MED-SURG HESI PN*++ EXAM 2026
ACTUAL QUESTIONS AND CORRECT
ANSWERS (LATEST
During a clinic visit, a client reports to the practical nurse (PN) that they felt a solid
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mass in their breast during self-
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examination, but it was not painful. What instruction should the PN reinforce with t
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he client?gv
A. Continue to monitor the mass until the next scheduled annual exam.
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B. Notify the PCP if the mass becomes soft or painful or starts to drain.
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C. Schedule an appointment with the PCP for evaluation
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D. Breast masses are usually insignificant if they feel soft or are easily moveable. -
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ANSWERS-
gv
c. Schedule an appointment with the health care provider for evaluation.
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A painless breast mass is an abnormal finding, and the PN should instruct the clie
gv gv gv gv gv gv gv gv gv gv gv gv gv gv
nt to obtain prompt medical evaluation.
gv gv gv gv gv
The health care provider informed a client diagnosed with stage 4 liver cancer that
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the cancer has spread to their spine. The client states to the practical nurse, "I ha
v gv gv gv gv gv gv gv gv gv gv gv gv gv gv gv
ve a cancer, but it is not malignant." What is the best initial nursing action?
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A. Encourage the client to attend a cancer education program
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B. Perform a complete history and physical assessment
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C. Ask the client to explain his understanding of the term malignancy.
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D. Offer the client emotional support to deal with the diagnosis
gv gv gv gv gv gv gv gv gv gv
Submit - ANSWERS- gv gv
c. Ask the client to explain his understanding of the term malignancy.
gv gv gv gv gv gv gv gv gv gv gv
The best initial action is to assess the client's knowledge of the term malignancy w
gv gv gv gv gv gv gv gv gv gv gv gv gv gv
hen used to describe cancer. The client appears to have inaccurate knowledge. St
gv gv gv gv gv gv gv gv gv gv gv gv
age 4 cancer means the cancer has spread (metastasized) from where it has start
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ed to another body part.
gv gv gv gv
A client diagnosed with osteoarthritis. Which intervention should the practical nurse
gv gv gv gv gv gv gv gv gv gv
implement to help relieve joint pain and stiffness?
gv gv gv gv gv gv gv gv
a. Encourage the client to perform weight-bearing exercises.
gv gv gv gv gv gv gv
b. Teach the client how to perform range-of-motion exercises.
gv gv gv gv gv gv gv gv
c. Explain the use of ice and massage for pain relief.
gv gv gv gv gv gv gv gv gv gv
d. Instruct the client to take an analgesic before walking daily - ANSWERS-
gv gv gv gv gv gv gv gv gv gv gv gv
d. Instruct the client to take an analgesic before walking daily.
gv gv gv gv gv gv gv gv gv gv
,Adequate pain management is important for the success of an exercise program.
gv gv gv gv gv gv gv gv gv gv gv gv
Keeping the joints active decreases pain, so taking an analgesic and walking daily
gv gv gv gv gv gv gv gv gv gv gv gv gv
is likely to help decrease joint pain and stiffness.
gv gv gv gv gv gv gv gv
A client diagnosed with prostate cancer is prescribed radioactive seed implantation
gv gv gv gv gv gv gv gv gv gv g
(brachytherapy). What is the most important nursing action for the practical nurse (
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PN) to do? gv gv
a. Follow radiation exposure precautions
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b. Encourage regular meals
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c. Collect all urine in sealed containers
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d. Avoid touching the client. - ANSWERS-a. Follow radiation exposure precautions.
gv gv gv gv gv gv gv gv gv gv
Clients being treated for prostate cancer with brachytherapy (radioactive seeds imp
gv gv gv gv gv gv gv gv gv gv
lant) should be placed on radiation exposure precautions. The PN needs to follow t
gv gv gv gv gv gv gv gv gv gv gv gv gv
he institution's protocols put in place regarding the amount of time and distance ne
gv gv gv gv gv gv gv gv gv gv gv gv gv
eded to prevent excessive exposure that would pose a hazard to others.
