MED-SURG HESI PN*++ QUESTIONS
WITH VERIFIED ANSWERS
During ea eclinic evisit, ea eclient ereports eto ethe epractical enurse e(PN) ethat ethey efelt ea
esolid emass ein etheir ebreast eduring eself-examination, ebut eit ewas enot epainful. eWhat
einstruction eshould ethe ePN ereinforce ewith ethe eclient?
A. eContinue eto emonitor ethe emass euntil ethe enext escheduled eannual eexam.
B. eNotify ethe ePCP eif ethe emass ebecomes esoft eor epainful eor estarts eto edrain.
C. eSchedule ean eappointment ewith ethe ePCP efor eevaluation
D. eBreast emasses eare eusually einsignificant eif ethey efeel esoft eor eare eeasily
emoveable. e- eAnswer ec. eSchedule ean eappointment ewith ethe ehealth ecare eprovider
efor eevaluation.
A epainless ebreast emass eis ean eabnormal efinding, eand ethe ePN eshould einstruct ethe
eclient eto eobtain eprompt emedical eevaluation.
The ehealth ecare eprovider einformed ea eclient ediagnosed ewith estage e4 eliver ecancer
ethat ethe ecancer ehas espread eto etheir espine. eThe eclient estates eto ethe epractical
enurse, e"I ehave ea ecancer, ebut eit eis enot emalignant." eWhat eis ethe ebest einitial
enursing eaction?
A. eEncourage ethe eclient eto eattend ea ecancer eeducation eprogram
B. ePerform ea ecomplete ehistory eand ephysical eassessment
C. eAsk ethe eclient eto eexplain ehis eunderstanding eof ethe eterm emalignancy.
D. eOffer ethe eclient eemotional esupport eto edeal ewith ethe ediagnosis
Submit e- eAnswer ec. eAsk ethe eclient eto eexplain ehis eunderstanding eof ethe eterm
emalignancy.
The ebest einitial eaction eis eto eassess ethe eclient's eknowledge eof ethe eterm emalignancy
ewhen eused eto edescribe ecancer. eThe eclient eappears eto ehave einaccurate
eknowledge. eStage e4 ecancer emeans ethe ecancer ehas espread e(metastasized) efrom
ewhere eit ehas estarted eto eanother ebody epart.
A eclient ediagnosed ewith eosteoarthritis. eWhich eintervention eshould ethe epractical
enurse eimplement eto ehelp erelieve ejoint epain eand estiffness?
a. eEncourage ethe eclient eto eperform eweight-bearing eexercises.
b. eTeach ethe eclient ehow eto eperform erange-of-motion eexercises.
c. eExplain ethe euse eof eice eand emassage efor epain erelief.
,d. eInstruct ethe eclient eto etake ean eanalgesic ebefore ewalking edaily e- eAnswer ed.
eInstruct ethe eclient eto etake ean eanalgesic ebefore ewalking edaily.
Adequate epain emanagement eis eimportant efor ethe esuccess eof ean eexercise eprogram.
eKeeping ethe ejoints eactive edecreases epain, eso etaking ean eanalgesic eand ewalking
edaily eis elikely eto ehelp edecrease ejoint epain eand estiffness.
A eclient ediagnosed ewith eprostate ecancer eis eprescribed eradioactive eseed
eimplantation e(brachytherapy). eWhat eis ethe emost eimportant enursing eaction efor ethe
epractical enurse e(PN) eto edo?
a. eFollow eradiation eexposure eprecautions
b. eEncourage eregular emeals
c. eCollect eall eurine ein esealed econtainers
d. eAvoid etouching ethe eclient. e- eAnswer ea. eFollow eradiation eexposure eprecautions.
Clients ebeing etreated efor eprostate ecancer ewith ebrachytherapy e(radioactive eseeds
eimplant) eshould ebe eplaced eon eradiation eexposure eprecautions. eThe ePN eneeds eto
efollow ethe einstitution's eprotocols eput ein eplace eregarding ethe eamount eof etime eand
edistance eneeded eto eprevent eexcessive eexposure ethat ewould epose ea ehazard eto
eothers.
