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MED-SURG HESI FINAL PRACTICE QUESTIONS AND CORRECT ANSWERS
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MED-SURG HESI FINAL PRACTICE QUESTIONS AND CORRECT ANSWERS
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MED-SURG HESI FINAL PRACTICEQUESTIONS AND CORRECT ANSWERS
The6nurse6is6assessing6a6client's6laboratory6values6following6administration6of6chemothe
rapy.6Which6lab6value6leads6the6nurse6to6suspect6that6the6client6is6experiencing6tumor6ly
sis6syndrome6(TLS)?
a.6Serum6PTT6of6106seconds.
b.6Serum6calcium6of656mg/dL.
c.6Oxygen6saturation6of690%.6
d.6Hemoglobin6of6106g/dL6-6ans--✔✔B6-
6Tumor6lysis6syndrome6(TLS)6results6in6hyperkalemia,6hypocalcemia,6hyperuricemia,6an
d6hyperphosphatemia.6A6serum6calcium6level6of65,6which6is6low,6is6an6indicator6of6possibl
e6tumor6lysis6syndrome.
Which6description6of6symptoms6is6characteristic6of6a6client6diagnosed6with6trigeminal6ne
uralgia6(tic6douloureux)?
a.6Tinnitus,6vertigo,6and6hearing6difficulties.
b.6Sudden,6stabbing,6severe6pain6over6the6lip6and6chin.6
c.6Facial6weakness6and6paralysis.
d.6Difficulty6in6chewing,6talking,6and6swallowing.6-6ans--✔✔B6-
6Trigeminal6neuralgia6is6characterized6by6paroxysms6of6pain,6similar6to6an6electric6shock,
6in6the6area6innervated6by6one6or6more6branches6of6the6trigeminal6nerve6(5th6cranial).6W
omen6are6more6often6afflicted6with6this6condition6and6generally6occurs6in6clients6over6the
6age6of6506years6old.
Which6discharge6instruction6is6most6important6for6a6client6after6a6kidney6transplant?
a.6Weigh6weekly.
b.6Report6symptoms6of6secondary6Candidiasis.
c.6Use6daily6reminders6to6take6immunosuppressants.6
d.6Stop6cigarette6smoking.6-6ans--✔✔C6-
6After6a6renal6transplantation,6acute6rejection6is6a6high6risk6for6several6months.6The6orga
n6recipient6will6have6to6take6immunosuppressive6therapy6for6the6rest6of6their6lives,6such6a
s6corticosteroids6and6azathioprine,6to6prevent6organ6transplant6rejection.6Discharge6instr
uctions6include6measures6such6as6daily6reminders6to6ensure6the6client6takes6these6medi
cations6regularly6to6prevent6organ6rejection6from6occurring.
The6nurse6is6providing6dietary6instructions6to6a668-year-
old6client6who6is6at6high6risk6for6development6of6coronary6heart6disease6(CHD).6Which6inf
ormation6should6the6nurse6include?
,a.6Limit6dietary6selection6of6cholesterol6to63006mg6per6day.6
b.6Increase6intake6of6soluble6fiber6to6106to6256grams6per6day.6
c.6Decrease6plant6stanols6and6sterols6to6less6than626grams/day.
d.6Ensure6saturated6fat6is6less6than630%6of6total6caloric6intake.6-6ans--✔✔B6-
6To6reduce6risk6factors6associated6with6coronary6heart6disease,6the6daily6intake6of6solubl
e6fiber6should6be6increased6to6between6106and6256grams6per6day.6According6to6the6Ame
rican6Heart6Association,6soluble6fibers6helps6reduce6LDL6cholesterol6levels.
Two6days6postoperative,6a6male6client6reports6aching6pain6in6his6left6leg.6The6nurse6asse
sses6redness6and6warmth6on6the6lower6left6calf.6Which6intervention6would6be6most6helpf
ul6to6this6client?
a.6Apply6sequential6compression6devices6(SCDs)6bilaterally.
b.6Assess6for6a6positive6Homan's6sign6in6each6leg.
c.6Pad6all6bony6prominences6on6the6affected6leg.
d.6Advise6the6client6to6remain6in6bed6with6the6leg6elevated.6-6ans--✔✔D6-
6For6a6client6exhibiting6symptoms6of6deep6vein6thrombosis6(DVT),6a6complication6of6imm
obility,6the6initial6care6includes6bedrest6and6elevation6of6the6extremity.
A6middle-
aged6male6client6with6diabetes6continues6to6eat6an6abundance6of6foods6that6are6high6in6s
ugar6and6fat.6According6to6the6Health6Belief6Model,6which6event6is6most6likely6to6increas
e6the6client's6willingness6to6become6compliant6with6the6prescribed6diet?
a.6He6visits6his6diabetic6brother6who6just6had6surgery6to6amputate6an6infected6foot.6
b.6He6is6provided6with6the6most6current6information6about6the6dangers6of6untreated6diabe
tes.
c.6He6comments6on6the6community6service6announcements6about6preventing6complicati
ons6associated6with6diabetes.
d.6His6wife6expresses6a6sincere6willingness6to6prepare6meals6that6are6within6his6prescrib
ed6diet.6-6ans--✔✔A6-
6The6loss6of6a6limb6due6to6diabetes6by6a6family6member6should6be6the6strongest6event6or
6"cue6to6action"6and6is6most6likely6to6increase6the6client's6perceived6seriousness6of6the6di
sease.
