Practice Exam: HESI Med Surg
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. Clients SaO2 level increases from 92% to 96% - ANSWER:A. nitroglycerin reduces mycocardial oxygen
consumption which decreases ischemia and reduces chest pain
A client with hyperlipidemia recieves a prescription for niacin (niaspan). which client teaching is most
important for the nurse to provide
a. expected duration of flushing
b. symptoms of hyperglycemia
c. diets that minimize gi irritation
d. comfort measure for pruritis - ANSWER:A. flushing of the face and neck, lasting up to an hour, is a
frequent reason for discontinuing niacin. inclusion of this effect in clietn teaching may promote
compliance in taking the med.
When assessing an adolescent who recently overdosed on acetaminophen (tylonel), it is most important
for the nurse to assess for pain in which area of the body
a. flank
b. abdomen
c. chest
d. head - ANSWER:B. acetaminophen toxicisty an result in liver damage; therefore, it is especially
important for the nurse to assess for pain in the right upper quadrant of the abdomen (which might
indicated liver damage)
A client is admitted to the coronary care unit with a medical diagnosis of acute myocardial infarction.
which medication prescription decreases both preload and afterload
a. nitroglycerin
b. propranolol
c. propranolol
d. captopril - ANSWER:A. nitroglycerin is a nitrate that causes peripheral vasodilation and decreases
contractility, thereby decreasing both preload and afterload
,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 the 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. PTU is an adjunct therapy used to
control hyperthyroidism by inhibiting production of thyroid hormones. It is often prescribed in prep for
thyroidectomy or radioactive iodine therapy
Which change in data indicates to the nurse the desired effect of the angiotensin II receptor antagonist
has been achieved
A. Dependent edema reduced form +3 to +1
B. Serum HDL increased from 35 to 55mg/dl
C. PUlse rate reduced from 150 to 90 beats/min
D. Blood pressure reducedf rom 160/90 to 130.80 - ANSWER:D. angiotensin II receptor antagonist
(blocker), prescribed from treatment of HTN. The desired effect is a decrease in blood pressure.
Which instructions should the nurse give to a female client who just recieved a prescription for oral
metronidazole (flagyl) for treatment of trichomonas vaginalis (select all that apply)
A. increase fluid intake, especially cranberry juice
B. Do not abruptly discontinue the medication; taper use
C. Check blood pressure daily to detect hypertension
D. Avoid drinking alcohol while taking this medication
E. Use condoms until treatment is completed
F. Ensure that all sexual partners are treated at the same time - ANSWER:ADEF
The nurse is transcribing a new prescription for spironolactone (aldactone) for a client who receives an
angiotensin-converting enzyme inhibitor. Which action should the nurse implement
A. verify both prescriptions with the HCP
B. report the med interactions to the nurse manager
C. hold the ACE inhibitor and give the new prescription
D. Transcribe and send the prescription to the pharmacy - ANSWER:A. the concomitant use of an ACE
inhibitor and a potassium-sparing diuretic sucha s spironolactone, should be given with caution b/c the
two drugs may interact to cause an elevation in serum potassium levels.
, A client has myxedema, which results from a deficiency of thyroid hormone synthesis in adults. The
nurse knows that which medication should be contraindicated for this client?
A. liothyronine (cytomel) to replace iodine
B. Furosemide (Lasix) for relief of fluid retention
C. Pentobarbital sodium for sleep
D. nitroglycerin for angina pain - ANSWER:C. persons with myxedema are dangerously hypersensitive to
narcotics, barbiturates, and anesthetics. They do not tolerate liothyronine and usually receive iodine
replacement therapy. These clients are also suceptable to heart problems such as angina for which
nitroglycerine would be indicated and and congestive heart failure for which furosemide would be
indicated
A client has a continuous IV infusion of dopamine and an IV of normal saline at 50ml/hour. The nurse
noes that the client's urinary output has been 20ml/hour for the last two hours. Which intervention
should the nurse initiate?
A. stop the infusion of dopamine
B. change the normal saline to a keep open rate
C. replace the urinary catheter
D. notify the healthcare provider of the urinary output. - ANSWER:D.
A healthcare provider prescrives cephalexin monhydrate (Keflex) for a client with a postoperative
infection. It is most important for the nurse to assess for what additional drug allergy before
administering this prescription?
A. Penicillins
B. Aminoglycosides
C. Erythromycins
D.Sulfonamides - ANSWER:A. Cross-allergies exist between penicillins and cephalosporines, such as
keflex. so checking for penicillin allergy is a wise precaution
Which medications should the nurse caution the client about taking while receiving an opioid analgesic?
A. Antacids.
B. Benzodiasepines
C. Antihypertensives
D. Oral antidiabetics - ANSWER:B. respiratory depression increases with the concurrent use of opioid
analgesics and other cns depressant agents, such as alcohol, barbiturates, and benzodiasepines
Which nursing diagnosis is important to include in the plan of care for a client recieving the angiotensin II
receptor antagonist irbesartan (avapro)?
