266 Med surg hesi Exam/109
Questions and Answers 2024
A nurse is reinforcing teaching with a client who has HIV
and is being discharged to home. Which of the following
instructions should the nurse include in the teaching? - -A. Take temperature
once a day.
-A nurse is caring for a client who is postoperative following
a tracheostomy, and has copious and tenacious secre-
tions. Which of the following is an acceptable method for
the nurse to use to thin this client's secretions? - -A. Provide humidified
oxygen.
-Following admission, a client with a vascular occlusion
of the right lower extremity calls the nurse and reports
difficulty sleeping because of cold feet. Which of the fol-
lowing nursing actions should the nurse take to promote
the client's comfort? - -B. Obtain a pair of slipper socks for the client
-A nurse is caring for a client is who is 4 hr postoperative
following a transurethral resection of the prostate (TURP).
Which of the following is the priority finding for the nurse
report to the provider? - -C. Thick, red-colored urine
-A nurse is caring for a client who has a temperature
of 39.7° C (103.5° F) and has a prescription for a hy-
pothermia blanket. The nurse should monitor the client for
which of the following adverse effects of the hypothermia
blanket? - -A. Shivering
-A nurse is reinforcing teaching about exercise with a client
who has type 1 diabetes mellitus. Which of the following
statements by the client indicates an understanding of the
teaching? - -D. "I will not exercise if my urine is positive for ketones."
-A nurse notes a small section of bowel protruding from
the abdominal incision of a client who
is postoperative. After calling for assistance, which of the
following actions should the nurse take first - -A. Cover the client's wound
with a moist, sterile dressing.
-A nurse is collecting data from a client who has alco-
hol use disorder and is experiencing metabolic acidosis.
, Which of the following manifestations should the nurse
expect? - -B. Hyperventilation
-A nurse is reinforcing discharge teaching with a client fol-
lowing a cataract extraction. Which of the following should
the nurse include in the teaching? - -A. Avoid bending at the waist.
-A nurse is caring for a client who has heart failure and
has been taking digoxin 0.25 mg daily. The client refuses
breakfast and reports nausea. Which of the following ac-
tions should the nurse take first - -C. Check the client's vital signs.
-A nurse is caring for a client who is 3 days postoper-
ative following a cholecystectomy. The nurse suspects
the client's wound is infected because the drainage from
the dressing is yellow and thick. Which of the following
findings should the nurse report as the type of drainage
found? - -D. Purulent
-A nurse is reinforcing discharge teaching to a client follow-
ing arthroscopic surgery. To prevent postoperative compli-
cations which of the following actions should be reinforced
during the teaching? - -Administer an opioid analgesic to the client 30 min
prior
to initiating CPM exercises
-A nurse is collecting data from a client who has emphy-
sema. Which of the following findings should the nurse
expect? (Select all that apply.) - -1) Dyspnea
2) Barrel chest
3) Clubbing of the fingers
4) Shallow respirations
-A nurse is caring for a client who sustained a basal
skull fracture. When performing morning hygiene care,
the nurse notices a thin stream of clear drainage coming
from out of the client's right nostril. - -4) Test the drainage for glucose.
-A nurse is caring for a client who has a spinal cord
injury at T-4. The nurse should recognize that the client
is at risk for autonomic dysreflexia. Which of the following
interventions should the nurse take to prevent autonomic
dysreflexia? - -3) Prevent bladder distention.
-A nurse is caring for a client who is being evaluated for
endometrial cancer. Which of the following findings should
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