A eclient ediagnosed ewith eemphysema ethat eis eoxygen-dependent elives ealone eat
ehome eand emanages eself-care ewith eno edifficulty. eWhich efinding eshould eprompt ethe
ehome ehealth epractical enurse eto econsult ethe eregistered enurse ecase emanager?
a. eA epulse eoximetry ereading eof e91% eon eoxygen eat e2 eL/m
b. eA eweight eloss eof e5 epounds esince ethe elast emonthly ehome evisit
c. eThe eclient ereports efeeling eas etired eas eat ethe elast evisit eby ethe enurse
d. eUpon eentering ethe ehome, ethe ePN enoticed edirty edishes eand eclothing escattered
earound ethe ehome. e- eAnswer eb. eA eweight eloss eof e5 epounds esince ethe elast
emonthly ehome evisit
A eweight eloss eof e5 epounds ein e1 emonth eis ea econcern. eClients ewith eCOPD eneed
eadditional ecalorie eintake ebecause ethey eare eusing eup ea elot efrom ethe eenergy ethey
eare eusing eto ebreath. eThe epractical enurse eneeds eto econsult ewith ethe eregistered
enurse ecase emanager efor ea enutrition econsult
The enurse ehas ereinforced einstructions eto ea eclient ewith ediabetes emellitus eon ehow
eto eself-monitor efor esymptoms eof ediabetic eketoacidosis e(DKA). eThe enurse erealizes
ethe einstructions ehave ebeen eeffective eif ethe eclient ecan elist ewhich esymptoms?
e(Select eall ethat eapply.)
a. eFruity ebreath eodor
b. eRapid, eweak epulse
c. eCold, eclammy eskin
,d. eExtreme ethirst
e. eUrinary efrequency
f. eProtruding eeyeballs e- eAnswer ea. eFruity ebreath eodor
b. eRapid, eweak epulse
d. eExtreme ethirst
e. eUrinary efrequency
Diabetic eketoacidosis eis ecaused eby ea eprofound edeficiency eof einsulin. eSome
ecommon echaracteristics einclude ea esweet, efruity ebreath eodor, ea erapid eweak epulse,
eextreme ethirst, eurinary efrequency, eand esunken-appearing eeyeballs.
A eclient ementions eusing egarlic edaily eas ean eherb eto elower echolesterol eand
etriglyceride elevels. eWhich enursing eaction eis ea epriority?
a. eMonitor ethe eclient efor esigns eof ebleeding.
b. eInstruct ethe eclient ethat egarlic etends eto ecause ehypertension.
c. eThis emay erelieve efever ein ethe esame eway ethat eacetaminophen edoes.
d. eRemind ethe epatient eto euse etooth ebrushing eand emouthwash eto eprevent egarlic
eodor. e- eAnswer ea. eMonitor ethe eclient efor esigns eof ebleeding.
Garlic einhibits eplatelet eaggregation ein ethe esame eway ethat easpirin eworks, eand ethe
eclient eshould ebe emonitored efor ebleeding. eGarlic ecan elower ethe eblood epressure,
enot eraise eit. eIt edoes enot erelieve efever. eWhile ethe eclient ewill elikely ewant eto eavoid
egarlic eodor, eit eis enot ea epriority.
The epractical enurse e(PN) eis ereviewing ethe ehealth ehistories eof eassigned eclients.
eWhich efactors ehave ea epotential efor edevelopment eof ethroat ecancer? e(Select eall ethat
eapply.)
a. eTobacco euse
b. eExcessive eintake eof ealcohol
c. eIntake eof ehot eand espicy efoods
d. eHuman epapillomavirus e(HPV)
e. eLack eof eexercise
f. eLack eof edietary efiber e- eAnswer ea. eTobacco euse
b. eExcessive eintake eof ealcohol
d. eHuman epapillomavirus e(HPV)
Rationale:
The emost ecommon erisk efactors efor ethroat ecancer eare etobacco euse, ealcohol eabuse,
ehuman epapillomavirus e(HPV), ea ediet elacking ein efruits eand evegetable, eand
egastroesophageal ereflux edisease e(GERD). eFoods eseasoned ewith eherbs eand espices
ehave eshown eto ehave esome ehealth ebenefits ein edecreasing ethe erisk eof edeveloping
ecancer.