gv gv gv gv gv gv gv gv gv gv gv
A client diagnosed with emphysema that is oxygen-
gv gv gv gv gv gv gv
dependent lives alone at home and manages self- gv gv gv gv gv gv gv
care with no difficulty. Which finding should prompt the home health practical nurse
gv gv gv gv gv gv gv gv gv gv gv gv
to consult the registered nurse case manager?
gv gv gv gv gv gv gv
a. A pulse oximetry reading of 91% on oxygen at 2 L/m
gv gv gv gv gv gv gv gv gv gv gv
b. A weight loss of 5 pounds since the last monthly home visit
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c. The client reports feeling as tired as at the last visit by the nurse
gv gv gv gv gv gv gv gv gv gv gv gv gv gv
d. Upon entering the home, the PN noticed dirty dishes and clothing scattered arou
gv gv gv gv gv gv gv gv gv gv gv gv gv
nd the home. - ANSWERS-
gv gv gv gv
b. A weight loss of 5 pounds since the last monthly home visit
gv gv gv gv gv gv gv gv gv gv gv gv
A weight loss of 5 pounds in 1 month is a concern. Clients with COPD need additi
gv gv gv gv gv gv gv gv gv gv gv gv gv gv gv gv
onal calorie intake because they are using up a lot from the energy they are using
gv gv gv gv gv gv gv gv gv gv gv gv gv gv gv gv
to breath. The practical nurse needs to consult with the registered nurse case man
gv gv gv gv gv gv gv gv gv gv gv gv gv
ager for a nutrition consult
gv gv gv gv
The nurse has reinforced instructions to a client with diabetes mellitus on how to s
gv gv gv gv gv gv gv gv gv gv gv gv gv gv
elf-
monitor for symptoms of diabetic ketoacidosis (DKA). The nurse realizes the instru
gv gv gv gv gv gv gv gv gv gv gv
ctions have been effective if the client can list which symptoms? (Select all that ap
gv gv gv gv gv gv gv gv gv gv gv gv gv gv
ply.)
a. Fruity breath odor
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b. Rapid, weak pulse
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c. Cold, clammy skin
gv gv gv
d. Extreme thirst
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e. Urinary frequency
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f. Protruding eyeballs - ANSWERS-a. Fruity breath odor
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b. Rapid, weak pulse
gv gv gv
d. Extreme thirst
gv gv
e. Urinary frequency
gv gv
,Diabetic ketoacidosis is caused by a profound deficiency of insulin. Some common
gv gv gv gv gv gv gv gv gv gv gv g
characteristics include a sweet, fruity breath odor, a rapid weak pulse, extreme thir
v gv gv gv gv gv gv gv gv gv gv gv gv
st, urinary frequency, and sunken-appearing eyeballs.
gv gv gv gv gv
A client mentions using garlic daily as an herb to lower cholesterol and triglyceride
gv gv gv gv gv gv gv gv gv gv gv gv gv gv
levels. Which nursing action is a priority?
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a. Monitor the client for signs of bleeding.
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b. Instruct the client that garlic tends to cause hypertension.
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c. This may relieve fever in the same way that acetaminophen does.
gv gv gv gv gv gv gv gv gv gv gv
d. Remind the patient to use tooth brushing and mouthwash to prevent garlic odor.
gv gv gv gv gv gv gv gv gv gv gv gv gv g
- ANSWERS-a. Monitor the client for signs of bleeding.
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Garlic inhibits platelet aggregation in the same way that aspirin works, and the clie
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nt should be monitored for bleeding. Garlic can lower the blood pressure, not raise
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it. It does not relieve fever. While the client will likely want to avoid garlic odor, it is
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not a priority.
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The practical nurse (PN) is reviewing the health histories of assigned clients. Whic
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h factors have a potential for development of throat cancer? (Select all that apply.)
