MED SURG II HESI REVIEW EXAM PAPER QUESTIONS
AND ANSWERS SURE A+
✔✔A client with a peptic ulcer has been instructed to avoid intense physical
activity and stress. Which strategy should the client incorporate into the home care
plan?
1. Conduct physical activity in the morning in order to be able to rest in the
afternoon.
2. Have the family agree to perform the necessary yard work at home.
3. Give up jogging and substitute a less demanding hobby.
4. Incorporate periods of physical and mental rest in the daily schedule. - ✔✔4.
Incorporate periods of physical and mental rest in the daily schedule.
✔✔A client is to take one daily dose of ranitidine (Zantac) at home to treat a peptic
ulcer. The client understands proper drug administration of ranitidine when the client will
take the drug at which of the following times?
1. Before meals.
2. With meals.
3. At bedtime.
4. When pain occurs. - ✔✔3. At bedtime.
✔✔A client has been taking aluminum hydroxide 30 mL six times per day at home to
treat a peptic ulcer. The client has been unable to have a bowel movement for 3 days.
Based on this information, the nurse would determine that which of the following is the
most likely cause of the client's constipation?
1. The client has not been including enough fiber in the diet.
2. The client needs to increase the daily exercise.
3. The client is experiencing an adverse effect of the aluminum hydroxide.
4. The client has developed a gastrointestinal obstruction. - ✔✔3. The client is
experiencing an adverse effect of the aluminum hydroxide.
✔✔A client is taking an antacid for treatment of a peptic ulcer. Which of the
following statements best indicates that the client understands how to correctly take the
antacid?
1. "I should take my antacid before I take my other medications."
2. "I need to decrease my intake of fluids so that I don't dilute the effects of my antacid."
3. "My antacid will be most effective if I take it whenever I experience stomach pains."
4. "It is best for me to take my antacid 1 to 3 hours after meals." - ✔✔4. "It is best for me
to take my antacid 1 to 3 hours after meals."
,✔✔Which of the following would be an expected outcome for a client with peptic ulcer
disease? The client will:
1. Demonstrate appropriate use of analgesics to control pain.
2. Explain the rationale for eliminating alcohol from the diet.
3. Verbalize the importance of monitoring hemoglobin and hematocrit every 3 months.
4. Eliminate engaging in contact sports. - ✔✔2. Explain the rationale for eliminating
alcohol from the diet.
✔✔Which of the following would be an expected outcome for a client with peptic ulcer
disease? The client will:
1. Demonstrate appropriate use of analgesics to control pain.
2. Explain the rationale for eliminating alcohol from the diet.
3. Verbalize the importance of monitoring hemoglobin and hematocrit every 3 months.
4. Eliminate engaging in contact sports. - ✔✔2. Explain the rationale for eliminating
alcohol from the diet.
✔✔A client with suspected gastric cancer undergoes an endoscopy of the stomach.
Which of the following assessments made after the procedure would indicate the
development of a potential complication?
1. The client has a sore throat.
2. The client displays signs of sedation.
3. The client experiences a sudden increase in temperature.
4. The client demonstrates a lack of appetite. - ✔✔3. The client experiences a sudden
increase in temperature.
✔✔A client has been diagnosed with adenocarcinoma of the stomach and is
scheduled to undergo a subtotal gastrectomy (Billroth II procedure). During preoperative
teaching, the nurse is reinforcing information about the surgical procedure. Which of the
following explanations is most accurate?
1. The procedure will result in enlargement of the pyloric sphincter.
2. The procedure will result in anastomosis of the gastric stump to the jejunum.
3. The procedure will result in removal of the duodenum.
4. The procedure will result in repositioning of the vagus nerve. - ✔✔2. The procedure
will result in anastomosis of the gastric stump to the jejunum.
✔✔Since the diagnosis of stomach cancer, the client has been having trouble
sleeping and is frequently preoccupied with thoughts about how life will change. The
client says, "I wish my life could stay the same." Based on this information, the nurse
should understand that the client:
1. Is having difficulty coping.
, 2. Has a sleep disorder.
