HESI Med Surg 2020/2021-100% Correct Questions and Answers The best Study Guide for Exam Preparation
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Nursing
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Med Surg Study Guide
HESI Med Surg 2020/2021
100% Correct Questions and Answers
The best Study Guide for Exam Preparation
Over 120 Questions and Answers
1.The nurse assesses a patient with shortness of breath for evidence of long-standing hypoxemia
by inspecting:
A. Chest excursion
B. Spinal curvatures
C. The ...
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HESI Med Surg 2020/2021
100% Correct Questions and Answers
The best Study Guide for Exam Preparation
1.The nurse assesses a patient with shortness of breath for evidence of long-standing hypoxemia
by inspecting:
A. Chest excursion
B. Spinal curvatures
C. The respiratory pattern
D. The fingernail and its base
D. The fingernail and its base Clubbing, a sign of long-standing hypoxemia, is evidenced by an
increase in the angle between the base of the nail and the fingernail to 180 degrees or more,
usually accompanied by an increase in the depth, bulk, and sponginess of the end of the finger.
2. The nurse is caring for a patient with COPD and pneumonia who has an order for arterial
blood gases to be drawn. Which of the following is the minimum length of time the nurse should
plan to hold pressure on the puncture site?
A. 2 minutes
B. 5 minutes
C. 10 minutes
D. 15 minutes
B. 5 minutes Following obtaining an arterial blood gas, the nurse should hold pressure on the
puncture site for 5 minutes by the clock to be sure that bleeding has stopped. An artery is an
elastic vessel under higher pressure than veins, and significant blood loss or hematoma formation
could occur if the time is insufficient.
3. The nurse notices clear nasal drainage in a patient newly admitted with facial trauma,
including a nasal fracture. The nurse should:
A. test the drainage for the presence of glucose.
B. suction the nose to maintain airway clearance.
,C. document the findings and continue monitoring.
D. apply a drip pad and reassure the patient this is normal.
A. test the drainage for the presence of glucose. Clear nasal drainage suggests leakage of
cerebrospinal fluid (CSF). The drainage should be tested for the presence of glucose, which
would indicate the presence of CSF.
4. When caring for a patient who is 3 hours postoperative laryngectomy, the nurse's highest
priority assessment would be:
A. Airway patency
B. Patient comfort
C. Incisional drainage
D. Blood pressure and heart rate
A. Airway patency Remember ABCs with prioritization. Airway patency is always the highest
priority and is essential for a patient undergoing surgery surrounding the upper respiratory
system.
5. When initially teaching a patient the supraglottic swallow following a radical neck dissection,
with which of the following foods should the nurse begin?
A. Cola
B. Applesauce
C. French fries
D. White grape juice
A. ColaWhen learning the supraglottic swallow, it may be helpful to start with carbonated
beverages because the effervescence provides clues about the liquid's position. Thin, watery
fluids should be avoided because they are difficult to swallow and increase the risk of aspiration.
Nonpourable pureed foods, such as applesauce, would decrease the risk of aspiration, but
carbonated beverages are the better choice to start with.
6. The nurse is caring for a patient admitted to the hospital with pneumonia. Upon assessment,
the nurse notes a temperature of 101.4° F, a productive cough with yellow sputum and a
respiratory rate of 20. Which of the following nursing diagnosis is most appropriate based upon
this assessment? A. Hyperthermia related to infectious illness
B. Ineffective thermoregulation related to chilling
,C. Ineffective breathing pattern related to pneumonia
D. Ineffective airway clearance related to thick secretions
A. Hyperthermia related to infectious illness Because the patient has spiked a temperature and
has a diagnosis of pneumonia, the logical nursing diagnosis is hyperthermia related to infectious
illness. There is no evidence of a chill, and her breathing pattern is within normal limits at 20
breaths per minute. There is no evidence of ineffective airway clearance from the information
given because the patient is expectorating sputum.
7. Which of the following physical assessment findings in a patient with pneumonia best
supports the nursing diagnosis of ineffective airway clearance?
A. Oxygen saturation of 85%
B. Respiratory rate of 28
C. Presence of greenish sputum
D. Basilar crackles
D. Basilar crackles The presence of adventitious breath sounds indicates that there is
accumulation of secretions in the lower airways. This would be consistent with a nursing
diagnosis of ineffective airway clearance because the patient is retaining secretions.
8. Which of the following clinical manifestations would the nurse expect to find during
assessment of a patient admitted with pneumococcal pneumonia? A. Hyperresonance on
percussion
B. Fine crackles in all lobes on auscultation
C. Increased vocal fremitus on palpation
D. Vesicular breath sounds in all lobes
C. Increased vocal fremitus on palpation. A typical physical examination finding for a patient
with pneumonia is increased vocal fremitus on palpation. Other signs of pulmonary
consolidation include dullness to percussion, bronchial breath sounds, and crackles in the
affected area.
9. Which of the following nursing interventions is of the highest priority in helping a patient
expectorate thick secretions related to pneumonia?
A. Humidify the oxygen as able
B. Increase fluid intake to 3L/day if tolerated.
, C. Administer cough suppressant q4hr.
D. Teach patient to splint the affected area.
B. Increase fluid intake to 3L/day if tolerated. Although several interventions may help the
patient expectorate mucus, the highest priority should be on increasing fluid intake, which will
liquefy the secretions so that the patient can expectorate them more easily. Humidifying the
oxygen is also helpful, but is not the primary intervention. Teaching the patient to splint the
affected area may also be helpful, but does not liquefy the secretions so that they can be
removed.
10. During discharge teaching for a 65-year-old patient with emphysema and pneumonia, which
of the following vaccines should the nurse recommend the patient receive?
A. S. aureus
B. H. influenzae
C. Pneumococcal
D. Bacille Calmette-Guérin (BCG)
C. Pneumococcal The pneumococcal vaccine is important for patients with a history of heart or
lung disease, recovering from a severe illness, age 65 or over, or living in a long-term care
facility.
11. The nurse evaluates that discharge teaching for a patient hospitalized with pneumonia has
been most effective when the patient states which of the following measures to prevent a
relapse?
A. "I will increase my food intake to 2400 calories a day to keep my immune system well."
B. "I must use home oxygen therapy for 3 months and then will have a chest x-ray to reevaluate."
C. "I will seek immediate medical treatment for any upper respiratory infections."
D. "I should continue to do deep-breathing and coughing exercises for at least 6 weeks."
D. "I should continue to do deep-breathing and coughing exercises for at least 6 weeks." It is
important for the patient to continue with coughing and deep breathing exercises for 6 to 8 weeks
until all of the infection has cleared from the lungs. A patient should seek medical treatment for
upper respiratory infections that persist for more than 7 days. Increased fluid intake, not caloric
intake, is required to liquefy secretions. Home O2 is not a requirement unless the patient's
oxygenation saturation is below normal.
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