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a. Tobacco use
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b. Excessive intake of alcohol
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c. Intake of hot and spicy foods
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d. Human papillomavirus (HPV)
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e. Lack of exercise
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f. Lack of dietary fiber - ANSWERS-a. Tobacco use
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b. Excessive intake of alcohol
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d. Human papillomavirus (HPV)
gv gv gv
Rationale:
The most common risk factors for throat cancer are tobacco use, alcohol abuse, h
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uman papillomavirus (HPV), a diet lacking in fruits and vegetable, and gastroesoph
gv gv gv gv gv gv gv gv gv gv gv
ageal reflux disease (GERD). Foods seasoned with herbs and spices have shown
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to have some health benefits in decreasing the risk of developing cancer.
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A client has undergone craniotomy to remove a brain tumor. The client spent sever
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al days in the intensive care unit, and is now on the post-
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surgical unit. The nurse has urgently contact the surgeon to report signs of increasi
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ng intracranial pressure (ICP). Which was the most likely EARLY sign that the clie
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nt was experiencing increased ICP?
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a. The client's blood pressure dropped from 128/70 to 124/68, preoperative BP 122
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/72
b. The client became more confused than he was upon transfer to the post-
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surgical unit. gv
c. The client had a large amount of sanguineous drainage noted on the gauze dre
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ssings.
, d. The client's pulse rate had increased from 70 to 82 beats/min. - ANSWERS-
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b. The client became more confused than he was upon transfer to the post-
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surgical unit. gv
Rationale:
A change in the level of consciousness is most likely the earliest symptom of incre
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ased ICP. Vital sign changes can also occur, with a widening pulse pressure and b
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radycardia. Neither of these are indicated by data in the options. Sanguineous drai
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nage does not indicate increased ICP.
gv gv gv gv gv
The home health practical nurse is visiting with a client who has a history of secon
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d-
degree heart block and pacemaker placement 6 months ago. Which symptom com
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pliant by the client would be indicative of pacemaker failure?
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a. Facial flushing
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b. Nauseagv
c. Pounding headache
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d. Feelings of dizziness - ANSWERS-d. Feelings of dizziness
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Rationale:
Feelings of dizziness may occur as the result of a decreased heart rate, leading to
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decreased cardiac output as a result of pacemaker failure.
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Which actions demonstrate to the practical nurse that the client understands the co
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rrect procedure administration of a metered dose inhaler (MDI)? (Select all that ap
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ply.)
a. Sit or stand.
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b. Shake the inhaler.
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c. Attach the canister of medication to the mouthpiece.
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d. Breathe in through the mouth, filling the lungs.
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e. Use a spacer attachment and place the mouthpiece in the mouth.
gv gv gv gv gv gv gv gv gv gv gv
f. Close the lips around the mouthpiece.
gv gv gv gv gv gv
g. After inhaling the medication, hold the breath 10 seconds. - ANSWERS-
gv gv gv gv gv gv gv gv gv gv gv
b. Shake the inhaler.
gv gv gv
c. Attach the canister of medication to the mouthpiece.
gv gv gv gv gv gv gv gv
e. Use a spacer attachment and place the mouthpiece in the mouth.
gv gv gv gv gv gv gv gv gv gv gv
f. Close the lips around the mouthpiece.
gv gv gv gv gv gv
g. After inhaling the medication, hold the breath 10 seconds.
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Rationale:
The correct sequence of MDI administration includes shaking the inhaler, attaching
gv gv gv gv gv gv gv gv gv gv g
the canister to the mouthpiece, attaching the spacer, the client should then let thei
v gv gv gv gv gv gv gv gv gv gv gv gv gv
r breath out through the mouth to empty the lungs and place the mouthpiece in the
gv gv gv gv gv gv gv gv gv gv gv gv gv gv gv
mouth, closing the lips and mouth around the mouthpiece, and inhaling medicatio
gv gv gv gv gv gv gv gv gv gv gv gv
n and holding the breath for 10 seconds.