3. Is grieving.
4. Is anxious. - ✔✔3. Is grieving
✔✔After a subtotal gastrectomy, the nasogastric tube drainage will be what color for
about 12 to 24 hours after surgery?
1. Dark brown.
2. Bile green.
3. Bright red.
4. Cloudy white. - ✔✔1. Dark brown
✔✔A client has a nasogastric (NG) tube following a subtotal gastrectomy. The
nurse should:
1. Irrigate the tube with 30 mL of sterile water every hour, if needed.
2. Reposition the tube if it is not draining well.
3. Monitor the client for nausea, vomiting, and abdominal distention.
4. Turn the machine to high suction if the drainage is sluggish on low suction. - ✔✔3.
Monitor the client for nausea, vomiting, and abdominal distention.
✔✔A client who is recovering from gastric surgery is receiving IV fluids to be infused at
100 mL/h. The IV tubing delivers 15 gtt/mL. The nurse should infuse the solution at a
flow rate of how many drops per minute to ensure that the client receives 100 mL/h?
____________ gtt/min. - ✔✔25 gtt/min
To administer IV fluids at 100 mL/h using tubing that has a drip factor of 15 gtt/mL, the
nurse should use the following formula: 100 mL/60 minutes × 15 gtts/1 mL = 25 gtt/min.
✔✔Following a gastrectomy, the nurse should position the client in which of the
following positions?
1. Prone.
2. Supine.
3. Low Fowler's.
4. Right or left Sims. - ✔✔3. Low Fowler's
✔✔After a subtotal gastrectomy, the nurse is developing a plan with the client to assist
the client to gain weight. To help the client meet nutritional goals at home, the nurse
should:
1. Instruct the client to increase the amount eaten at each meal.
2. Encourage the client to eat smaller amounts more frequently.
3. Explain that if vomiting occurs after a meal, nothing more should be eaten that day.
AND ANSWERS SURE A+
✔✔A client with a peptic ulcer has been instructed to avoid intense physical
activity and stress. Which strategy should the client incorporate into the home care
plan?
1. Conduct physical activity in the morning in order to be able to rest in the
afternoon.
2. Have the family agree to perform the necessary yard work at home.
3. Give up jogging and substitute a less demanding hobby.
4. Incorporate periods of physical and mental rest in the daily schedule. - ✔✔4.
Incorporate periods of physical and mental rest in the daily schedule.
✔✔A client is to take one daily dose of ranitidine (Zantac) at home to treat a peptic
ulcer. The client understands proper drug administration of ranitidine when the client will
take the drug at which of the following times?
1. Before meals.
2. With meals.
3. At bedtime.
4. When pain occurs. - ✔✔3. At bedtime.
✔✔A client has been taking aluminum hydroxide 30 mL six times per day at home to
treat a peptic ulcer. The client has been unable to have a bowel movement for 3 days.
Based on this information, the nurse would determine that which of the following is the
most likely cause of the client's constipation?
1. The client has not been including enough fiber in the diet.
2. The client needs to increase the daily exercise.
3. The client is experiencing an adverse effect of the aluminum hydroxide.
4. The client has developed a gastrointestinal obstruction. - ✔✔3. The client is
experiencing an adverse effect of the aluminum hydroxide.
✔✔A client is taking an antacid for treatment of a peptic ulcer. Which of the
following statements best indicates that the client understands how to correctly take the
antacid?
1. "I should take my antacid before I take my other medications."
2. "I need to decrease my intake of fluids so that I don't dilute the effects of my antacid."
3. "My antacid will be most effective if I take it whenever I experience stomach pains."
4. "It is best for me to take my antacid 1 to 3 hours after meals." - ✔✔4. "It is best for me
to take my antacid 1 to 3 hours after meals."
