MED SURG HESI UPDATED EXAM |FULL REAL EXAM
WITH VERIFIED Q&A WITH ACCURATE
ANSWERS|GRADED A+
- A client with eczema is using an over-the-counter (OTC) topical product with urea 10%
OTC (Aqua Care Cream) to the affected skin areas. Which finding reflects the expected
therapeutic response? - Correct Answer:Hydration of affected dry skin areas
(Photo) The charge nurse observes a newly employed nurse gathering equipment to
obtain a venous blood sample from a client's implanted port. The nurse has obtained
the equipment seen in the photo. What actions should the charge nurse take? (Select
all that apply) - Correct Answer:Determine if the nurse has ever performed this skill
Assist in obtaining the correct needle to access the port
* Venous Insufficiency. All Apply? - Correct Answer:-When the pt. is sitting or lying
elevate the legs
-Diet rich in protein and Vit. A and C
-Assessment the legs for dark discoloration*
1.A young adult male who has had type 2 diabetes mellitus (DM) is admitted to the
intensive care unit with hyperglycemic nonketotic syndrome (HHNS). A sliding scale
protocol for an isotonic IV solution with regular insulin is prescribed based on the results
of a continuous blood glucose monitoring device that is attached to the client's central
venous catheter. When the client's respirations become labored and his lungs sound
indicate crackles what action should the nurse take? - Correct Answer:decrease
infusion rate to address fluid overload
A client diagnose with stable angina secondary to ischemic heart disease has a
prescription for sublingual (SL) nitroglycerin (NTG). The nurse should tell the client to
follow which instructions if chest pain is not relieved after taking 3 NTG tables 5 min
apart - Correct Answer:call 911 pain is unrelieved and chew a tablet of aspirin 325mg
A client diagnosed with stable angina secondary to ischemic heart disease has a
prescription for sublingual (SL) nitroglycerin (NTG). The nurse should tell the client to
follow which instructions if chest pain is not relieved after taking 3 NTG tables 5 min
apart? - Correct Answer:call 911 pain is unrelieved and chew a tablet of aspirin 325mg
A client experiences an ABO incompatibility reaction after multiple blood transfusions.
Which finding should the nurse report immediately to the health care provider? - Correct
Answer:low back pain and hypotension
A client in the operating room received succinylcholine. The client is experiencing
muscle rigidity and has an extremely high temperature. What action should the nurse
implement? - Correct Answer:Call the PACU nurse to prepare for prolonged ventilatory
support Also know that PACU is BP, Respiration and Pulse
,A client is admitted with a sudden onset of right sided the nurse complete first? -
Correct Answer:Observe for peripheral edema
A client is discharged with a prescription for warfarin (Coumadin). What discharge
instructions should the nurse emphasize to the client? - Correct Answer:avoid going
barefoot especially outside
A client is who is diagnose with schizophrenia receives a prescription for an atypical
antipsychotic drug aripipazole (Abilify). Which assessment should the nurse perform to
monitor for an adrenergic receptor antagonist side effect that commonly occurs atypical
antipsychotic agents - Correct Answer:obtain the client finger stick glucose levels
A client returns from surgery following a hiatal hernia repair via Nissen fundoplication.
Which position should the nurse implement for this client? - Correct Answer:30 degree
semi-Fowler's to drop the diaphragm
A client subjective data includes dysuria, urgency, and urinary frequency.
What action should the nurse implement next? - Correct Answer:collect a clean catch
specimen
A client subjective data includes dysuria, urgency, and urinary frequency. What action
should the nurse implement next? - Correct Answer:collect a clean catch specimen
A client tells the nurse that her biopsy results indicate that the cancer cells are well
differentiated How should the nurse respond?
ask the client in the healthcare provider has giving her any information about the -
Correct Answer:classification of her cancer
A client tells the nurse that her biopsy results indicate that the cancer cells are well
differentiated How should the nurse respond? - Correct Answer:ask the client in the
healthcare provider has giving her any information about the classification of her cancer
A client uses triamcinolone (Kenalog), a corticosteroid ointment, to manage pruritis
caused by a chronic skin rash. The client calls the clinic nurse to report increased
erythema with purulent exudate at the site. What action should the nurse implement? -
Correct Answer:Schedule an appointment for the client to see the healthcare
providerSchedule an appointment for the client to see the healthcare provider
A client who had a biliopancreatic diversion procedure (BOP) 3 months ago is admitted
with severe dehydration. Which assessment finding warrants immediate intervention by
the nurse? - Correct Answer:Gastroccult positive emesis
A client who had a myocardial infarction is admitted to the coronary critical care unit
(CCU) with a nitroglycerin drip infusing. The clients last blood pressure measurements
, was 78/36.What action should the nurse implement? - Correct Answer:reduce the rate
of the nitroglycerin infusion
A client who has a history of long-standing back pain treated with methadone
(Dolophine), is admitted to the surgical unit following urological surgery. What
modifications in the plan of care should the nurse make for this client's pain
management during the postoperative period? - Correct Answer:Maintain client's
methadone, and medicate surgical pain based on pain rating
A client who is receiving packed red blood cells develops nausea and vomiting. What
action should the nurse take first? - Correct Answer:Stop the infusion of blood
A client who is taking and oral dose of tetracycline complains of gastrointestinal upset.
What snack should the nurse instruct the client to take with the tetracycline? - Correct
Answer:toasted wheat bread and jelly
A client who suffered an electrical injury on the left foot is admitted to the burn include
in this client's plan of care? (incomplete) - Correct Answer:Continuous cardiac
monitoring
A client who took a camping vacation two weeks ago in a country with a
tropical climate comes to the clinic describing vague symptoms and
diarrhea for the past week. Which finding is most important for the nurse
to report? - Correct Answer:jaundice sclera
A client who took a camping vacation two weeks ago in a country with a tropical climate
comes to the clinic describing vague symptoms and diarrhea for the past week. Which
finding is most important for the nurse to report? - Correct Answer:jaundice sclera
A client who weighs 176 pounds is admitted to the intensive care unit with a serum
glucose level of 600 mg/dl and a serum acetone level of 50 mg/dl. Regular insulin at a
rate of 0.1unit/kg/hour is prescribed. The pharmacy provides a solution of Regular
insulin 100 units/100 ml of normal saline. The nurse should set the infusion pump to
deliver how many ml/hour? (Enter numeric value only) - Correct Answer:8ML/H
A client whose history includes IV drug abuse is admitted to the intensive care unit
(ICU) with Kaposi's sarcoma associated with Acquired Immune Deficiency Syndrome
(AIDS). Which intervention is most important for the nurse to include in the client's plan
of care? - Correct Answer:Identify signs of opportunistic infections
A client with a chronic kidney disease is treated on hemodialysis. During the 1
treatment clients blood pressure drops from 150/90 to 80/30 Which action should the
nurse take first? - Correct Answer:stop dialysis treatment
A client with deep vain thrombosis (DVT) is receiving a continues infusion of heparin
sodium 25,000 unit in 5% dextrose injection 250ml. The prescription indicates the
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