gv gv gv gv gv gv gv
The Centers for Disease Control and Prevention (CDC) has issued guidelines for h
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ealth care workers in relation to protection from HIV. The practical nurse (PN) who
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ACTUAL QUESTIONS AND CORRECT
ANSWERS (LATEST
During a clinic visit, a client reports to the practical nurse (PN) that they felt a solid
gv gv gv gv gv gv gv gv gv gv gv gv gv gv gv gv g
mass in their breast during self-
v gv gv gv gv gv
examination, but it was not painful. What instruction should the PN reinforce with t
gv gv gv gv gv gv gv gv gv gv gv gv gv
he client?gv
A. Continue to monitor the mass until the next scheduled annual exam.
gv gv gv gv gv gv gv gv gv gv gv
B. Notify the PCP if the mass becomes soft or painful or starts to drain.
gv gv gv gv gv gv gv gv gv gv gv gv gv gv
C. Schedule an appointment with the PCP for evaluation
gv gv gv gv gv gv gv gv
D. Breast masses are usually insignificant if they feel soft or are easily moveable. -
gv gv gv gv gv gv gv gv gv gv gv gv gv gv
ANSWERS-
gv
c. Schedule an appointment with the health care provider for evaluation.
gv gv gv gv gv gv gv gv gv gv
A painless breast mass is an abnormal finding, and the PN should instruct the clie
gv gv gv gv gv gv gv gv gv gv gv gv gv gv
nt to obtain prompt medical evaluation.
gv gv gv gv gv
The health care provider informed a client diagnosed with stage 4 liver cancer that
gv gv gv gv gv gv gv gv gv gv gv gv gv g
the cancer has spread to their spine. The client states to the practical nurse, "I ha
v gv gv gv gv gv gv gv gv gv gv gv gv gv gv gv
ve a cancer, but it is not malignant." What is the best initial nursing action?
gv gv gv gv gv gv gv gv gv gv gv gv gv gv
A. Encourage the client to attend a cancer education program
gv gv gv gv gv gv gv gv gv
B. Perform a complete history and physical assessment
gv gv gv gv gv gv gv
C. Ask the client to explain his understanding of the term malignancy.
gv gv gv gv gv gv gv gv gv gv gv
D. Offer the client emotional support to deal with the diagnosis
gv gv gv gv gv gv gv gv gv gv
Submit - ANSWERS- gv gv
c. Ask the client to explain his understanding of the term malignancy.
gv gv gv gv gv gv gv gv gv gv gv
The best initial action is to assess the client's knowledge of the term malignancy w
gv gv gv gv gv gv gv gv gv gv gv gv gv gv
hen used to describe cancer. The client appears to have inaccurate knowledge. St
gv gv gv gv gv gv gv gv gv gv gv gv
age 4 cancer means the cancer has spread (metastasized) from where it has start
gv gv gv gv gv gv gv gv gv gv gv gv gv
ed to another body part.
gv gv gv gv
A client diagnosed with osteoarthritis. Which intervention should the practical nurse
gv gv gv gv gv gv gv gv gv gv
implement to help relieve joint pain and stiffness?
gv gv gv gv gv gv gv gv
a. Encourage the client to perform weight-bearing exercises.
gv gv gv gv gv gv gv
b. Teach the client how to perform range-of-motion exercises.
gv gv gv gv gv gv gv gv
c. Explain the use of ice and massage for pain relief.
gv gv gv gv gv gv gv gv gv gv
d. Instruct the client to take an analgesic before walking daily - ANSWERS-
gv gv gv gv gv gv gv gv gv gv gv gv
d. Instruct the client to take an analgesic before walking daily.
gv gv gv gv gv gv gv gv gv gv
,Adequate pain management is important for the success of an exercise program.
gv gv gv gv gv gv gv gv gv gv gv gv
Keeping the joints active decreases pain, so taking an analgesic and walking daily
gv gv gv gv gv gv gv gv gv gv gv gv gv
is likely to help decrease joint pain and stiffness.
gv gv gv gv gv gv gv gv
A client diagnosed with prostate cancer is prescribed radioactive seed implantation
gv gv gv gv gv gv gv gv gv gv g
(brachytherapy). What is the most important nursing action for the practical nurse (
v gv gv gv gv gv gv gv gv gv gv gv gv
PN) to do? gv gv
a. Follow radiation exposure precautions
gv gv gv gv
b. Encourage regular meals
gv gv gv
c. Collect all urine in sealed containers
gv gv gv gv gv gv
d. Avoid touching the client. - ANSWERS-a. Follow radiation exposure precautions.