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. Clients SaO2 level increases from 92% to 96% - ANSWER:A. nitroglycerin reduces mycocardial oxygen
consumption which decreases ischemia and reduces chest pain
A client with hyperlipidemia recieves a prescription for niacin (niaspan). which client teaching is most
important for the nurse to provide
a. expected duration of flushing
b. symptoms of hyperglycemia
c. diets that minimize gi irritation
d. comfort measure for pruritis - ANSWER:A. flushing of the face and neck, lasting up to an hour, is a
frequent reason for discontinuing niacin. inclusion of this effect in clietn teaching may promote
compliance in taking the med.
When assessing an adolescent who recently overdosed on acetaminophen (tylonel), it is most important
for the nurse to assess for pain in which area of the body
a. flank
b. abdomen
c. chest
d. head - ANSWER:B. acetaminophen toxicisty an result in liver damage; therefore, it is especially
important for the nurse to assess for pain in the right upper quadrant of the abdomen (which might
indicated liver damage)
A client is admitted to the coronary care unit with a medical diagnosis of acute myocardial infarction.
which medication prescription decreases both preload and afterload
a. nitroglycerin
b. propranolol
c. propranolol
d. captopril - ANSWER:A. nitroglycerin is a nitrate that causes peripheral vasodilation and decreases
contractility, thereby decreasing both preload and afterload
,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 the 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. PTU is an adjunct therapy used to
control hyperthyroidism by inhibiting production of thyroid hormones. It is often prescribed in prep for
thyroidectomy or radioactive iodine therapy
Which change in data indicates to the nurse the desired effect of the angiotensin II receptor antagonist
has been achieved
A. Dependent edema reduced form +3 to +1
B. Serum HDL increased from 35 to 55mg/dl
C. PUlse rate reduced from 150 to 90 beats/min
D. Blood pressure reducedf rom 160/90 to 130.80 - ANSWER:D. angiotensin II receptor antagonist
(blocker), prescribed from treatment of HTN. The desired effect is a decrease in blood pressure.
Which instructions should the nurse give to a female client who just recieved a prescription for oral
metronidazole (flagyl) for treatment of trichomonas vaginalis (select all that apply)
A. increase fluid intake, especially cranberry juice
B. Do not abruptly discontinue the medication; taper use
C. Check blood pressure daily to detect hypertension
D. Avoid drinking alcohol while taking this medication
E. Use condoms until treatment is completed
F. Ensure that all sexual partners are treated at the same time - ANSWER:ADEF
The nurse is transcribing a new prescription for spironolactone (aldactone) for a client who receives an
angiotensin-converting enzyme inhibitor. Which action should the nurse implement
A. verify both prescriptions with the HCP
B. report the med interactions to the nurse manager
C. hold the ACE inhibitor and give the new prescription
D. Transcribe and send the prescription to the pharmacy - ANSWER:A. the concomitant use of an ACE
inhibitor and a potassium-sparing diuretic sucha s spironolactone, should be given with caution b/c the
two drugs may interact to cause an elevation in serum potassium levels.
, A client has myxedema, which results from a deficiency of thyroid hormone synthesis in adults. The
nurse knows that which medication should be contraindicated for this client?
A. liothyronine (cytomel) to replace iodine
B. Furosemide (Lasix) for relief of fluid retention
C. Pentobarbital sodium for sleep
D. nitroglycerin for angina pain - ANSWER:C. persons with myxedema are dangerously hypersensitive to
narcotics, barbiturates, and anesthetics. They do not tolerate liothyronine and usually receive iodine
replacement therapy. These clients are also suceptable to heart problems such as angina for which
nitroglycerine would be indicated and and congestive heart failure for which furosemide would be
indicated
A client has a continuous IV infusion of dopamine and an IV of normal saline at 50ml/hour. The nurse
noes that the client's urinary output has been 20ml/hour for the last two hours. Which intervention
should the nurse initiate?
A. stop the infusion of dopamine
B. change the normal saline to a keep open rate
C. replace the urinary catheter
D. notify the healthcare provider of the urinary output. - ANSWER:D.
A healthcare provider prescrives cephalexin monhydrate (Keflex) for a client with a postoperative
infection. It is most important for the nurse to assess for what additional drug allergy before
administering this prescription?
A. Penicillins
B. Aminoglycosides
C. Erythromycins
D.Sulfonamides - ANSWER:A. Cross-allergies exist between penicillins and cephalosporines, such as
keflex. so checking for penicillin allergy is a wise precaution
Which medications should the nurse caution the client about taking while receiving an opioid analgesic?
A. Antacids.
B. Benzodiasepines
C. Antihypertensives
D. Oral antidiabetics - ANSWER:B. respiratory depression increases with the concurrent use of opioid
analgesics and other cns depressant agents, such as alcohol, barbiturates, and benzodiasepines
Which nursing diagnosis is important to include in the plan of care for a client recieving the angiotensin II
receptor antagonist irbesartan (avapro)?
