Medical Surgical Nursing HESI Practice Exam (Created by Jamie Mayo All Information Directly From HESI Evolve Website 2019).

Medical Surgical Nursing HESI Practice Exam (Created by Jamie Mayo All Information Directly From HESI Evolve Website 2019). The nurse is assessing a clients laboratory values following the administration of chemotherapy. Which lab value leads the nurse to suspect that the client is experiencing tumor lysis syndrome? A. Hemoglobin of 10 g/dl B. Serum calcium of 5mg/dl C. Serum PTT of 10 seconds D. Oxygen saturation of 90% - correct answers.Answer: B TLS results in hyperkalemia, hypocalcemia, hyperuricemia, and hyperphosphatemia. A serum calcium level of 5 is low and so is an indicator of possible TLS. HESI Evolve Website 11/20/2019 A client is admitted to the hospital with severe acute diverticulitis. Which assessment finding should the nurse expect this client to exhibit? A. Severe pain at McBurney's point and nausea. B. Lower left quadrant pain and a low grade fever. C. Abdominal pain and intermittent tenesmus. D. Exacerbations of severe diarrhea. - correct answers.Answer: B Left lower quadrant pain occurs with diverticulitis because the sigmoid colon is the most common area for diverticula and the inflammation of diverticula causes a low grade fever. A is indicative of appendicitis. C and D are indicitive of ulcerative colitis. HESI Evolve Website 11/20/2019 A client is placed on a mechanical ventilator following a cerebral hemorrhage, and vecuronium bromide (Norcuron) 0.04 mg/kg q12 hours IV is prescribed. What is the priority nursing diagnosis for this client? A. Potential for injury related to impaired lung expansion. B. Impaired communication related to paralysis of skeletal muscles. C. High risk for infection related to increased intracranial pressure. D. Social isolation related to inability to communicate. - correct answers.Answer: B To increase the client's tolerance of endotracheal intubation and/or mechanical ventilation, a skeletal-muscle relaxant, such as vecuronium, is usually prescribed. Impaired communication is a serious outcome because the client cannot communicate his/her needs due to intubation and diaphragmatic paralysis caused by the drug. HESI Evolve Website 11/20/2019 The nurse would be correct in withholding a dose of digoxin in a client with congestive heart failure without specific instrucions from the healthcare provider if the client's A. Serum potassium level is a 3 B. Blood pressure is 104/68 C. Serum digoxin level is 1.5 D. apical pulse is 68/min - correct answers.Answer: A Hypokalemia can precipitate digoxin toxicity in persons receiving digoxin which will increase the chance of dangerous dysrhythmias. The therapeutic range for digoxin is 0.8 to 2 ng/ml. The nurse should also hold the digoxin if the apical pulse is below 60/min. HESI Evolve Website 11/20/2019 After the fourth dose of gentamicin sulfate (Garamycin) IV, the nurse plans to draw blood samples to determine peak and trough levels. When are the best times to draw these samples? A) 15 minutes before and 15 minutes after the next dose. B) One hour before and one hour after the next dose. C) 5 minutes before and 30 minutes after the next dose. D) 30 minutes before and 30 minutes after the next dose. - correct answers.Answer: C Peak drug serum levels are achieved 30 minutes after IV administration of aminoglycosides. The best time to draw a trough is the closest time to the next administration. HESI Evolve Website 11/20/2019 In preparing a discharge plan for a 22-year-old male client diagnosed with Buerger's disease (thromboangiitis obliterans), which referral is most important? A. A twelve step recovery program. B. Smoking cessation program. C. Genetic counseling. D. Clinical nutritionist. - correct answers.Answer: B Buerger's disease is strongly related to smoking. The most effective means of controlling the symptoms and disease progression is through smoking cessation. HESI Evolve Website 11/20/2019 Which symptoms should the nurse expect a client to exhibit who is known to have a pheochromocytoma? A) Numbness, tingling, and cramps in the extremities. B) Headache, diaphoresis, and palpitations. C) Cyanosis, fever, and classic signs of shock. D) Nausea, vomiting, and muscular weakness. - correct answers.Answer: B Pheochromocytoma is a catecholamine secreting tumor of the adrenal medulla and B is the typical triad of symptoms depending upon the relative proportions of epinephrine and norepinephrine secretion. A-hypoparathyroidism C- addisonian adrenal crisis D- hyperparathyroidism HESI Evolve Website 11/20/2019 A middle-aged male client with diabetes continues to eat an abundance of foods that are high in sugar and fat. According to the Health Belief Model, which event is most likely to increase the client's willingness to become compliant with the prescribed diet? A) He visits his diabetic brother who just had surgery to amputate an infected foot. B) He is provided with the most current information about the dangers of untreated diabetes. C) He comments on the community service announcements about preventing complications associated with diabetes. D) His wife expresses a sincere willingness to prepare meals that are within his prescribed diet. - correct answers.Answer: A The loss of a limb by a family member will be the strongest call to action and is most likely to increase the perceived seriousness of the disease. HESI Evolve Website 11/20/2019 The nurse is taking the history of a newly diagnosed Type 2 diabetic patient who is beginning treatment. Which subjective information is most important for the nurse to note? A. An allergy to sulfa drugs. B. Cessation of smoking three years ago. C. A history of obesity. D. Numbness in the soles of the feet. - correct answers.Answer: A An allergy to sulfa drugs may make the client unable to use some of the most common antihyperglycemic agents (sulfonylureas). The nurse needs to highlight this allergy for the healthcare provider. HESI Evolve Website 11/20/2019 The nurse is assessing a client with a history of Parkinson's disease for the past five years. What symptoms would this client most likely exhibit? A. Numbness of the extremities, loss of balance, and visual disturbances. B. Shuffeling gait, masklike facial expressions, and tremors of the head. C. Extreme muscular weakness, easy fatigability, and ptosis. D. Loss of short-term memory, facial tics and grimaces, and constant writhing movements. - correct answers.Answer: B Common clinical features of Parkinsonism. A-symptoms of chorea C-myasthenia gravis D- multiple scelorisis HESI Evolve Website 11/20/2019