, A eclient ehas eundergone ecraniotomy eto eremove ea ebrain etumor. eThe eclient espent
eseveral edays ein ethe eintensive ecare eunit, eand eis enow eon ethe epost-surgical eunit.
eThe enurse ehas eurgently econtact ethe esurgeon eto ereport esigns eof eincreasing
eintracranial epressure e(ICP). eWhich ewas ethe emost elikely eEARLY esign ethat ethe
eclient ewas eexperiencing eincreased eICP?
a. eThe eclient's eblood epressure edropped efrom e128/70 eto e124/68, epreoperative eBP
e122/72
b. eThe eclient ebecame emore econfused ethan ehe ewas eupon etransfer eto ethe epost-
surgical eunit.
c. eThe eclient ehad ea elarge eamount eof esanguineous edrainage enoted eon ethe egauze
edressings.
d. eThe eclient's epulse erate ehad eincreased efrom e70 eto e82 ebeats/min. e- eAnswer eb.
eThe eclient ebecame emore econfused ethan ehe ewas eupon etransfer eto ethe epost-
surgical eunit.
Rationale:
A echange ein ethe elevel eof econsciousness eis emost elikely ethe eearliest esymptom eof
eincreased eICP. eVital esign echanges ecan ealso eoccur, ewith ea ewidening epulse
epressure eand ebradycardia. eNeither eof ethese eare eindicated eby edata ein ethe eoptions.
eSanguineous edrainage edoes enot eindicate eincreased eICP.
The ehome ehealth epractical enurse eis evisiting ewith ea eclient ewho ehas ea ehistory eof
esecond-degree eheart eblock eand epacemaker eplacement e6 emonths eago. eWhich
esymptom ecompliant eby ethe eclient ewould ebe eindicative eof epacemaker efailure?
a. eFacial eflushing
b. eNausea
c. ePounding eheadache
d. eFeelings eof edizziness e- eAnswer ed. eFeelings eof edizziness
Rationale:
Feelings eof edizziness emay eoccur eas ethe eresult eof ea edecreased eheart erate, eleading
eto edecreased ecardiac eoutput eas ea eresult eof epacemaker efailure.
Which eactions edemonstrate eto ethe epractical enurse ethat ethe eclient eunderstands ethe
ecorrect eprocedure eadministration eof ea emetered edose einhaler e(MDI)? e(Select eall
ethat eapply.)
a. eSit eor estand.
b. eShake ethe einhaler.
c. eAttach ethe ecanister eof emedication eto ethe emouthpiece.
d. eBreathe ein ethrough ethe emouth, efilling ethe elungs.
e. eUse ea espacer eattachment eand eplace ethe emouthpiece ein ethe emouth.
f. eClose ethe elips earound ethe emouthpiece.
WITH VERIFIED ANSWERS
During ea eclinic evisit, ea eclient ereports eto ethe epractical enurse e(PN) ethat ethey efelt ea
esolid emass ein etheir ebreast eduring eself-examination, ebut eit ewas enot epainful. eWhat
einstruction eshould ethe ePN ereinforce ewith ethe eclient?
A. eContinue eto emonitor ethe emass euntil ethe enext escheduled eannual eexam.
B. eNotify ethe ePCP eif ethe emass ebecomes esoft eor epainful eor estarts eto edrain.
C. eSchedule ean eappointment ewith ethe ePCP efor eevaluation
D. eBreast emasses eare eusually einsignificant eif ethey efeel esoft eor eare eeasily
emoveable. e- eAnswer ec. eSchedule ean eappointment ewith ethe ehealth ecare eprovider
efor eevaluation.
A epainless ebreast emass eis ean eabnormal efinding, eand ethe ePN eshould einstruct ethe
eclient eto eobtain eprompt emedical eevaluation.
The ehealth ecare eprovider einformed ea eclient ediagnosed ewith estage e4 eliver ecancer
ethat ethe ecancer ehas espread eto etheir espine. eThe eclient estates eto ethe epractical
enurse, e"I ehave ea ecancer, ebut eit eis enot emalignant." eWhat eis ethe ebest einitial
enursing eaction?
A. eEncourage ethe eclient eto eattend ea ecancer eeducation eprogram
B. ePerform ea ecomplete ehistory eand ephysical eassessment
C. eAsk ethe eclient eto eexplain ehis eunderstanding eof ethe eterm emalignancy.
D. eOffer ethe eclient eemotional esupport eto edeal ewith ethe ediagnosis
Submit e- eAnswer ec. eAsk ethe eclient eto eexplain ehis eunderstanding eof ethe eterm
emalignancy.
The ebest einitial eaction eis eto eassess ethe eclient's eknowledge eof ethe eterm emalignancy
ewhen eused eto edescribe ecancer. eThe eclient eappears eto ehave einaccurate
eknowledge. eStage e4 ecancer emeans ethe ecancer ehas espread e(metastasized) efrom
ewhere eit ehas estarted eto eanother ebody epart.
