HESI FINAL STUDY QUESTIONS: MED
SURG II
A6nurse6is6caring6for6a6client6who6is6learning6how6to6take6care6of6a6newly6created6colosto
my.6When6observing6a6return6demonstration6of6the6colostomy6irrigation,6the6nurse6evalu
ates6that6more6teaching6is6required6when6the6client:6-
6Hangs6the6irrigation6bag6on6the6door6clothes6hook6during6fluid6insertion
Following6surgery,6a6client6asks6the6nurse6if6he6or6she6can6help6measure6intake6and6outp
ut.6What6is6the6best6nursing6response?6-
6Assess6the6client's6ability6to6measure6the6intake6and6output
A6client6with6cancer6of6the6pancreas6has6a6pancreaticoduodenectomy6(Whipple6procedur
e).6The6nurse6expects6that6the6client6will6have6which6tube6after6surgery?6-6Nasogastric
A6nurse6is6assessing6a6client6with6a6diagnosis6of6early6left6ventricular6heart6failure.6Specif
ic6to6this6type6of6heart6failure,6the6nurse6expects6the6client6to6state:6-
6"I6have6trouble6breathing6when6I6walk6rapidly."
A6client6with6a6spontaneous6pneumothorax6asks,6"Why6did6they6put6this6tube6into6my6ch
est?"6The6nurse6explains6that6the6purpose6of6the6chest6tube6is6to:6-
6Remove6air6from6the6pleural6space
Following6surgery6in6the6inguinal6area,6the6client6complains6of6pain6on6the6right6side6of6th
e6chest,6becomes6dyspneic,6and6begins6to6cough6violently.6The6nurse6suspects6that6a6pu
lmonary6embolus6has6occurred.6What6is6the6priority6nursing6action?6-
6Elevate6the6head6of6the6bed
As6an6acute6episode6of6rheumatoid6arthritis6subsides,6active6and6passive6range-of-
motion6exercises6are6taught6to6the6client's6spouse.6The6nurse6should6teach6that6direct6pr
essure6should6not6be6applied6to6the6client's6joints6because6this6may6precipitate:6-6Pain
A6client6is6admitted6to6the6hospital6with6the6diagnosis6of6cancer6of6the6thyroid6and6a6thyro
idectomy6is6scheduled.6What6is6important6for6the6nurse6to6consider6when6caring6for6this6c
lient6during6the6postoperative6period?6-
6Hoarseness6and6airway6obstruction6may6result6from6laryngeal6nerve6damage.
A6client6is6scheduled6to6have6a6cardiac6catheterization6via6the6femoral6approach.6The6nu
rse6teaches6the6client6about6post-
procedure6interventions6that6protect6the6catheter6insertion6site.6The6nurse6instructs6the6cl
ient6that6the6leg6used6for6catheter6insertion6will6be:6-6Kept6extended6while6on6bed6rest
, A6female6client6who6has6recurrent6urinary6tract6infections6(UTIs)6is6inquiring6about6the6pr
evention6of6future6UTIs.6What6information6should6the6nurse6include6when6teaching6the6cli
ent?6(Select6all6that6apply.)6-6-Drink686to6106glasses6of6water6each6day
-Urinate6immediately6after6sexual6intercourse
A6client6is6diagnosed6with6Cushing6syndrome.6Which6clinical6manifestation6does6the6nur
se6expect6to6increase6in6a6client6with6Cushing6syndrome?6-6Glucose6level
A6client6with6hepatic6cirrhosis6begins6to6develop6slurred6speech,6confusion,6drowsiness,6
and6a6flapping6tremor.6With6this6evidence6of6impending6hepatic6coma,6which6diet6can6the
6nurse6expect6will6be6prescribed6for6this6client?6-6206g6of6protein,620006calories
A6nurse6concludes6that6the6anemia6that6accompanies6chronic6kidney6disease6should6be6
treated6because6it6contributes6to:6-6Chronic6fatigue
A6client6is6scheduled6to6receive6general6anesthesia6during6an6upcoming6surgery.6The6nu
rse6provides6education6about6common6side6effects6of6general6anesthesia.6The6nurse6co
ncludes6that6the6teaching6has6been6effective6when6the6client6states,6"Immediately6after6s
urgery6I6may6experience:6-6A6sore6throat."
