HESI Med Surg Final Exit Exam 2021
1. You see a 73-year-old woman with a 40 pack year smoking history, chronic obstruction
pulmonary disease and peripheral artery disease who presents with an ulcer on the soul
of her left foot. The also has an irregular edge and pale face and punched out
appearance, with the surrounding skin white and shiny. The patient states that the pain is
worse at night in bed and when the legs are elevated. The most likely diagnosis is:
-arterial ulcer
2. Hey 75-year-old man presents with chief complaints of headache, Nausea, and
muscle weakness. His creatinine level is 2.1 MG/DLNGFR is 30 ML/MIN/1.73 m2. He
currently takes a thiazides diuretic for the management of hypertension. Which of the
following statements is false regarding the use of diuretics in the elderly?
-loop diuretics are contraindicated when GFR is <40 ml/min/1.73 m2
3. All of the following practices are recommended when prescribing medication with
confusing or similar-sounding names except:
- including either the generic or brand name on the prescription order, but not both
4. A 19-year-old is diagnosed with meningococcal meningitis. In order to prevent
secondary infections among adults who had close contact with the patient, all of the
following are recommended except:
- Prophylaxis with acyclovir (Zovirax)
5. A 38-year-old woman comes to the emergency department complaining of a rapid
heartbeat, tremors, and chest tightness. She reports early in the day she was feeling a
migraine starting so she took a pill giving to her by her friend who also experience
migraines. Her medical history reveals that she is currently taking a monoamine oxidase
inhibitor for depression. Which migraine medication did see most likely take?
-Almotriptan ( alert)
6. 826-year-old woman presents with uncomplicated UTI. She is otherwise healthy, has
not received any systematic anti microbials in the past year and it’s not taking any
medications. She is currently not pregnant and is using etonogestrel/ estradiol vaginal
ring for contraception. The local E. Coli resistance rate to TMP/SMX is about 12%. The
preferred therapy for this patient is:
- Trimethoprim-sulfamethoxazole
7. As part of the Deficit reduction act of 2005, Medicare will incorporate quality payment
adjustments for certain hospitals-acquired conditions, including all of the following
except:
-Myocardial ischemic
8. Which of the following example describes a potential malpractice scenario?
-A post-myocardial infraction patient is prescribed an inappropriate dose clopidogrel and
experience a severe blessing episode.
9. A 57-year-old woman presents for a flu shot as she has heard reports that it will be “a
bad flu season’. She has had no primary care for more than 10 years she like health
,HESI Med Surg Final Exit Exam 2021
insurance. She admits to a 30 pack here cigarette smoking history, currently smoking
one pack for a day. Her history and examination are unremarkable. Which screening test
would you recommend?
- Mammography
10. A 28-year-old woman presents who complains of tugging chest pain unrelated to
physical activity. She is generally in good health and non-smoker has a BMI of 23
KG/M2, and denies dyspnea of dizziness. Physical examination reveals a grade 2/6 late
systolic murmur that follows a midsystoloc click at the 5th intercostal space, mid-
clavicular line. An echocardiogram Fails to reveal mitral valve tissue redundancy. This
can you go presentation is most consistent with:
- Mitral Valve prolapse
11. A quality improvement plan characterized by Limiting variability and removing defects
in a process best describes:
- six sigma
12. Laboratory findings of a 28-year-old male suspected of a heart stroke can include all
of the following except:
- Hypermatremia
13. A 42-year-old male presents with a sudden onset of inability to tightly close the eye
lid, frown, or smile on the right side. His examination is otherwise unremarkable and past
medical history is unremarkable. This likely represent paralysis of cranial nerve:
- VII
14. You see a 71-year-old man with atrial fibrillation and chronic obstructive pulmonary
Disease who is diagnosed with community-acquired Pneumonia. His medical history
does not show any drug allergies and he completed a course of respiratory
fluoroquindore for the treatment of acute bacterial sinuses within the past month. Which
of the following would you consider The most appropriate choice of anti-microbial?
-High dose amoxicillin
15. According to the Consolidated Omnibus Reconciliation Act ( CORBA), The spouse of
an eligible employee will be eligible for COBRA coverage in all of the following
circumstances except when the eligible employee:
- is terminated for misconduct
16. A 43-year-old woman presents in the emergency department with a chief complaint
of swelling of the ankles, hands, and face. She also reports urine dad is darkly colored
and foamy. Her blood pressure is 184/118 mm hg. All of the following urinalysis findings
will support a diagnosis of glomerulonephritis except:
- Elevated levels of ketones
17. A 78-year-old male is being treated for hypoglycemia episode. He has a long history
of type 2 diabetes mellitus as well as congestive heart failure and COPD. He is currently
taking basal insulin with a sulfonylurea. What is the acceptable a A1C goal for this
, HESI Med Surg Final Exit Exam 2021
patient?
- <8%
18. Tertiary Prevention activities for a 69-year-old woman with congestive heart failure
and type 2 diabetes mellitus include:
- Adjusting therapy to minimize dyspnea
19. A physicians employs an NP to provide service at a satellite acute care clinic. If the
physician is never present at the clinic, which of the following statements is true?
- The NP services should be billed under the NP’s provider number.
20. You see a 48-year-old man with a chief complaint of pain during urination. Imaging
reveals the presence of a kidney stone in the ureter. Do you consider all of the following
management option except:
- Thiazides diuretic use
21. In managing a 58-year-old woman who is admitted for deep vein thrombosis, caution
should be used with which of the following medication due to risk of heparin induced
thrombocytopenia?
- Enoxaparin (lovenox)
22. You see a 76-year-old woman living at home who is accompanied by her home care
provider. She has COPD and type two diabetes mellitus. An example of a secondary
prevention strategy is:
- Checking her blood pressure
23. All of the following persons are eligible for Medicare service except:
- A 69-year-old undocumented resident in the US with atrial fibrillation
24. The NP is called to treat a 43-year-old woman for multiple contusions following a
domestic violence attack. The NP realizes that one of the best predictors of a
subsequent homicide of victims are domestic violence is:
- History of perpetrator attempting to strangle the victim
25. When initiating therapy for a spironolactone for a patient who Is also and ace
inhibitor, you advise the patient to return in 5 days to check which of the following
laboratory parameters?
- Potassium
26. All of the following are examples of primary prevention strategies except:
- performing a hemoglobin A1C for all patients admitted to the hospital
27. When considering HIPAA regulations, all the following are examples of” individual
identifiable health information” except:
- The number of prescriptions of oxycodone written each month by a provider
28. Which of the following statements is false regarding end-of-life decisions making for
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