A eclient ediagnosed ewith eosteoarthritis. eWhich eintervention eshould ethe epractical
enurse eimplement eto ehelp erelieve ejoint epain eand estiffness?
a. eEncourage ethe eclient eto eperform eweight-bearing eexercises.
b. eTeach ethe eclient ehow eto eperform erange-of-motion eexercises.
c. eExplain ethe euse eof eice eand emassage efor epain erelief.
,d. eInstruct ethe eclient eto etake ean eanalgesic ebefore ewalking edaily e- eAnswer ed.
eInstruct ethe eclient eto etake ean eanalgesic ebefore ewalking edaily.
Adequate epain emanagement eis eimportant efor ethe esuccess eof ean eexercise eprogram.
eKeeping ethe ejoints eactive edecreases epain, eso etaking ean eanalgesic eand ewalking
edaily eis elikely eto ehelp edecrease ejoint epain eand estiffness.
A eclient ediagnosed ewith eprostate ecancer eis eprescribed eradioactive eseed
eimplantation e(brachytherapy). eWhat eis ethe emost eimportant enursing eaction efor ethe
epractical enurse e(PN) eto edo?
a. eFollow eradiation eexposure eprecautions
b. eEncourage eregular emeals
c. eCollect eall eurine ein esealed econtainers
d. eAvoid etouching ethe eclient. e- eAnswer ea. eFollow eradiation eexposure eprecautions.
Clients ebeing etreated efor eprostate ecancer ewith ebrachytherapy e(radioactive eseeds
eimplant) eshould ebe eplaced eon eradiation eexposure eprecautions. eThe ePN eneeds eto
efollow ethe einstitution's eprotocols eput ein eplace eregarding ethe eamount eof etime eand
edistance eneeded eto eprevent eexcessive eexposure ethat ewould epose ea ehazard eto
eothers.
A eclient ediagnosed ewith eemphysema ethat eis eoxygen-dependent elives ealone eat
ehome eand emanages eself-care ewith eno edifficulty. eWhich efinding eshould eprompt ethe
ehome ehealth epractical enurse eto econsult ethe eregistered enurse ecase emanager?
a. eA epulse eoximetry ereading eof e91% eon eoxygen eat e2 eL/m
b. eA eweight eloss eof e5 epounds esince ethe elast emonthly ehome evisit
c. eThe eclient ereports efeeling eas etired eas eat ethe elast evisit eby ethe enurse
d. eUpon eentering ethe ehome, ethe ePN enoticed edirty edishes eand eclothing escattered
earound ethe ehome. e- eAnswer eb. eA eweight eloss eof e5 epounds esince ethe elast
emonthly ehome evisit
A eweight eloss eof e5 epounds ein e1 emonth eis ea econcern. eClients ewith eCOPD eneed
eadditional ecalorie eintake ebecause ethey eare eusing eup ea elot efrom ethe eenergy ethey
eare eusing eto ebreath. eThe epractical enurse eneeds eto econsult ewith ethe eregistered
enurse ecase emanager efor ea enutrition econsult
The enurse ehas ereinforced einstructions eto ea eclient ewith ediabetes emellitus eon ehow
eto eself-monitor efor esymptoms eof ediabetic eketoacidosis e(DKA). eThe enurse erealizes
ethe einstructions ehave ebeen eeffective eif ethe eclient ecan elist ewhich esymptoms?
e(Select eall ethat eapply.)
a. eFruity ebreath eodor
b. eRapid, eweak epulse
c. eCold, eclammy eskin
,d. eExtreme ethirst
e. eUrinary efrequency
f. eProtruding eeyeballs e- eAnswer ea. eFruity ebreath eodor
b. eRapid, eweak epulse
d. eExtreme ethirst
e. eUrinary efrequency
Diabetic eketoacidosis eis ecaused eby ea eprofound edeficiency eof einsulin. eSome
ecommon echaracteristics einclude ea esweet, efruity ebreath eodor, ea erapid eweak epulse,
eextreme ethirst, eurinary efrequency, eand esunken-appearing eeyeballs.
A eclient ementions eusing egarlic edaily eas ean eherb eto elower echolesterol eand
etriglyceride elevels. eWhich enursing eaction eis ea epriority?
a. eMonitor ethe eclient efor esigns eof ebleeding.
b. eInstruct ethe eclient ethat egarlic etends eto ecause ehypertension.
c. eThis emay erelieve efever ein ethe esame eway ethat eacetaminophen edoes.
d. eRemind ethe epatient eto euse etooth ebrushing eand emouthwash eto eprevent egarlic
eodor. e- eAnswer ea. eMonitor ethe eclient efor esigns eof ebleeding.
