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EVOLVE ELSEVIER HESI MEDCIAL SURGICAL ACTUAL EXAM QUESTIONS AND ANSWERS 2024
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EVOLVE ELSEVIER HESI MEDCIAL SURGICAL ACTUAL EXAM QUESTIONS AND ANSWERS 2024
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EVOLVE ELSEVIER HESI MEDCIAL SURGICALACTUAL EXAM
The nurse includes frequent oral care in the plan of care for a client scheduled for
an esophagogastrostomy for esophageal cancer. This intervention is included in
the client's plan of care to address which nursing diagnosis?
A.
Fluid volume deficit
B.
Self-care deficit
C.
Risk for infection
D.
Impaired nutrition
C
Rationale: The primary reason for performing frequent mouth care preoperatively
is to reduce the risk of postoperative infection because these clients may be
regurgitating retained food particles, blood, or pus from the tumor. Meticulous
oral care should be provided several times a day before surgery. Although oral
care will be of benefit to the client who may also be experiencing option A, B, or
D, these problems are not the primary reason for the provision of frequent oral
care.
,The nurse is completing an admission interview for a client with Parkinson
disease. Which question will provide additional information about manifestations
that the client is likely to experience?
A.
"Have you ever experienced any paralysis of your arms or legs?"
B.
"Do you have frequent blackout spells?"
C.
"Have you ever been frozen in one spot, unable to move?"
D.
"Do you have headaches, especially ones with throbbing pain?"
C
Rationale: Clients with Parkinson disease frequently experience difficulty in
initiating, maintaining, and performing motor activities. They may even
experience being rooted to the spot and unable to move. Parkinson disease does
not typically cause option A, B, or D.
When a nurse assesses a client receiving total parenteral nutrition (TPN), which
laboratory value is most important for the nurse to monitor regularly?
A.
Albumin
B.
Calcium
,C.
Glucose
D.
Alkaline phosphatase
C
Rationale: TPN solutions contain high concentrations of glucose, so the blood
glucose level is often monitored as often as q6h because of the risk for
hyperglycemia. Option A is monitored periodically because an increase in the
albumin level, a serum protein, is generally a desired effect of TPN. Option B may
be added to TPN solutions, but calcium imbalances are not generally a risk during
TPN administration. Option D may be decreased in the client with malnutrition
who receives TPN, but abnormal values, reflecting liver or bone disorders, are not
a common complication of TPN administration.
A 55-year-old male client has been admitted to the hospital with a medical
diagnosis of chronic obstructive pulmonary disease (COPD). Which risk factor is
the most significant in the development of this client's COPD?
A.
The client's father was diagnosed with COPD in his 50s.
B.
A close family member contracted tuberculosis last year.
C.
The client smokes one to two packs of cigarettes per day.
D.
, The client has been 40 pounds overweight for 15 years.
C
Rationale: Smoking, considered to be a modifiable risk factor, is the most
significant risk factor for the development of COPD. The exact mechanism of
genetic and hereditary implications for the development of COPD is still under
investigation, although exposure to similar predisposing factors (e.g., smoking or
inhaling secondhand smoke) may increase the likelihood of COPD incidence
among family members. Options B and D do not exceed the risks associated with
cigarette smoking in the development of COPD.
A 43-year-old homeless, malnourished female client with a history of alcoholism is
transferred to the ICU. She is placed on telemetry, and the rhythm strip shown is
obtained. The nurse palpates a heart rate of 160 beats/min, and the client's blood
pressure is 90/54 mm Hg. Based on these findings, which IV medication should
the nurse administer?
A.
Amiodarone (Cordarone)
B.
Magnesium sulfate
C.
Lidocaine (Xylocaine)
D.
Procainamide (Pronestyl)
B
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