Practice Exam: HESI Med Surg
An antacid (Maalox) is prescribed for a client with peptic ulcer disease. The nurse knows that the
purpose of this medication is to
a. decrease production of gastric secretions.
b. produce an adherent barrier over the ulcer.
c. maintain a gastric pH of 3.5 or above.
d. decrease gastric motor activity. - ANSWER:c. maintain a gastric pH of 3.5 or above.
The objective of antacids is to neutralize gastric acids and keep pH of 3.5 or above (C) which is necessary
for pepsinogen inactivity. (A) is the purpose of H2 receptor antagonists (cimetidine, ranitidine). (B) is the
purpose of sucralfate (Carafate). (D) is the purpose of anticholinergic drugs which are often used in
conjunction with antacids to allow the antacid to remain in the stomach longer.
In evaluating the effects of lactulose (Cephulac), which outcome would indicate that the drug is
performing as intended?
a. An increase in urine output.
b. Two or three soft stools per day.
c. Watery, diarrhea stools.
d. Increased serum bilirubin. - ANSWER:b. Two or three soft stools per day.
Lactulose is administered to reduce blood ammonia by excretion of ammonia through the stool. Two to
three stools a day indicate that lactulose is performing as intended (B). (A) would be expected if the
patient received a diuretic. (C) would indicate an overdose of lactulose and is not expected. Lactulose
does not affect (D).
The healthcare provider prescribes digitalis (Digoxin) for a client diagnosed with congestive heart failure.
Which intervention should the nurse implement prior to administering the digoxin?
a. Observe respiratory rate and depth.
b. Assess the serum potassium level.
,c. Obtain the client's blood pressure.
d. Monitor the serum glucose level. - ANSWER:b. Assess the serum potassium level.
Hypokalemia (decreased serum potassium) will precipitate digitalis toxicity in persons receiving digoxin
(B). (A and C) will not affect the administration of digoxin. (D) should be monitored if he/she is a diabetic
and is perhaps receiving insulin.
Following the administration of sublingual nitroglycerin to a client experiencing an acute anginal attack,
which assessment finding indicates to the nurse that the desired effect has been achieved?
a. Client states chest pain is relieved.
b. Client's pulse decreases from 120 to 90.
c. Client's systolic blood pressure decreases from 180 to 90.
d. Client's SaO2 level increases from 92% to 96%. - ANSWER:a. Client states chest pain is relieved.
Nitroglycerin reduces myocardial oxygen consumption which decreases ischemia and reduces chest pain
(A). (B and D) would also occur if the angina was relieved, but are not as significant as the client's
subjective report of decreased pain. (C) may indicate a reduction in pain, or a potentially serious side
effect of the medication.
A client with congestive heart failure (CHF) is being discharged with a new prescription for the
angiotensin-converting enzyme (ACE) inhibitor captopril (Capoten). The nurse's discharge instruction
should include reporting which problem to the healthcare provider?
a. Weight loss.
b. Dizziness.
c. Muscle cramps.
d. Dry mucous membranes. - ANSWER:b. Dizziness.
Angiotensin-converting enzyme (ACE) inhibitors are used in CHF to reduce afterload by reversing
vasoconstriction common in heart failure. This vasodilation can cause hypotension and resultant
dizziness (B). (A) is desired if fluid overload is present, and may occur as the result of effective
combination drug therapy such as diuretics with ACE inhibitors. (C) often indicates hypokalemia in the
client receiving diuretics. Excessive diuretic administration may result in fluid volume deficit, manifested
by symptoms such as (D).
, A client is being treated for hyperthyroidism with propylthiouracil (PTU). The nurse knows that the action
of this drug is to
a. decrease the amount of thyroid-stimulating hormone circulating in the blood.
b. increase the amount of thyroid-stimulating hormone circulating in the blood.
c. increase the amount of T4 and decrease the amount of T3 produced by the thyroid.
d. inhibit synthesis of T3 and T4 by the thyroid gland. - ANSWER:d. inhibit synthesis of T3 and T4 by the
thyroid gland.
PTU is an adjunct therapy used to control hyperthyroidism by inhibiting production of thyroid hormones
(D). It is often prescribed in preparation for thyroidectomy or radioactive iodine therapy. Thyroid-
stimulating hormone (TSH) is produced by the pituitary gland, and PTU does not affect the pituitary (A
and B). PTU inhibits the synthesis of all thyroid hormones--both T3 and T4(C).
A client with Parkinson's disease is taking carbidopa-levodopa (Sinemet). Which observation by the
nurse would indicate that the desired outcome of the medication is being achieved?
a. Decreased blood pressure.
b. Lessening of tremors.
c. Increased salivation.
d. Increased attention span. - ANSWER:b. Lessening of tremors.
Sinemet increases the amount of levodopa to the CNS (dopamine to the brain). Increased amounts of
dopamine improve the symptoms of Parkinson's, such as involuntary movements, resting tremors (B),
shuffling gait, etc. (A) is a side effect of Sinemet. Decreased drooling would be a desired effect, not (C).
Sinemet does not affect (D).
Following heparin treatment for a pulmonary embolism, a client is being discharged with a prescription
for warfarin (Coumadin). In conducting discharge teaching, the nurse advises the client to have which
diagnostic test monitored regularly after discharge?
a. Perfusion scan.
b. Prothrombin Time (PT/INR).
c. Activated partial thromboplastin (APTT).
d. Serum Coumadin level (SCL). - ANSWER:b. Prothrombin Time (PT/INR).