gv gv gv gv gv gv gv gv gv gv
Clients being treated for prostate cancer with brachytherapy (radioactive seeds imp
gv gv gv gv gv gv gv gv gv gv
lant) should be placed on radiation exposure precautions. The PN needs to follow t
gv gv gv gv gv gv gv gv gv gv gv gv gv
he institution's protocols put in place regarding the amount of time and distance ne
gv gv gv gv gv gv gv gv gv gv gv gv gv
eded to prevent excessive exposure that would pose a hazard to others.
gv gv gv gv gv gv gv gv gv gv gv
A client diagnosed with emphysema that is oxygen-
gv gv gv gv gv gv gv
dependent lives alone at home and manages self- gv gv gv gv gv gv gv
care with no difficulty. Which finding should prompt the home health practical nurse
gv gv gv gv gv gv gv gv gv gv gv gv
to consult the registered nurse case manager?
gv gv gv gv gv gv gv
a. A pulse oximetry reading of 91% on oxygen at 2 L/m
gv gv gv gv gv gv gv gv gv gv gv
b. A weight loss of 5 pounds since the last monthly home visit
gv gv gv gv gv gv gv gv gv gv gv gv
c. The client reports feeling as tired as at the last visit by the nurse
gv gv gv gv gv gv gv gv gv gv gv gv gv gv
d. Upon entering the home, the PN noticed dirty dishes and clothing scattered arou
gv gv gv gv gv gv gv gv gv gv gv gv gv
nd the home. - ANSWERS-
gv gv gv gv
b. A weight loss of 5 pounds since the last monthly home visit
gv gv gv gv gv gv gv gv gv gv gv gv
A weight loss of 5 pounds in 1 month is a concern. Clients with COPD need additi
gv gv gv gv gv gv gv gv gv gv gv gv gv gv gv gv
onal calorie intake because they are using up a lot from the energy they are using
gv gv gv gv gv gv gv gv gv gv gv gv gv gv gv gv
to breath. The practical nurse needs to consult with the registered nurse case man
gv gv gv gv gv gv gv gv gv gv gv gv gv
ager for a nutrition consult
gv gv gv gv
The nurse has reinforced instructions to a client with diabetes mellitus on how to s
gv gv gv gv gv gv gv gv gv gv gv gv gv gv
elf-
monitor for symptoms of diabetic ketoacidosis (DKA). The nurse realizes the instru
gv gv gv gv gv gv gv gv gv gv gv
ctions have been effective if the client can list which symptoms? (Select all that ap
gv gv gv gv gv gv gv gv gv gv gv gv gv gv
ply.)
a. Fruity breath odor
gv gv gv
b. Rapid, weak pulse
gv gv gv
c. Cold, clammy skin
gv gv gv
d. Extreme thirst
gv gv
e. Urinary frequency
gv gv
f. Protruding eyeballs - ANSWERS-a. Fruity breath odor
gv gv gv gv gv gv gv
b. Rapid, weak pulse
gv gv gv
d. Extreme thirst
gv gv
e. Urinary frequency
gv gv
,Diabetic ketoacidosis is caused by a profound deficiency of insulin. Some common
gv gv gv gv gv gv gv gv gv gv gv g
characteristics include a sweet, fruity breath odor, a rapid weak pulse, extreme thir
v gv gv gv gv gv gv gv gv gv gv gv gv
st, urinary frequency, and sunken-appearing eyeballs.
gv gv gv gv gv
A client mentions using garlic daily as an herb to lower cholesterol and triglyceride
gv gv gv gv gv gv gv gv gv gv gv gv gv gv
levels. Which nursing action is a priority?
gv gv gv gv gv gv
a. Monitor the client for signs of bleeding.
gv gv gv gv gv gv gv
b. Instruct the client that garlic tends to cause hypertension.
gv gv gv gv gv gv gv gv gv
c. This may relieve fever in the same way that acetaminophen does.
gv gv gv gv gv gv gv gv gv gv gv
d. Remind the patient to use tooth brushing and mouthwash to prevent garlic odor.
gv gv gv gv gv gv gv gv gv gv gv gv gv g
- ANSWERS-a. Monitor the client for signs of bleeding.