A6client6has6surgery6for6the6creation6of6burr6holes6after6sustaining6head6trauma.6An6early
6clinical6manifestation6of6meningeal6irritation6for6which6the6nurse6assesses6the6client6is:6-
6Kernig's6sign
What6therapeutic6effect6should6the6nurse6identify6as6the6reason6for6administration6of6neo
mycin6sulfate6to6a6client6before6colon6surgery?6-6Destroy6intestinal6bacteria
A6client6newly6diagnosed6with6myasthenia6gravis6is6concerned6about6fluctuations6in6phys
ical6condition6and6generalized6weakness.6When6caring6for6this6client6it6is6most6important6
for6the6nurse6to6plan6to:6-6Space6activities6throughout6the6day
A6client6is6diagnosed6with6myasthenia6gravis,6and6the6anticholinesterase6medication6pyri
dostigmine6(Mestinon)6is6prescribed.6When6teaching6the6client6about6this6medication,6the
6nurse6explains6that6the6desired6effect6is6to6increase:6-6Contraction6of6skeletal6muscles
A6client6with6a6history6of6a6pulmonary6embolus6is6to6receive636mg6of6warfarin6(Coumadin)
6daily.6The6client6has6blood6drawn6twice6weekly6to6ascertain6that6the6international6normal
ized6ratio6(INR)6stays6within6a6therapeutic6range.6The6nurse6provides6dietary6teaching.6
Which6food6selected6by6the6client6indicates6that6further6teaching6is6necessary?6-
6Spinach6salad
A6client6with6advanced6bone6cancer6is6experiencing6cachexia.6The6nurse6discusses6the6
nutritional6aspect6of6palliative6care6with6the6family.6Why6is6it6important6to6explain6these6n
utritional6interventions6to6the6family?6-6Enhance6the6quality6of6the6client's6life
SURG II
A6nurse6is6caring6for6a6client6who6is6learning6how6to6take6care6of6a6newly6created6colosto
my.6When6observing6a6return6demonstration6of6the6colostomy6irrigation,6the6nurse6evalu
ates6that6more6teaching6is6required6when6the6client:6-
6Hangs6the6irrigation6bag6on6the6door6clothes6hook6during6fluid6insertion
Following6surgery,6a6client6asks6the6nurse6if6he6or6she6can6help6measure6intake6and6outp
ut.6What6is6the6best6nursing6response?6-
6Assess6the6client's6ability6to6measure6the6intake6and6output
A6client6with6cancer6of6the6pancreas6has6a6pancreaticoduodenectomy6(Whipple6procedur
e).6The6nurse6expects6that6the6client6will6have6which6tube6after6surgery?6-6Nasogastric
A6nurse6is6assessing6a6client6with6a6diagnosis6of6early6left6ventricular6heart6failure.6Specif
ic6to6this6type6of6heart6failure,6the6nurse6expects6the6client6to6state:6-
6"I6have6trouble6breathing6when6I6walk6rapidly."
A6client6with6a6spontaneous6pneumothorax6asks,6"Why6did6they6put6this6tube6into6my6ch
est?"6The6nurse6explains6that6the6purpose6of6the6chest6tube6is6to:6-
6Remove6air6from6the6pleural6space
Following6surgery6in6the6inguinal6area,6the6client6complains6of6pain6on6the6right6side6of6th
e6chest,6becomes6dyspneic,6and6begins6to6cough6violently.6The6nurse6suspects6that6a6pu
lmonary6embolus6has6occurred.6What6is6the6priority6nursing6action?6-
6Elevate6the6head6of6the6bed
As6an6acute6episode6of6rheumatoid6arthritis6subsides,6active6and6passive6range-of-
motion6exercises6are6taught6to6the6client's6spouse.6The6nurse6should6teach6that6direct6pr
essure6should6not6be6applied6to6the6client's6joints6because6this6may6precipitate:6-6Pain
A6client6is6admitted6to6the6hospital6with6the6diagnosis6of6cancer6of6the6thyroid6and6a6thyro
idectomy6is6scheduled.6What6is6important6for6the6nurse6to6consider6when6caring6for6this6c
lient6during6the6postoperative6period?6-
6Hoarseness6and6airway6obstruction6may6result6from6laryngeal6nerve6damage.