Garlic einhibits eplatelet eaggregation ein ethe esame eway ethat easpirin eworks, eand ethe
eclient eshould ebe emonitored efor ebleeding. eGarlic ecan elower ethe eblood epressure,
enot eraise eit. eIt edoes enot erelieve efever. eWhile ethe eclient ewill elikely ewant eto eavoid
egarlic eodor, eit eis enot ea epriority.
The epractical enurse e(PN) eis ereviewing ethe ehealth ehistories eof eassigned eclients.
eWhich efactors ehave ea epotential efor edevelopment eof ethroat ecancer? e(Select eall ethat
eapply.)
a. eTobacco euse
b. eExcessive eintake eof ealcohol
c. eIntake eof ehot eand espicy efoods
d. eHuman epapillomavirus e(HPV)
e. eLack eof eexercise
f. eLack eof edietary efiber e- eAnswer ea. eTobacco euse
b. eExcessive eintake eof ealcohol
d. eHuman epapillomavirus e(HPV)
Rationale:
The emost ecommon erisk efactors efor ethroat ecancer eare etobacco euse, ealcohol eabuse,
ehuman epapillomavirus e(HPV), ea ediet elacking ein efruits eand evegetable, eand
egastroesophageal ereflux edisease e(GERD). eFoods eseasoned ewith eherbs eand espices
ehave eshown eto ehave esome ehealth ebenefits ein edecreasing ethe erisk eof edeveloping
ecancer.
, A eclient ehas eundergone ecraniotomy eto eremove ea ebrain etumor. eThe eclient espent
eseveral edays ein ethe eintensive ecare eunit, eand eis enow eon ethe epost-surgical eunit.
eThe enurse ehas eurgently econtact ethe esurgeon eto ereport esigns eof eincreasing
eintracranial epressure e(ICP). eWhich ewas ethe emost elikely eEARLY esign ethat ethe
eclient ewas eexperiencing eincreased eICP?
a. eThe eclient's eblood epressure edropped efrom e128/70 eto e124/68, epreoperative eBP
e122/72
b. eThe eclient ebecame emore econfused ethan ehe ewas eupon etransfer eto ethe epost-
surgical eunit.
c. eThe eclient ehad ea elarge eamount eof esanguineous edrainage enoted eon ethe egauze
edressings.
d. eThe eclient's epulse erate ehad eincreased efrom e70 eto e82 ebeats/min. e- eAnswer eb.
eThe eclient ebecame emore econfused ethan ehe ewas eupon etransfer eto ethe epost-
surgical eunit.
Rationale:
A echange ein ethe elevel eof econsciousness eis emost elikely ethe eearliest esymptom eof
eincreased eICP. eVital esign echanges ecan ealso eoccur, ewith ea ewidening epulse
epressure eand ebradycardia. eNeither eof ethese eare eindicated eby edata ein ethe eoptions.
eSanguineous edrainage edoes enot eindicate eincreased eICP.
The ehome ehealth epractical enurse eis evisiting ewith ea eclient ewho ehas ea ehistory eof
esecond-degree eheart eblock eand epacemaker eplacement e6 emonths eago. eWhich
esymptom ecompliant eby ethe eclient ewould ebe eindicative eof epacemaker efailure?
a. eFacial eflushing
b. eNausea
c. ePounding eheadache
d. eFeelings eof edizziness e- eAnswer ed. eFeelings eof edizziness
Rationale:
Feelings eof edizziness emay eoccur eas ethe eresult eof ea edecreased eheart erate, eleading
eto edecreased ecardiac eoutput eas ea eresult eof epacemaker efailure.
Which eactions edemonstrate eto ethe epractical enurse ethat ethe eclient eunderstands ethe
ecorrect eprocedure eadministration eof ea emetered edose einhaler e(MDI)? e(Select eall
ethat eapply.)
a. eSit eor estand.
b. eShake ethe einhaler.
c. eAttach ethe ecanister eof emedication eto ethe emouthpiece.
d. eBreathe ein ethrough ethe emouth, efilling ethe elungs.
e. eUse ea espacer eattachment eand eplace ethe emouthpiece ein ethe emouth.
f. eClose ethe elips earound ethe emouthpiece.
