HESI MED SURG EXAM – STUDY GUIDE Latest 2021/2022 150 Correct Questions & Answers
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Course
HESI MED SURG
Institution
Chamberlain College Of Nursing
HESI MED SURG EXAM – STUDY GUIDE Latest 2021/2022
150 Correct Questions & Answers
1. A client with gout experiences an acute attack. The client reports he has been trying to lose weight. Which client information is most important for the nurse to obtain?
• Serum cholesterol level (not rel...
1 a client with gout experiences an acute attack the client reports he has been trying to lose weight which client information is most important for the nurse to ob
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HESI MED SURG
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HESI MED SURG EXAM – STUDY GUIDE Latest 2021/2022
150 Correct Questions & Answers
1. A client with gout experiences an acute attack. The client reports he has been trying
to lose weight. Which client information is most important for the nurse to obtain?
• Serum cholesterol level (not related to the acute attack gout)
• Capillary glucose level (not related to the acute attack gout)
• Daily caloric intake (Starvation diet can cause an acute attack of gout)
• Daily calcium intake (not related to the acute attack gout)
2. A male client with a C-6 spinal cord injury is in rehabilitation. In the middle of the
night he reports a severe, pounding headache, and has observable goose bumps. The
nurse should assess for which trigger?
• Loud hallway noise (Not manifestation of autonomic hyperreflexia)
• Fever (Not manifestation of autonomic hyperreflexia)
• Full bladder
• Frequent cough (Not manifestation of autonomic hyperreflexia)
* A pounding headache is a sign of autonomic hyperreflexia, an acute emergency that occurs
because of an exaggerated sympathetic response in a client with a high-level spinal cord
injury. Any stimulus below the level of injury can trigger autonomic hyperreflexia, but the
most common cause is an overly distended bladder.
3. After learning that she as terminal pancreatic cancer, a female client becomes very
angry and says to the nurse, “God has abandoned me. What did I do to deserve this”?
Based on this response, the nurse deicides to include Which nursing problem in the
client’s plan of care?
• Acute pain (physical pain less than 6 month)
• Spiritual distress (indicates anger toward God for her disease)
• Ineffective coping (not reflect)
• Complicated grieving (not reflect)
, 2
4. A nurse working on an Endocrine Unit should see which client first?
• An Adolescent male with type 1 diabetes who is arguing about his insulin dose
(dealt with at a later time)
• A older client with Addison’s disease whose current blood sugar level is 62 mg/dl
(blood sugar level is low (normal 60 -110 mg/dl, but is not critical)
• An adult with a blood sugar of 384 mg/dl and a urine output of 350 ml in the last hour
(exhibiting sign of diabetes insipidus, which include hyperglycemia & urine output,
but this patient can be seen after corticosteroid pt)
• A client taking corticosteroids who has become disoriented in the last two hours (safety)
* Rationale: safety is a priority intervention. Mania & psychosis can occur during
corticosteroid therapy, which places the client at risk for injury, so this should be first seen.
5. A young boy who is in a chronic vegetative state and living at home is readmitted to
the hospital with pneumonia and pressure ulcers. The mother insists that she is
capable of caring for her son and that she is going to take him home when he is
discharged. Which action should the nurse implement next?
• Report the incident to the local Child Protective Service (further assessment is
needed before implementing)
• Find a home health agency that specializes in brain injuries (further assessment
is needed before implementing)
• Determine the mother’s basic skill level in providing care (client is manifesting
disease syndrome complications, and the mother’s skill in providing basic care should
be determined)
• Consult the ethics committee to determine how to proceed (further assessment
is needed before implementing)
6. A male client with persistent low back pain has received a prescription for an
electronic stimulator (TENS) unit. After the nurse applies the electrodes and turns on
the power, the client reports feeling a tingling sensation. How should the nurse
respond?
, 3
• Determine if the sensation feels uncomfortable (Electronic stimulators, such as a
transelectrial nerve stimulator (TENS) unit, effective in reducing low back pain by
“closing the gate” to pain stimuli. A tingling sensation should be felt when the power
is turned on, and the nurse should assess whether the sensation is too strong, causing
discomfort or muscle twitching)
• Decrease the strength of the electrical signals (indicated if the sensation is too strong)
• Remove electrodes and observe for skin redness (not necessary because the
tingling sensation is expected)
• Check the amount of gel coating on the electrodes (not necessary because the
tingling sensation is expected)
7. A male client returns to the mental health clinic for assistance with his anxiety reaction
that is manifested by a rapid heartbeat, sweating, shaking, and nausea while driving
over the bay bridge. What action in the treatment plan should the nurse implement?
• Tell client to drive over the bridge until fear is manageable
• Teach client to listen to music or audio books while driving
• Encourage client to have spouse drive in stressful places
• Recommend that the client avoid driving over the bridge
8. The nurse preparing to administer 1.6 ml of medication IM to a 4-month-old
infant. Which action the nurse include?
• Select a 22 gauge 1 ½ inch (3.8 cm) needle for the intramuscular injection A short,
small gauge needle should be to inject into the small muscle mass of an infant rather
than which is used for an adult)
• Administer into the deltoid muscle while the parent holds the infant securely
(deltoid muscle site in the arm should not be used in infants whose muscle mass is
underdeveloped)
• Divide the medication into two injections with volumes under 1 ml
• Use a quick dart-like motion to inject into the dorsogluteal site (dorsoglutel site is
not recommended due to the proximity to nerves and blood vessels)
* IM injection for children under 3 year of age should not exceed 1 ml, so the prescribed
dose should be divided into smaller volumes for injection in two different sites.
9. Which problem reported by a client taking lovastatin requires the most
immediate follow-up by the nurse?
• Diarrhea and flatulence (are also side effect of lovastatin that require intervention,
but are of loss priority)
, 4
• Abdominal cramps (are also side effect of lovastatin that require intervention, but are
of loss priority)
• Muscle pain (Lovastatin main priority of side effect)
• Altered taste (are also side effect of lovastatin that require intervention, but are of
loss priority)
* Statins can cause rhabdomyolysis, a potentially fatal disease of skeletal muscle
characterized by myoglobinuria and manifested with muscle pain, so this symptom should
immediately be reported to the health care provider
10. The nurse is triaging victims of a tornado at an emergency shelter. An adult woman
who has been wandering and crying comes to the nurse. What action should the nurse
take?
• Check the client’s temperature, blood sugar, and urine output
• Transport the client for laboratory tests and electrocardiogram (EKG)
• Delegate care of the crying client to an unlicensed assistant
• Send the client to the shelter’s nutrient center to obtain water and food
11. The nurse is collecting a sterile sample for culture and sensitivity form a disposable
three chamber-seal drainage system connected to a pleural chest tube. The nurse
should obtain the sample from which site on the drainage system?
• Tubing located on the top of the suction chamber (do not provide access to
chest drainage)
• Plastic tubing located at the chest insertion site (should not be disconnected or
accessed to collect a sample)
• Stopper port located above the water-seal level (do not provide access to
chest drainage)
• Rubberized port at the bottom of collection chamber (with one-way value)
12. The healthcare provider prescribes a low-fiber diet for a client with ulcerative
colitis. Selection of which food items indicates to the nurse that the client
understands the prescribed diet?
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