MED SURG II HESI CORRECT EXAMS SCRIPT
QUESTIONS AND ANSWERS SURE A+
✔✔A nurse in a rehabilitation center teaches clients with quadriplegia to use an
adaptive wheelchair. Why is it important that the nurse provide this instruction? - ✔✔It is
unlikely that the client will regain the ability to walk.
✔✔A male client has discharge from his penis. Gonorrhea is suspected. To obtain a
specimen for a culture, the nurse should: - ✔✔Swab the drainage directly from the
urethra to obtain a specimen
✔✔A nurse teaches the signs of organ rejection to a client who had a kidney transplant.
What should be included in the education? - ✔✔Elevated blood pressure
✔✔Which relationship does the nurse consider reflective of the relationship of naloxone
(Narcan) to morphine sulfate? - ✔✔Protamine sulfate to parenteral heparin
✔✔On the first postoperative day following a thyroidectomy, a client tolerates a full-fluid
diet. This is changed to a soft diet on the second postoperative day. The client reports
having a sore throat when swallowing. What should the nurse do first? - ✔✔Administer
analgesics as prescribed before meals
✔✔When caring for an anxious patient, the nurse should monitor for which signs of
hyperventilation? - ✔✔Respiratory alkalosis
✔✔A nurse obtains daily stool specimens for a client with chronic bowel inflammation.
The nurse concludes that these stool examinations were prescribed to determine: -
✔✔Occult blood.
✔✔Which clinical indicator is the nurse most likely to identify when assessing a client
with a ruptured cerebral aneurysm? - ✔✔Sudden severe headache
, ✔✔A nurse is evaluating a client's response to fluid replacement therapy. Which clinical
finding indicates adequate tissue perfusion to vital organs? - ✔✔Urinary output of 30 mL
in an hour
✔✔In response to a client's question, the nurse explains the difference between partial-
thickness (second-degree) burns and full-thickness (third-degree) burns. What
information about partial-thickness burns should the nurse include in the discussion? -
✔✔They are painful, reddened, and have blisters
✔✔A client with acute kidney failure is to receive peritoneal dialysis and asks why the
procedure is necessary. The nurse's best response is, "It: - ✔✔Helps perform some of
the work usually done by the kidneys."
✔✔A client has a closed chest drainage system in place. To determine the amount of
chest tube drainage, the nurse should: - ✔✔Refer to the date and time markings on the
outside of the collection chamber
✔✔A farmer seeks medical care for a large crusty patch of skin on the cheek. The client
states that even after using different remedies, it still bleeds easily and has not gotten
better. From the client's history, the nurse suspects skin cancer because the major
precipitating factor associated with skin cancer is: - ✔✔Exposure to radiation
✔✔A nurse determines that a client in the acute phase of burns has eaten only a small
portion of each meal. Considering this finding, the nurse should assess the client for: -
✔✔Prolonged wound healing
✔✔A client has had a total gastrectomy. What should the nurse include in the discharge
teaching? - ✔✔Injections of vitamin B12 for life.
✔✔A client with extensive bone and soft tissue injuries to the right leg is on bed rest.
When positioning the client, the nurse should: - ✔✔Elevate the entire right leg with
pillows, keeping the foot higher than the knee
✔✔A nurse is caring for a client with a new colostomy. Which client outcome is most
important for achievement of long-range goals associated with adjusting to a new
colostomy? - ✔✔Readiness to accept an altered body function
✔✔On the third postoperative day after a subtotal thyroidectomy for a tumor, a client
complains of a "funny, jittery feeling." On the basis of this statement, the nurse's best
action is to: - ✔✔est for Chvostek's and Trousseau's signs and notify the health care
provider of the complaints
QUESTIONS AND ANSWERS SURE A+
✔✔A nurse in a rehabilitation center teaches clients with quadriplegia to use an
adaptive wheelchair. Why is it important that the nurse provide this instruction? - ✔✔It is
unlikely that the client will regain the ability to walk.
✔✔A male client has discharge from his penis. Gonorrhea is suspected. To obtain a
specimen for a culture, the nurse should: - ✔✔Swab the drainage directly from the
urethra to obtain a specimen
✔✔A nurse teaches the signs of organ rejection to a client who had a kidney transplant.
What should be included in the education? - ✔✔Elevated blood pressure
✔✔Which relationship does the nurse consider reflective of the relationship of naloxone
(Narcan) to morphine sulfate? - ✔✔Protamine sulfate to parenteral heparin
✔✔On the first postoperative day following a thyroidectomy, a client tolerates a full-fluid
diet. This is changed to a soft diet on the second postoperative day. The client reports
having a sore throat when swallowing. What should the nurse do first? - ✔✔Administer
analgesics as prescribed before meals
✔✔When caring for an anxious patient, the nurse should monitor for which signs of
hyperventilation? - ✔✔Respiratory alkalosis
✔✔A nurse obtains daily stool specimens for a client with chronic bowel inflammation.
The nurse concludes that these stool examinations were prescribed to determine: -
✔✔Occult blood.
✔✔Which clinical indicator is the nurse most likely to identify when assessing a client
with a ruptured cerebral aneurysm? - ✔✔Sudden severe headache
, ✔✔A nurse is evaluating a client's response to fluid replacement therapy. Which clinical
finding indicates adequate tissue perfusion to vital organs? - ✔✔Urinary output of 30 mL
in an hour
✔✔In response to a client's question, the nurse explains the difference between partial-
thickness (second-degree) burns and full-thickness (third-degree) burns. What
information about partial-thickness burns should the nurse include in the discussion? -
✔✔They are painful, reddened, and have blisters
✔✔A client with acute kidney failure is to receive peritoneal dialysis and asks why the
procedure is necessary. The nurse's best response is, "It: - ✔✔Helps perform some of
the work usually done by the kidneys."
✔✔A client has a closed chest drainage system in place. To determine the amount of
chest tube drainage, the nurse should: - ✔✔Refer to the date and time markings on the
outside of the collection chamber
✔✔A farmer seeks medical care for a large crusty patch of skin on the cheek. The client
states that even after using different remedies, it still bleeds easily and has not gotten
better. From the client's history, the nurse suspects skin cancer because the major
precipitating factor associated with skin cancer is: - ✔✔Exposure to radiation
✔✔A nurse determines that a client in the acute phase of burns has eaten only a small
portion of each meal. Considering this finding, the nurse should assess the client for: -
✔✔Prolonged wound healing
✔✔A client has had a total gastrectomy. What should the nurse include in the discharge
teaching? - ✔✔Injections of vitamin B12 for life.
✔✔A client with extensive bone and soft tissue injuries to the right leg is on bed rest.
When positioning the client, the nurse should: - ✔✔Elevate the entire right leg with
pillows, keeping the foot higher than the knee
✔✔A nurse is caring for a client with a new colostomy. Which client outcome is most
important for achievement of long-range goals associated with adjusting to a new
colostomy? - ✔✔Readiness to accept an altered body function
✔✔On the third postoperative day after a subtotal thyroidectomy for a tumor, a client
complains of a "funny, jittery feeling." On the basis of this statement, the nurse's best
action is to: - ✔✔est for Chvostek's and Trousseau's signs and notify the health care
provider of the complaints
