting an out-of-network HCP.
A client is admitted to the hospital with a medical diagnosis of pneumococcal
pneumonia. The nurse knows that the prognosis for gram-negative pneumonias (such
as E. coli, Klebsiella, Pseudomonas, and Proteus) is very poor. Which information
relates most directly to the prognosis for gram-negative pneumonias?
A. The gram-negative infections occur in the lower lobe alveoli which are more sensitive
to infection.
B. Gram-negative organisms are more resistant to antibiotic therapy.
C. Usually occur in healthy young adults who have recently been debilitated by an
upper respiratory infection.
D. Gram-negative pneumonias usually affect infants and small children. - Answers -B
Gram-negative organisms are very resistant to drug therapy which makes recovery
difficult. Antibiotic resistance has become a world-wide concern and the World Health
Organization is keeping a very close surveillance on these occurrences.
The nurse is planning care to prevent complications for a client with multiple myeloma.
Which intervention is most important for the nurse to include?
A. Safety precautions during activity.
B. Assess for changes in size of lymph nodes.
C. Maintain a fluid intake of 3 to 4 L per day.
D. Administer narcotic analgesic around the clock. - Answers -C
Multiple myeloma is a malignancy of plasma cells that infiltrate bone causing
demineralization and hypercalcemia, so maintaining a urinary output of 1.5 to 2 L per
day requires an intake of 3 to 4 L to promote excretion of serum calcium.
A 58-year-old client, who has no health problems, asks the nurse about the Pneumovax
vaccine. The nurse's response to the client should be based on which information?
A. The vaccine is given annually before the flu season to those over 50 years of age.
B. The immunization is administered once to older adults or persons with a history of
chronic illness.
C. The vaccine is for all ages and is given primarily to those persons traveling overseas
to areas of infection.
D. The vaccine will prevent the occurrence of pneumococcal pneumonia for up to five
years. - Answers -B
It is recommended by the CDC (Dec 2016) that persons over 65 years of age and those
with a history of chronic illness receive the vaccine once in a lifetime.
The nurse is caring for a client who has been diagnosed with primary
hyperaldosteronism. Which laboratory test result should the nurse expect an increase in
the serum level?
, A. Sodium.
B. Antidiuretic hormone.
C. Potassium.
D. Glucose. - Answers -A
Clients with primary aldosteronism exhibit an increase in serum sodium levels
(hypernatremia) and have profound decline in the serum levels of potassium
(hypokalemia)--hypertension is the most prominent and universal sign. Antidiuretic
hormone is decreased with diabetes insipidus. Glucose is not affected by primary
aldosteronism.
Which information about mammograms is most important to provide a post-menopausal
female client?
A. Breast self-examinations are not needed if annual mammograms are obtained.
B. Radiation exposure is minimized by shielding the abdomen with a lead-lined apron.
C. Yearly mammograms should be done regardless of previous normal x-rays.
D. Women at high risk should have annual routine and ultrasound mammograms. -
Answers -C
There are different recommendations from different agnecies. For a client with no risk
factors, the earliest breast screening recommendation is a yearly mammogram at the
age 40 and till the age of 54. After that every two years. The American College of
OB/GYN still recommend starting mammograms starting at the age of 40 and yearly
screeenings. The American Cancer Society new guidelines recommend starting at the
age of 45 and thereafter till the age of 54 years old, then every two years. The US
Preventive Services Task Force Services (USPSTS) recommends starting at the age of
50 years old and screenings every two years thereafter.
A client receiving cholestyramine for hyperlipidemia should be evaluated for which
vitamin deficiency?
A. K.
B. B12.
C. B6.
D. C. - Answers -A
Cholestyramine is administered to help lower the triglycerides levels. Side effects clients
should be monitored for include increased prothrombin time and prolonged bleeding
times which would alert the nurse to a vitamin K deficiency. These drugs reduce
absorption of the fat soluble (lipid) vitamins A, D, E, and K.
An adult client is admitted to the hospital burn unit with partial-thickness and full-
thickness burns over 40% of the body surface area. In assessing the potential for skin
regeneration, which should the nurse remember about full-thickness burns?
A. Regenerative function of the skin is absent because the dermal layer has been
destroyed.
B. Tissue regeneration will begin several days following return of normal circulation.
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