HESI RN MED SURG Exam Version A & Version
B | All Questions and Correct Answers with
Rationales | Graded A+ | Verified Answers |
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Which condition should the nurse anticipate as a potential problem in a female
client with a neurogenic bladder?
A.
Stress incontinence
B.
Infection
C.
Painless gross hematuria
D.
Peritonitis ------------Correct Answer--------------------B
Rationale:Infection is the major complication resulting from stasis of urine and
subsequent catheterization. Option A is the involuntary loss of urine through an
intact urethra as a result of a sudden increase in intra-abdominal pressure.
Option C is the most common symptom of bladder cancer. Option D is the most
common and serious complication of peritoneal dialysis.
The client is admitted to an inpatient unit from the Emergency Department with a
swollen, reddened area to the left calf which is warm and painful to the touch.
The results of the remaining tests are pending. What admission prescriptions does
the nurse anticipate from the healthcare provider? (Select all that apply.)
,A.
Bed rest
B.
Elevate the right leg.
C.
Anticoagulant therapy
D.
Massage the area of calf tenderness tid.
E.
Warm moist compress to the area of calf tenderness tid
F.
Place a pillow under the left knee. ------------Correct Answer--------------------A, C, E
Rationale:The left leg needs to be elevated above the level of the heart, not the
right leg. Massaging the area of tenderness could dislodge the clot and cause a
pulmonary embolism. Avoid the use of the knee gatch or a pillow under the
knee as that could cause stasis in the lower leg. The remaining are
recommendations for the client with a deep vein thrombosis.
Which content about self-care should the nurse include in the teaching plan of a
female client who has genital herpes? (Select all that apply.)
A.
Encourage annual physical and Pap smear.
B.
Take antiviral medication as prescribed.
C.
,Use condoms to avoid transmission to others.
D.
Warm sitz baths may relieve itching.
E.
Use Nystatin suppositories to control itching.
F.
Use a douche with weak vinegar solution to decrease itching. ------------Correct
Answer--------------------A, B, C, D
Rationale:The nurse should include (A, B, C, and D) in the teaching plan of a
female client with genital herpes. (E) is specific for Candida infections, and
option (F) is used to treat Trichomonas.
The nurse initiates neurologic checks for a client who is at risk for neurologic
compromise. Which manifestation typically provides the first indication of altered
neurologic function?
A.
Change in level of consciousness
B.
Increasing muscular weakness
C.
Changes in pupil size bilaterally
D.
Progressive nuchal rigidity ------------Correct Answer--------------------A
Rationale:A decrease or change in the level of consciousness is usually the first
indication of neurologic deterioration. Options B and C may also occur but are
, much less likely to be the first sign of neurologic compromise. Option D is often
a sign of meningitis.
The nurse is concerned about infection for a client after an esophagogastrostomy
for esophageal cancer. Which actions should the nurse include in the client's plan
of care? (Select all that apply.)
A.
Frequent oral care every 2 hours while awake.
B.
Use incentive spirometer every 2 hours.
C.
Empty contents from NG tube every 8 hours.
D.
Ambulate within 1 hour of return from the PACU.
E.
Limit visitors until postoperative day 2. ------------Correct Answer--------------------A,
B, C
Rationale:One hour post op is too soon to ambulate for this client. Visitors help
support the patient and are encouraged to visit. Oral care is necessary as the
client will be NPO. To decrease the risk of infection post operatively, implement
routine pulmonary exercises. The client will have an NG tube in place, likely to
intermittent suction, to decompress the stomach post surgery.
B | All Questions and Correct Answers with
Rationales | Graded A+ | Verified Answers |
Just Released
Which condition should the nurse anticipate as a potential problem in a female
client with a neurogenic bladder?
A.
Stress incontinence
B.
Infection
C.
Painless gross hematuria
D.
Peritonitis ------------Correct Answer--------------------B
Rationale:Infection is the major complication resulting from stasis of urine and
subsequent catheterization. Option A is the involuntary loss of urine through an
intact urethra as a result of a sudden increase in intra-abdominal pressure.
Option C is the most common symptom of bladder cancer. Option D is the most
common and serious complication of peritoneal dialysis.
The client is admitted to an inpatient unit from the Emergency Department with a
swollen, reddened area to the left calf which is warm and painful to the touch.
The results of the remaining tests are pending. What admission prescriptions does
the nurse anticipate from the healthcare provider? (Select all that apply.)
,A.
Bed rest
B.
Elevate the right leg.
C.
Anticoagulant therapy
D.
Massage the area of calf tenderness tid.
E.
Warm moist compress to the area of calf tenderness tid
F.
Place a pillow under the left knee. ------------Correct Answer--------------------A, C, E
Rationale:The left leg needs to be elevated above the level of the heart, not the
right leg. Massaging the area of tenderness could dislodge the clot and cause a
pulmonary embolism. Avoid the use of the knee gatch or a pillow under the
knee as that could cause stasis in the lower leg. The remaining are
recommendations for the client with a deep vein thrombosis.
Which content about self-care should the nurse include in the teaching plan of a
female client who has genital herpes? (Select all that apply.)
A.
Encourage annual physical and Pap smear.
B.
Take antiviral medication as prescribed.
C.
,Use condoms to avoid transmission to others.
D.
Warm sitz baths may relieve itching.
E.
Use Nystatin suppositories to control itching.
F.
Use a douche with weak vinegar solution to decrease itching. ------------Correct
Answer--------------------A, B, C, D
Rationale:The nurse should include (A, B, C, and D) in the teaching plan of a
female client with genital herpes. (E) is specific for Candida infections, and
option (F) is used to treat Trichomonas.
The nurse initiates neurologic checks for a client who is at risk for neurologic
compromise. Which manifestation typically provides the first indication of altered
neurologic function?
A.
Change in level of consciousness
B.
Increasing muscular weakness
C.
Changes in pupil size bilaterally
D.
Progressive nuchal rigidity ------------Correct Answer--------------------A
Rationale:A decrease or change in the level of consciousness is usually the first
indication of neurologic deterioration. Options B and C may also occur but are
, much less likely to be the first sign of neurologic compromise. Option D is often
a sign of meningitis.
The nurse is concerned about infection for a client after an esophagogastrostomy
for esophageal cancer. Which actions should the nurse include in the client's plan
of care? (Select all that apply.)
A.
Frequent oral care every 2 hours while awake.
B.
Use incentive spirometer every 2 hours.
C.
Empty contents from NG tube every 8 hours.
D.
Ambulate within 1 hour of return from the PACU.
E.
Limit visitors until postoperative day 2. ------------Correct Answer--------------------A,
B, C
Rationale:One hour post op is too soon to ambulate for this client. Visitors help
support the patient and are encouraged to visit. Oral care is necessary as the
client will be NPO. To decrease the risk of infection post operatively, implement
routine pulmonary exercises. The client will have an NG tube in place, likely to
intermittent suction, to decompress the stomach post surgery.