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Garlic inhibits platelet aggregation in the same way that aspirin works, and the clie
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nt should be monitored for bleeding. Garlic can lower the blood pressure, not raise
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it. It does not relieve fever. While the client will likely want to avoid garlic odor, it is
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not a priority.
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The practical nurse (PN) is reviewing the health histories of assigned clients. Whic
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h factors have a potential for development of throat cancer? (Select all that apply.)
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a. Tobacco use
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b. Excessive intake of alcohol
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c. Intake of hot and spicy foods
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d. Human papillomavirus (HPV)
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e. Lack of exercise
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f. Lack of dietary fiber - ANSWERS-a. Tobacco use
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b. Excessive intake of alcohol
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d. Human papillomavirus (HPV)
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Rationale:
The most common risk factors for throat cancer are tobacco use, alcohol abuse, h
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uman papillomavirus (HPV), a diet lacking in fruits and vegetable, and gastroesoph
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ageal reflux disease (GERD). Foods seasoned with herbs and spices have shown
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to have some health benefits in decreasing the risk of developing cancer.
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A client has undergone craniotomy to remove a brain tumor. The client spent sever
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al days in the intensive care unit, and is now on the post-
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surgical unit. The nurse has urgently contact the surgeon to report signs of increasi
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ng intracranial pressure (ICP). Which was the most likely EARLY sign that the clie
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nt was experiencing increased ICP?
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a. The client's blood pressure dropped from 128/70 to 124/68, preoperative BP 122
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/72
b. The client became more confused than he was upon transfer to the post-
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surgical unit. gv
c. The client had a large amount of sanguineous drainage noted on the gauze dre
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ssings.
, d. The client's pulse rate had increased from 70 to 82 beats/min. - ANSWERS-
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b. The client became more confused than he was upon transfer to the post-
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surgical unit. gv
Rationale:
A change in the level of consciousness is most likely the earliest symptom of incre
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ased ICP. Vital sign changes can also occur, with a widening pulse pressure and b
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radycardia. Neither of these are indicated by data in the options. Sanguineous drai
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nage does not indicate increased ICP.
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The home health practical nurse is visiting with a client who has a history of secon
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d-
degree heart block and pacemaker placement 6 months ago. Which symptom com
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pliant by the client would be indicative of pacemaker failure?
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a. Facial flushing
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b. Nauseagv
c. Pounding headache
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d. Feelings of dizziness - ANSWERS-d. Feelings of dizziness
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Rationale:
Feelings of dizziness may occur as the result of a decreased heart rate, leading to
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decreased cardiac output as a result of pacemaker failure.
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Which actions demonstrate to the practical nurse that the client understands the co
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rrect procedure administration of a metered dose inhaler (MDI)? (Select all that ap
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ply.)
a. Sit or stand.
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b. Shake the inhaler.
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c. Attach the canister of medication to the mouthpiece.
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d. Breathe in through the mouth, filling the lungs.
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e. Use a spacer attachment and place the mouthpiece in the mouth.
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f. Close the lips around the mouthpiece.
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g. After inhaling the medication, hold the breath 10 seconds. - ANSWERS-
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b. Shake the inhaler.
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c. Attach the canister of medication to the mouthpiece.
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e. Use a spacer attachment and place the mouthpiece in the mouth.
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f. Close the lips around the mouthpiece.
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g. After inhaling the medication, hold the breath 10 seconds.
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Rationale:
The correct sequence of MDI administration includes shaking the inhaler, attaching
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the canister to the mouthpiece, attaching the spacer, the client should then let thei
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r breath out through the mouth to empty the lungs and place the mouthpiece in the
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mouth, closing the lips and mouth around the mouthpiece, and inhaling medicatio
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n and holding the breath for 10 seconds.
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The Centers for Disease Control and Prevention (CDC) has issued guidelines for h
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ealth care workers in relation to protection from HIV. The practical nurse (PN) who
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