,✔✔Which of the following would be an expected outcome for a client with peptic ulcer
disease? The client will:
1. Demonstrate appropriate use of analgesics to control pain.
2. Explain the rationale for eliminating alcohol from the diet.
3. Verbalize the importance of monitoring hemoglobin and hematocrit every 3 months.
4. Eliminate engaging in contact sports. - ✔✔2. Explain the rationale for eliminating
alcohol from the diet.
✔✔Which of the following would be an expected outcome for a client with peptic ulcer
disease? The client will:
1. Demonstrate appropriate use of analgesics to control pain.
2. Explain the rationale for eliminating alcohol from the diet.
3. Verbalize the importance of monitoring hemoglobin and hematocrit every 3 months.
4. Eliminate engaging in contact sports. - ✔✔2. Explain the rationale for eliminating
alcohol from the diet.
✔✔A client with suspected gastric cancer undergoes an endoscopy of the stomach.
Which of the following assessments made after the procedure would indicate the
development of a potential complication?
1. The client has a sore throat.
2. The client displays signs of sedation.
3. The client experiences a sudden increase in temperature.
4. The client demonstrates a lack of appetite. - ✔✔3. The client experiences a sudden
increase in temperature.
✔✔A client has been diagnosed with adenocarcinoma of the stomach and is
scheduled to undergo a subtotal gastrectomy (Billroth II procedure). During preoperative
teaching, the nurse is reinforcing information about the surgical procedure. Which of the
following explanations is most accurate?
1. The procedure will result in enlargement of the pyloric sphincter.
2. The procedure will result in anastomosis of the gastric stump to the jejunum.
3. The procedure will result in removal of the duodenum.
4. The procedure will result in repositioning of the vagus nerve. - ✔✔2. The procedure
will result in anastomosis of the gastric stump to the jejunum.
✔✔Since the diagnosis of stomach cancer, the client has been having trouble
sleeping and is frequently preoccupied with thoughts about how life will change. The
client says, "I wish my life could stay the same." Based on this information, the nurse
should understand that the client:
1. Is having difficulty coping.
, 2. Has a sleep disorder.
3. Is grieving.
4. Is anxious. - ✔✔3. Is grieving
✔✔After a subtotal gastrectomy, the nasogastric tube drainage will be what color for
about 12 to 24 hours after surgery?
1. Dark brown.
2. Bile green.
3. Bright red.
4. Cloudy white. - ✔✔1. Dark brown
✔✔A client has a nasogastric (NG) tube following a subtotal gastrectomy. The
nurse should:
1. Irrigate the tube with 30 mL of sterile water every hour, if needed.
2. Reposition the tube if it is not draining well.
3. Monitor the client for nausea, vomiting, and abdominal distention.
4. Turn the machine to high suction if the drainage is sluggish on low suction. - ✔✔3.
Monitor the client for nausea, vomiting, and abdominal distention.
✔✔A client who is recovering from gastric surgery is receiving IV fluids to be infused at
100 mL/h. The IV tubing delivers 15 gtt/mL. The nurse should infuse the solution at a
flow rate of how many drops per minute to ensure that the client receives 100 mL/h?
____________ gtt/min. - ✔✔25 gtt/min
To administer IV fluids at 100 mL/h using tubing that has a drip factor of 15 gtt/mL, the
nurse should use the following formula: 100 mL/60 minutes × 15 gtts/1 mL = 25 gtt/min.
✔✔Following a gastrectomy, the nurse should position the client in which of the
following positions?
1. Prone.
2. Supine.
3. Low Fowler's.
4. Right or left Sims. - ✔✔3. Low Fowler's
✔✔After a subtotal gastrectomy, the nurse is developing a plan with the client to assist
the client to gain weight. To help the client meet nutritional goals at home, the nurse
should:
1. Instruct the client to increase the amount eaten at each meal.
2. Encourage the client to eat smaller amounts more frequently.
3. Explain that if vomiting occurs after a meal, nothing more should be eaten that day.
