MedSurg Mini HESI Prep

MedSurg Mini HESI PrepMedSurg Mini HESI 1. A male client with high-density lipid (HDL) level of 35 and a Low-density (LDL) of 160 mg/dL receives a prescription for atorvastatin. His health education includes dietary teaching. Which selection of meals indicates to the PN that the client understands the correct diet for his condition? Grilled salmon and a cup of black coffee Rationales: The client’s lipid profile indicates hyperlipidemia (male norm for HDL is greater than 45 mg/dL and LDL is less than 130 mg/dL). Grilled salmon, which contains omega-3 fatty acids, is beneficial in managing hyperlipidemia, and black coffee without cream has no adverse effects. 2. The PN is caring for a client who had a transurethral prostatectomy (TURP) 12 hours ago. Which finding should the PN report to the charge nurse immediately? Urine output of 8 mL in the last hour 3. Twelve hours after a unilateral total knee replacement, a client reports that he is unable to sleep because of severe incisional pain. Which action should the PN take? Remind the client to use the patient-controlled analgesia (PCA) pump Rationales: Opioid analgesics via a PCA pump provide effective pain management after major orthopedic surgery and the client should be reminded to use it. 4. The PN is reviewing teaching with a client who has atherosclerosis with episodes of acute anginal pain. Which self-care instructions should be reinforced by the PN? SATA Balance food portions to avoid overeating Alternate short periods of activity with frequent break at rest Avoid exposure to intense cold in the winter months Minimize situations that may cause emotional outbursts Rationales: The focus of management for angina pectoris is symptomatic control by reducing factors that cause cardiac ischemia. The PN should reinforce with the client to avoid exposure to extreme cold, consuming heavy meals, emotionally stressful situations and engaging in sustained strenuous activity 5. The PN is completing the preoperative checklist for a client going to OR for a total abdominal hysterectomy. Which finding should the PN report to the RN? Hemoglobin 8 grams per droplet 6. A client is complaining of foot pain in the extremity that was amputated three days ago. Which intervention should the PN implement? Explain phantom pain and medicate with the prescribed analgesic 7. The client tells the PN “I have been applying triple antibiotic to my athlete’s foot for the past two days, but it still itches.” How should the PN respond? This study source was downloaded by from CourseH on :42:29 GMT -06:00 A+ Athlete’s foot is a fungus. Antibiotic will not relieve symptoms (Antifungal “zole”) Rationales: Triple antibiotic ointment contains the topical antibacterial medications bacitracin, neomycin, and polymyxin b which are used to treat a bacterial infection and will not effectively treat a fungal infection. Tinea pedis (athlete’s foot) is a fungal infection of the feet, so an antifungal ointment will be needed to treat the condition. 8. Which client’s vital signs should the PN report to the charge nurse? A 12-hour postop client with a BP of 90/40 and a pulse of 132 Decrease in BP and increase in pulse  bleeding; In ICP  BP will go up and Pulse will go down  first sign of ICP: Change in LOC and pupil changes; Cushing Triad  wide pulse pressure 9. The PN is caring for an older client with prostate cancer who is undergoing external radiation therapy. Which assessment finding is most important for the PN to report to the charge nurse? Output of 100 mL of pink-tinged urine in 4 hours Encourage protein (egg); in Injury  protein and vitamin C Rationale: Radiation therapy of the prostate can cause an inflammatory response that results in urethral swelling and compression. A urinary output of 100nmL in 4 hours is less than expected and should be reported to the charge nurse. 10. The PN is assigned to care for a client with Parkinson’s Disease. Which symptoms should the PN recognize as manifestations of Parkinson’s disease? Shuffling gait, mask-like facial expressions, and tremors of the hand (pill rolling) Levadopa – less tremors (therapeutic response) 11. The PN picks up a fold of skin on the back of a client’s forearm and notes that it “Tents.” This finding should be documented by the PN as an indication of which condition? Dehydration 12. The PN is performing a focused assessment on an adult client with a diagnoses of right sided heart failure. Which finding should the PN implement in the client’s medical record but not report to the healthcare provider because it is consistent with the client’s diagnosis? Pitting edema in the lower extremities Rationales: Failure of the right ventricle to contract effectively and move blood into the pulmonary artery results in an increase in hydrostatic pressure in the venous system and accumulation of fluid in dependent tissues, such as the lower extremities, and this edema should be documented 13. A client with primary Raynaud’s phenomenon is sitting outside on the patio of the long-term care facility on a cool day. The PN brings the client indoors for lunch and observes that the client’s fingers are very pale and dusky. Which action should the PN take