HESI Med SURG Practice EXAM QUESTIONS AND ANSWERS COMPLETE SOLUTION 2021 DOCS

 Questions

• The nurse is assessing a client's laboratory values

following administration of chemotherapy. Which lab value

leads the nurse to suspect that the client is experiencing

tumor lysis syndrome (TLS)?

• Serum PTT of 10 seconds.

• Serum calcium of 5 mg/dl. Correct

• Oxygen saturation of 90%.

• Hemoglobin of 10 g/dl.

•

TLS results in hyperkalemia, hypocalcemia, hyperuricemia,

and hyperphosphatemia. A serum calcium level of 5 (B),

which is low, is an indicator of possible tumor lysis

syndrome. (A, C, and D) are not particularly related to TLS.

Awarded 0.0 points out of 1.0 possible points.

• 2.

ID: 6974889585

A client is admitted to the hospital with a diagnosis of severe

acute diverticulitis. Which assessment finding should the

nurse expect this client to exhibit?

• Lower left quadrant pain and a low-grade fever. Correct

• Severe pain at McBurney's point and nausea.

• Abdominal pain and intermittent tenesmus.

• Exacerbations of severe diarrhea.

•

Left lower quadrant pain occurs with diverticulitis because

the sigmoid colon is the most common area for diverticula,

and the inflammation of diverticula causes a low-grade fever

(A). (B) would be indicative of appendicitis. (C and D) are

symptoms exhibited with ulcerative colitis. Awarded 0.0

points out of 1.0 possible points.

• 3.

ID: 6974891763

During CPR, when attempting to ventilate a client's lungs,

the nurse notes that the chest is not moving. What action

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should the nurse take first?

• Use a laryngoscope to check for a foreign body lodged in

the esophagus.

• Reposition the head to validate that the head is in the

proper position to open the airway. Correct

• Turn the client to the side and administer three back blows.

• Perform a finger sweep of the mouth to remove any

vomitus.

•

The most frequent cause of inadequate aeration of the

client's lungs during CPR is improper positioning of the head

resulting in occlusion of the airway (B). A foreign body can

occlude the airway, but this is not common unless choking

preceded the cardiac emergency, and (A, C and D) should

not be the nurse's first action. Awarded 0.0 points out of 1.0

possible points.

• 4.

ID: 6974891794

A client is admitted to the hospital with a medical diagnosis

of pneumococcal pneumonia. The nurse knows that the

prognosis for gram-negative pneumonias (such as E. coli,

Klebsiella, Pseudomonas, and Proteus) is very poor because

• they occur in the lower lobe alveoli which are more

sensitive to infection.

• gram-negative organisms are more resistant to antibiotic

therapy. Correct

• they occur in healthy young adults who have recently been

debilitated by an upper respiratory infection.

• gram-negative pneumonias usually affect infants and small

children.

•

The gram-negative organisms are resistant to drug therapy

(B) which makes recovery very difficult. Gram-negative

pneumonias affect all lobes of the lung (A). The mean age for

contracting this type of pneumonia is 50 years (C and D),

and it usually strikes debilitated persons such as alcoholics,

diabetics, and those with chronic lung diseases. Awarded 0.0

points out of 1.0 possible points.

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• 5.

ID: 6974891705

A client is placed on a mechanical ventilator following a

cerebral hemorrhage, and vecuronium bromide (Norcuron)

0.04 mg/kg q12 hours IV is prescribed. What is the priority

nursing diagnosis for this client?

• Impaired communication related to paralysis of skeletal

muscles. Correct

• High risk for infection related to increased intracranial

pressure.

• Potential for injury related to impaired lung expansion.

• Social isolation related to inability to communicate.

•

To increase the client's tolerance of endotracheal intubation

and/or mechanical ventilation, a skeletal-muscle relaxant,

such as vecuronium, is usually prescribed. Impaired

communication (A) is a serious outcome because the client

cannot communicate his/her needs due to intubation and

diaphragmatic paralysis caused by the drug. Although this

client might also experience (D), it is not a priority when

compared to (A). Infection is not related to increased

intracranial pressure (B). The mechanical venilator provides

consistent lung expansion (C). Awarded 0.0 points out of 1.0

possible points.

• 6.

ID: 6974890435

When preparing a client who has had a total laryngectomy

for discharge, what instruction is most important for the

nurse to include in the discharge teaching?

• Recommend that the client carry suction equipment at all

times.

• Instruct the client to have writing materials with him at all

times.

• Tell the client to carry a medic alert card stating that he is a

total neck breather. Correct

• Tell the client not to travel alone.

•

It is imperative that total neck breathers carry a medic alert

notice (C) so that if they have a cardiac arrest, mouth-toneck breathing can be done. Mouth-to-mouth resuscitation

will not help them. They do not need to carry (A) nor refrain

from (D). There are many alternative means of

 3 / 4

communication for clients who have had a laryngectomy;

depending on (B) is probably the least effective. How do you

know he can read and write? Awarded 0.0 points out of 1.0

possible points.

• 7.

ID: 6974891729

The nurse would be correct in withholding a dose of digoxin

in a client with congestive heart failure without specific

instruction from the healthcare provider if the client's

• serum digoxin level is 1.5.

• blood pressure is 104/68.

• serum potassium level is 3. Correct

• apical pulse is 68/min.

•

Hypokalemia (C) can precipitate digitalis toxicity in persons

receiving digoxin which will increase the chance of

dangerous dysrhythmias (normal potassium level is 3.5 to

5.5 mEq/L). The therapeutic range for digoxin is 0.8 to 2

ng/ml (toxic levels=>2 ng/ml); (A) is within this range. (B)

would not warrant the nurse withholding the digoxin. The

nurse should withhold the digoxin if the apical pulse is less

than 60/min (D). Awarded 0.0 points out of 1.0 possible

points.

• 8.

ID: 6974890473

After the fourth dose of gentamicin sulfate (Garamycin) IV,

the nurse plans to draw blood samples to determine peak

and trough levels. When are the best times to draw these

samples?

• 15 minutes before and 15 minutes after the next dose.

• One hour before and one hour after the next dose.

• 5 minutes before and 30 minutes after the next dose.

Correct

• 30 minutes before and 30 minutes after the next dose.

•

Peak drug serum levels are achieved 30 minutes after IV

administration of aminoglycosides. The best time to draw a

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ADVANCED Med SURG HESI Final RN V2 TEST BANK 1. Pulmonary artery wedge pressure (SWAN GANZ) ● Assess/monitor for dysrhythmias 2. Pt w/ dysrhythmias (pg 99) ● Calcium of 7.2 (low) 3. LOW Cardiac output ● MI 4. Renal Failure (pg 79) ● 45% BUN 5. S/S of shock (pg 30) ● Hypotension, thready pulse 6. How to check for Carbon monoxide poisoning ● Cherry red mouth or tongue 7. Paracentesis ● Empty bladder completely before procedure ...

Med surg Hesi 2021

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med surg hesi 2020/2021 EDITION ALL ANSWERS 100% CORRECT AID GRADE A+

1) A female client with a nasogastric tube attached to low suction states that she is nauseated. The nurse assesses that there has been no drainage through the nasogastric tube in the last 2 hours. Which action should the nurse take first? A. Irrigate the nasogastric tube with sterile normal saline. B. Reposition the client on her side. C. Advance the nasogastric tube 5 cm. D. Administer an intravenous antiemetic as prescribed. B. The priority is to determined if the tube is funct...

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