A658-year-old6client6who6has6been6post-
menopausal6for6five6years6is6concerned6about6the6risk6for6osteoporosis6because6her6mot
her6has6the6condition.6Which6information6should6the6nurse6offer?
a.6Osteoporosis6is6a6progressive6genetic6disease6with6no6effective6treatment.
b.6Calcium6loss6from6bones6can6be6slowed6by6increasing6calcium6intake6and6exercise.6
c.6Estrogen6replacement6therapy6should6be6started6to6prevent6the6progression6osteopor
osis.
d.6Low-dose6corticosteroid6treatment6effectively6halts6the6course6of6osteoporosis.6-6ans--
✔✔B6-6Post-
menopausal6females6are6at6risk6for6osteoporosis6due6to6the6cessation6of6estrogen6secret
ion,6but6a6regimen6including6calcium,6vitamin6D,6and6weight-
bearing6exercise6can6help6prevent6further6bone6loss.
, The6nurse6notes6that6the6only6ECG6for6a655-year-
old6male6client6scheduled6for6surgery6in6two6hours6is6dated6two6years6ago.6The6client6rep
orts6that6he6has6a6history6of6"heart6trouble,"6but6has6no6problems6at6present.6Hospital6pro
tocol6requires6that6those6over6506years6of6age6have6a6recent6ECG6prior6to6surgery.6Whic
h6nursing6action6is6best6for6the6nurse6to6implement?
a.6Ask6the6client6what6he6means6by6"heart6trouble."6
b.6Call6for6an6ECG6to6be6performed6immediately.6
c.6Notify6surgery6that6the6ECG6is6over6two6years6old.
d.6Notify6the6client's6surgeon6immediately.6-6ans--✔✔B
Which6information6about6mammograms6is6most6important6to6provide6a6post-
menopausal6female6client?
a.6Breast6self-examinations6are6not6needed6if6annual6mammograms6are6obtained.
b.6Radiation6exposure6is6minimized6by6shielding6the6abdomen6with6a6lead-lined6apron.
c.6Yearly6mammograms6should6be6done6regardless6of6previous6normal6x-rays.
d.6Women6at6high6risk6should6have6annual6routine6and6ultrasound6mammograms6-6ans--
✔✔C6-
6There6are6different6recommendations6from6different6agnecies.6For6a6client6with6no6risk6f
actors,6the6earliest6breast6screening6recommendation6is6a6yearly6mammogram6at6the6ag
e6406and6till6the6age6of654.6After6that6every6two6years.6The6American6College6of6OB/
GYN6still6recommend6starting6mammograms6starting6at6the6age6of6406and6yearly6screee
nings.6The6American6Cancer6Society6new6guidelines6recommend6starting6at6the6age6of64
56and6thereafter6till6the6age6of6546years6old,6then6every6two6years.6The6US6Preventive6S
ervices6Task6Force6Services6(USPSTS)6recommends6starting6at6the6age6of6506years6old6
and6screenings6every6two6years6thereafter.
The6nurse6is6caring6for6a6client6with6a6continuous6feeding6through6a6percutaneous6endos
copic6gastrostomy6(PEG)6tube.6Which6intervention6should6the6nurse6include6in6the6plan6o
f6care?
A.6Flush6the6tube6with6506ml6of6water6q686hours.6
B.6Check6for6tube6placement6and6residual6volume6q46hours.6
C.6Obtain6a6daily6x-6ray6to6verify6tube6placement.
D.6Position6on6left6side6with6head6of6bed6elevated6456degrees6-6ans--✔✔B6-
6Percutaneous6endoscopic6gastrostomy6(PEG)6tube6placement6and6residual6volume6sho
uld6be6checked6every6four6hours6for6clients6on6continuous6feeding.6If6the6gastric6residual6
is6more6than6200mL6for6an6adult6client;6stop6the6feeding6and6re-
check6the6gastric6residual6one6hour6later.6If6the6residual6still6remains6more6than6200mL;6
continue6to6keep6the6feeding6on6hold6and6contact6the6client's6health6care6provider.
A658-year-old6client6who6has6been6post-
menopausal6for6five6years6is6concerned6about6the6risk6for6osteoporosis6because6her6mot
her6has6the6condition.6Which6information6should6the6nurse6offer?
A.6Osteoporosis6is6a6progressive6genetic6disease6with6no6effective6treatment.
B.6Calcium6loss6from6bones6can6be6slowed6by6increasing6calcium6intake6and6exercise.6
C.6Estrogen6replacement6therapy6should6be6started6to6prevent6the6progression6osteopor
osis.
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