An antacid (Maalox) is prescribed for a client with peptic ulcer disease. The nurse knows that the
purpose of this medication is to
a. decrease production of gastric secretions.
b. produce an adherent barrier over the ulcer.
c. maintain a gastric pH of 3.5 or above.
d. decrease gastric motor activity. - ANSWER:c. maintain a gastric pH of 3.5 or above.
The objective of antacids is to neutralize gastric acids and keep pH of 3.5 or above (C) which is necessary
for pepsinogen inactivity. (A) is the purpose of H2 receptor antagonists (cimetidine, ranitidine). (B) is the
purpose of sucralfate (Carafate). (D) is the purpose of anticholinergic drugs which are often used in
conjunction with antacids to allow the antacid to remain in the stomach longer.
In evaluating the effects of lactulose (Cephulac), which outcome would indicate that the drug is
performing as intended?
a. An increase in urine output.
b. Two or three soft stools per day.
c. Watery, diarrhea stools.
d. Increased serum bilirubin. - ANSWER:b. Two or three soft stools per day.
Lactulose is administered to reduce blood ammonia by excretion of ammonia through the stool. Two to
three stools a day indicate that lactulose is performing as intended (B). (A) would be expected if the
patient received a diuretic. (C) would indicate an overdose of lactulose and is not expected. Lactulose
does not affect (D).
The healthcare provider prescribes digitalis (Digoxin) for a client diagnosed with congestive heart failure.
Which intervention should the nurse implement prior to administering the digoxin?
a. Observe respiratory rate and depth.
b. Assess the serum potassium level.
,c. Obtain the client's blood pressure.
d. Monitor the serum glucose level. - ANSWER:b. Assess the serum potassium level.
Hypokalemia (decreased serum potassium) will precipitate digitalis toxicity in persons receiving digoxin
(B). (A and C) will not affect the administration of digoxin. (D) should be monitored if he/she is a diabetic
and is perhaps receiving insulin.
Following the administration of sublingual nitroglycerin to a client experiencing an acute anginal attack,
which assessment finding indicates to the nurse that the desired effect has been achieved?
a. Client states chest pain is relieved.
b. Client's pulse decreases from 120 to 90.
c. Client's systolic blood pressure decreases from 180 to 90.
d. Client's SaO2 level increases from 92% to 96%. - ANSWER:a. Client states chest pain is relieved.
Nitroglycerin reduces myocardial oxygen consumption which decreases ischemia and reduces chest pain
(A). (B and D) would also occur if the angina was relieved, but are not as significant as the client's
subjective report of decreased pain. (C) may indicate a reduction in pain, or a potentially serious side
effect of the medication.
A client with congestive heart failure (CHF) is being discharged with a new prescription for the
angiotensin-converting enzyme (ACE) inhibitor captopril (Capoten). The nurse's discharge instruction
should include reporting which problem to the healthcare provider?
a. Weight loss.
b. Dizziness.
c. Muscle cramps.
d. Dry mucous membranes. - ANSWER:b. Dizziness.
Angiotensin-converting enzyme (ACE) inhibitors are used in CHF to reduce afterload by reversing
vasoconstriction common in heart failure. This vasodilation can cause hypotension and resultant
dizziness (B). (A) is desired if fluid overload is present, and may occur as the result of effective
combination drug therapy such as diuretics with ACE inhibitors. (C) often indicates hypokalemia in the
client receiving diuretics. Excessive diuretic administration may result in fluid volume deficit, manifested
by symptoms such as (D).
, A client is being treated for hyperthyroidism with propylthiouracil (PTU). The nurse knows that the action
of this drug is to
a. decrease the amount of thyroid-stimulating hormone circulating in the blood.
b. increase the amount of thyroid-stimulating hormone circulating in the blood.
c. increase the amount of T4 and decrease the amount of T3 produced by the thyroid.
d. inhibit synthesis of T3 and T4 by the thyroid gland. - ANSWER:d. inhibit synthesis of T3 and T4 by the
thyroid gland.
PTU is an adjunct therapy used to control hyperthyroidism by inhibiting production of thyroid hormones
(D). It is often prescribed in preparation for thyroidectomy or radioactive iodine therapy. Thyroid-
stimulating hormone (TSH) is produced by the pituitary gland, and PTU does not affect the pituitary (A
and B). PTU inhibits the synthesis of all thyroid hormones--both T3 and T4(C).
A client with Parkinson's disease is taking carbidopa-levodopa (Sinemet). Which observation by the
nurse would indicate that the desired outcome of the medication is being achieved?
a. Decreased blood pressure.
b. Lessening of tremors.
c. Increased salivation.
d. Increased attention span. - ANSWER:b. Lessening of tremors.
Sinemet increases the amount of levodopa to the CNS (dopamine to the brain). Increased amounts of
dopamine improve the symptoms of Parkinson's, such as involuntary movements, resting tremors (B),
shuffling gait, etc. (A) is a side effect of Sinemet. Decreased drooling would be a desired effect, not (C).
Sinemet does not affect (D).
Following heparin treatment for a pulmonary embolism, a client is being discharged with a prescription
for warfarin (Coumadin). In conducting discharge teaching, the nurse advises the client to have which
diagnostic test monitored regularly after discharge?
a. Perfusion scan.
b. Prothrombin Time (PT/INR).
c. Activated partial thromboplastin (APTT).
d. Serum Coumadin level (SCL). - ANSWER:b. Prothrombin Time (PT/INR).