A6client6is6scheduled6to6have6a6cardiac6catheterization6via6the6femoral6approach.6The6nu
rse6teaches6the6client6about6post-
procedure6interventions6that6protect6the6catheter6insertion6site.6The6nurse6instructs6the6cl
ient6that6the6leg6used6for6catheter6insertion6will6be:6-6Kept6extended6while6on6bed6rest
, A6female6client6who6has6recurrent6urinary6tract6infections6(UTIs)6is6inquiring6about6the6pr
evention6of6future6UTIs.6What6information6should6the6nurse6include6when6teaching6the6cli
ent?6(Select6all6that6apply.)6-6-Drink686to6106glasses6of6water6each6day
-Urinate6immediately6after6sexual6intercourse
A6client6is6diagnosed6with6Cushing6syndrome.6Which6clinical6manifestation6does6the6nur
se6expect6to6increase6in6a6client6with6Cushing6syndrome?6-6Glucose6level
A6client6with6hepatic6cirrhosis6begins6to6develop6slurred6speech,6confusion,6drowsiness,6
and6a6flapping6tremor.6With6this6evidence6of6impending6hepatic6coma,6which6diet6can6the
6nurse6expect6will6be6prescribed6for6this6client?6-6206g6of6protein,620006calories
A6nurse6concludes6that6the6anemia6that6accompanies6chronic6kidney6disease6should6be6
treated6because6it6contributes6to:6-6Chronic6fatigue
A6client6is6scheduled6to6receive6general6anesthesia6during6an6upcoming6surgery.6The6nu
rse6provides6education6about6common6side6effects6of6general6anesthesia.6The6nurse6co
ncludes6that6the6teaching6has6been6effective6when6the6client6states,6"Immediately6after6s
urgery6I6may6experience:6-6A6sore6throat."
A6client6has6surgery6for6the6creation6of6burr6holes6after6sustaining6head6trauma.6An6early
6clinical6manifestation6of6meningeal6irritation6for6which6the6nurse6assesses6the6client6is:6-
6Kernig's6sign
What6therapeutic6effect6should6the6nurse6identify6as6the6reason6for6administration6of6neo
mycin6sulfate6to6a6client6before6colon6surgery?6-6Destroy6intestinal6bacteria
A6client6newly6diagnosed6with6myasthenia6gravis6is6concerned6about6fluctuations6in6phys
ical6condition6and6generalized6weakness.6When6caring6for6this6client6it6is6most6important6
for6the6nurse6to6plan6to:6-6Space6activities6throughout6the6day
A6client6is6diagnosed6with6myasthenia6gravis,6and6the6anticholinesterase6medication6pyri
dostigmine6(Mestinon)6is6prescribed.6When6teaching6the6client6about6this6medication,6the
6nurse6explains6that6the6desired6effect6is6to6increase:6-6Contraction6of6skeletal6muscles
A6client6with6a6history6of6a6pulmonary6embolus6is6to6receive636mg6of6warfarin6(Coumadin)
6daily.6The6client6has6blood6drawn6twice6weekly6to6ascertain6that6the6international6normal
ized6ratio6(INR)6stays6within6a6therapeutic6range.6The6nurse6provides6dietary6teaching.6
Which6food6selected6by6the6client6indicates6that6further6teaching6is6necessary?6-
6Spinach6salad
A6client6with6advanced6bone6cancer6is6experiencing6cachexia.6The6nurse6discusses6the6
nutritional6aspect6of6palliative6care6with6the6family.6Why6is6it6important6to6explain6these6n
utritional6interventions6to6the6family?6-6Enhance6the6quality6of6the6client's6life
