HESI: Med Surg - Practice Questions And Accurate Answers

HESI: Med Surg - Practice Questions A client experiencing uncontrolled atrial fibrillation is admitted to the telemetry unit. Which initial medication should the nurse anticipate administering to the client? Xylocaine. Procainamide. Phenytoin. Digoxin. - Digoxin. Digoxin is administered for uncontrolled, symptomatic atrial fibrillation resulting in a decreased cardiac output. Digoxin slows the rate of conduction by prolonging the refractory period of the AV node, thus slowing the ventricular response, decreasing the heart rate, and effecting cardiac output. Which condition should the nurse suspect when a client reports vaginal dryness during intercourse? Obstructed Bartholin's glands. Hyperactive sebaceous glands. Infected bulbourethral glands. Strangulated prostate gland. - Obstructed Bartholin's glands. Bartholin's glands are located posteriorly on each side of the vaginal opening; they secrete lubrication fluid during sexual excitement. The nurse should suspect obstructed Bartholin's glands when a client reports vaginal dryness during intercourse.Ignatavicius, (2016). Medical-surgical nursing: Patient-centered collaborative care, eight edition., Ch. 69, p. 1450. Which physical assessment finding should the nurse anticipate in a client with long-term gastroesophagealreflux disease (GERD)? Hoarseness. Dry mouth. Mouth ulcers. Weight loss. - Hoarseness. Dyspepsia and regurgitation are the main symptoms of gastroesophageal reflux disease (GERD); however, hoarseness is one of the most common long-term symptoms of GERD due to the irritation of the reflux of gastric secretions. A client who is fully awake after a gastroscopy asks the nurse for something to drink. After confirming that liquids are allowed, which assessment action should the nurse consider a priority? Listen to bilateral lung and bowel sounds. Obtain the client's pulse and blood pressure. Assist the client to the bathroom to void. Check the client's gag and swallow reflexes. - Check the client's gag and swallow reflexes. Following gastroscopy, a client should remain nothing by mouth until the effects of local anesthesia have dissipated and the airway's protective gag and swallow reflexes have returned. A client has undergone insertion of a permanent pacemaker. When developing a discharge teaching plan, the nurse writes a goal of, "The client will verbalize symptoms of pacemaker failure." Which symptoms are most important to teach the client? Facial flushing. Fever. Pounding headache. Feelings of dizziness. - Feelings of dizziness. Feelings of dizziness may occur as the result of a decreased heart rate, leading to a decreased cardiac output which may be an indication of pacemaker failure. Two days postoperative, a male client reports aching pain in his left leg. The nurse assesses redness and warmth on the lower left calf. Which intervention would be most helpful to this client? Apply sequential compression devices (SCDs) bilaterally. Assess for a positive Homan's sign in each leg. Pad all bony prominences on the affected leg. Incorrect Advise the client to remain in bed with the leg elevated. - Advise the client to remain in bed with the leg elevated. Correct For a client exhibiting symptoms of deep vein thrombosis (DVT), a complication of immobility, the initial care includes bedrest and elevation of the extremity. A client receiving cholestyramine for hyperlipidemia should be evaluated for which vitamin deficiency? K. B12. B6. C. - K. Cholestyramine is administered to help lower the triglycerides levels. Side effects clients should be monitored for include increased prothrombin time and prolonged bleeding times which would alert the nurse to a vitamin K deficiency. These drugs reduce absorption of the fat soluble (lipid) vitamins A, D, E, and K. An elderly client is admitted with a diagnosis of bacterial pneumonia. When observing the client for the first signs of decreasing oxygenation, the nurse should assess for which clinical cues? Abominal distention. Undue fatigue. Cyanosis of the lips. Confusion and tachycardia. - Confusion and tachycardia. The onset of pneumonia in the elderly may be signaled by general deterioration, confusion, increased heart rate or increased respiratory rate due to the decreased oxygen- carbon dioxide exchange at the alveoli, known as the V-Q mismatch. Cyanosis is a very late sign. The nurse is caring for a client with a stroke resulting in right-sided paresis and aphasia. The client attempts to use the left hand for feeding and other self-care activities. The spouse becomes frustrated and insists on doing everything for the client. Based on this data, which nursing problem should the nurse document for this client? -Situational low self-esteem related to functional impairment and change in role function. -Disabled family coping related to dissonant coping style of significant person. Correct -Interrupted family processes related to shift in health status of family member. Incorrect -Risk for ineffective therapeutic regimen management related to complexity of care. - Disabled family coping related to dissonant coping style of significant person. A stroke affects the whole family and in this case the spouse probably thinks that she is helping and needs to feel that she is contributing to the client's care. Her help is noted as being incongruent with attempts of self-care by the client thereby disabling family coping. The nurse is planning to initiate a socialization group for older residents of a long-term facility. Which information would be most useful to the nurse when planning activities for the group? -The length of time each group member has resided at the nursing home. -A brief description of each resident's family life. -The age of each group member. -The usual activity patterns of each member of the group. - The usual activity patterns of each member of the group. An older person's level of activity is a determining factor in adjustment to aging as described by the Activity Theory of Aging. The most useful information initially would be an assessment of each individual's adjustment to the aging process. A client who is sexually active with several partners requests an intrauterine device (IUD) as a contraceptive method. Which information should the nurse provide? -Using an IUD offers no protection against sexually transmitted diseases (STD), which increase the risk for pelvic inflammatory disease (PID). -Getting pregnant while using an IUD is common and is not the best contraceptive choice. -Relying on an IUD may be a safer choice for monogamous partners, but a barrier method provides a better option in preventing STD transmission. -Selecting a contraceptive device should consider choosing a successful method used in the past. - Using an IUD offers no protection against sexually transmitted diseases (STD), which increase the risk for pelvic inflammatory disease (PID). The use of an intrauterine device (IUD) provides the client with no protection from sexually transmitted diseases (STD). Which finding should the nurse identify as most significant for a client diagnosed with polycystic kidney disease (PKD)? Hematuria. 2 pounds weight gain. 3+ bacteria in urine. Steady, dull flank pain. - 3+ bacteria in urine. Urinary tract infections (UTI) for a client with polycystic kidney disease (PKD) require prompt antibiotic therapy to prevent renal damage and scarring which may cause further progression of the disease so bacteria in the urine would be significant finding. A client with heart disease is on a continuous telemetry monitor and has developed sinus bradycardia. In determining the possible cause of the bradycardia, the nurse assesses the client's medication record. Which medication is most likely the cause of the bradycardia? Propanolol. Captopril. Furosemide. Dobutamine. - Propanolol. Propanolol is a beta adrenergic blocking agent, which causes decreased heart rate and decreased contractility. When providing discharge teaching for a client with osteoporosis, the nurse should reinforce which home care activity? A diet low in phosphates. Skin inspection for bruising. Exercise regimen, including swimming. Elimination of hazards to home safety. - Elimination of hazards to home safety. Discussion about fall prevention strategies is imperative for the discharged client with osteoporosis. Advice about safety measures in the home should be provided such as the elimination of throw rugs and proper lighting to minimize trip hazards and falls.