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HESI NSG 123 MEDICAL SURGICAL NURSING FINAL EXAM 3 LATEST ACTUAL TEST REAL QUESTIONS AND CORRECT ANSWERS (CORRECT VERIFIED SOLUTIONS) NEWEST UPDATED VERSION

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HESI NSG 123 MEDICAL SURGICAL NURSING FINAL EXAM 3 LATEST ACTUAL TEST REAL QUESTIONS AND CORRECT ANSWERS (CORRECT VERIFIED SOLUTIONS) NEWEST UPDATED VERSION

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1
NSGf101fHEf SIfReviewfoverf700fQUESTIONSfwithfAnswersf tofthef2016fandf2017fEXIT
EXAM

1. Followingfdischargefteaching,fafmalefclientfwithfduodenalfulcerftellsfthefnursefthefhefwillfdrin
kfplentyfoffdairyfproducts,fsuchfasfmilk,ftofhelpfcoatfandfprotectfhisfulcer.fWhatfisfthefbestffoll
ow-upfactionfbyfthefnurse?
• Reviewfwithfthefclientfthefneedftofavoidffoodsfthatfarefrichfinfmilkfandfcream
2. Afmalefclientfwithfhypertension,fwhofreceivedfnewfantihypertensivefprescriptionsfatfhisflastf
visitfreturnsftofthefclinicftwofweeksflaterftofevaluatefhisfbloodfpressuref(BP).fHisfBPfisf158/1
06fandfhefadmitsfthatfhefhasfnotfbeenftakingfthefprescribedfmedicationfbecausefthefdrugsfma
kefhimf“feelfbad”.fInfexplainingfthefneedfforfhypertensionfcontrol,fthefnursefshouldfstressftha
tfanfelevatedfBPfplacesfthefclientfatfriskfforfwhichfpathophysiologicalfcondition?
• Strokefsecondaryftofhemorrhage
3. Thefnursefobservesfanfunlicensedfassistivefpersonnelf(UAP)fpositioningfafnewlyfadmitte
dfclientfwhofhasfafseizurefdisorder.fThefclientfisfsupinefandfthefUAPfisfplacingfsoftfpillowsf
alongfthefsidefrails.fWhatfactionfshouldfthefnursefimplement?
• InstructfthefUAPftofobtainfsoftfblanketsftofsecureftofthefsidefrailsfinsteadfoffpill
ows.

4. Anfadolescentfwithfmajorfdepressivefdisorderfhasfbeenftakingfduloxetinef(Cymbalta)fforfthe
fpast f12fdays.fWhichfassessmentffindingfrequires fimmediateffollow-up?


• Describesflifefwithoutfpurpose
5. Af60-year-
oldffemalefclientfwithfafpositiveffamilyfhistoryfoffovarianfcancerfhasfdevelopedfanfabdomin
alfmassfandfisfbeingfevaluatedfforfpossiblefovarianfcancer.fHerfPapanicolauf(Pap)fsmearfres
ultsfarefnegative.fWhatfinformationfshouldfthefnursefincludefinfthefclient’sfteachingfplan?
• Furtherfevaluationfinvolvingfsurgeryfmayfbefneeded
6. Afclientfwhofrecentlyfunderwearfaftracheostomyfisfbeingfpreparedfforfdischargeftofhome.fWh
ichfinstructionsfisfmostfimportantfforfthefnurseftofincludefinfthefdischargefplan?
• Teachftrachealfsuctioningftechniques
7. Infassessingfanfadultfclientfwithfafpartialfrebreatherfmask,fthefnursefnotesfthatfthefoxygen
reservoirfbagfdoesfnotfdeflatefcompletelyfduringfinspirationfandfthefclient’sfrespiratoryfratefi
sf14fbreathsf/fminute.fWhatfactionfshouldfthefnursefimplement?
• Documentfthefassessmentfdata
• Rational:freservoirfbagfshouldfnotfdeflatefcompletelyfduringfinspirationfandfthefcli
ent’sfrespiratoryfratefisfwithinfnormalflimits.
8. Duringfshiftfreport,fthefcentralfelectrocardiogramf(EKG)fmonitoringfsystemfalarms.fW
hichfclientfalarmfshouldfthefnursefinvestigateffirs?
• Respiratoryfapneafoff30fseconds
9. Duringfafhomefvisit,fthefnursefobservedfanfelderlyfclientfwithfdiabetesfslipfandffall.fWhat
actionfshouldfthefnurseftakeffirst?
• Checkfthefclientfforflacerationsforffractures
10. Atf0600fwhilefadmittingfafwomanfforfafschedulefrepeatfcesareanfsectionf(C-Section),fthe
clientftellsfthefnursefthatfshefdrankfafcupfafcoffeefatf0400fbecausefshefwantedftofavoidfgettingfaf
headache.fWhichfactionfshouldfthefnurseftakeffirst?

,2
NSGf101fHEf SIfReviewfoverf700fQUESTIONSfwithfAnswersf tofthef2016fandf2017fEXIT
EXAM

• Informfthefanesthesiafcarefprovider
11. Afterfplacingfafstethoscopefasfseenfinfthefpicture,fthefnursefauscultatesfS1fandfS2fheart
sounds.fTofdeterminefiffanfS3fheartfsoundfisfpresent,fwhatfactionfshouldfthefnurseftakeffirst?
• Listenfwithfthefbellfatfthefsameflocation
12. Af66-year-oldfwomanfisfretiringfandfwillfnoflongerfhavefafhealthfinsurancefthroughfher
placefoffemployment.fWhichfagencyfshouldfthefclientfbefreferredftofbyfthefemployeefhealthfnu
rsefforfhealthfinsurancefneeds?
• Medicare
13. Afclientfwhofisftakingfanforalfdosefoffaftetracyclinefcomplainsfoffgastrointestinalfupset.fWh
atfsnackfshouldfthefnursefinstructfthefclientftoftakefwithftheftetracycline?
• Toastedfwheatfbreadfandfjelly
14. Followingfaflumbarfpuncture,fafclientfvoicesfseveralfcomplaints.fWhatfcomplaintfin
dicatedftofthefnursefthatfthefclientfisfexperiencingfafcomplication?
• “IfhavefafheadachefthatfgetsfworsefwhenfIfsitfup”

• “IfamfhavingfpainfinfmyflowerfbackfwhenfIfmovefmyflegs”
• “MyfthroatfhurtsfwhenfIfswallow”
• “Iffeelfsickftofmyfstomachfandfamfgoingftofthrowfup”
15. Anfelderlyfclientfseemsfconfusedfandfreportsfthefonsetfoffnausea,fdysuria,fandfurgencyfwit
hfincontinence.fWhichfactionfshouldfthefnursefimplement?
• Obtainfafcleanfcatchfmid-streamfspecimen
16. Thefnursefisfassistingfthefmotherfoffafchildfwithfphenylketonuriaf(PKU)ftofselectffoodsfthatf
arefinfkeepingfwithfthefchild’sfdietaryfrestrictions.fWhichffoodsfarefcontraindicatedfforfthisf
child?
• Foodsfsweetenedfwithfaspartame
17. Beforefpreparingfafclientfforftheffirstfsurgicalfcasefoffthefday,fafpart-
timefscrubfnursefasksfthefcirculatingfnursefiffaf3fminutefsurgicalfhandfscrubfisfadequatefprepa
rationfforfthisfclient.fWhichfresponsefshouldfthefcirculatingfnursefprovide?
• Directfthefnurseftofcontinuefthefsurgicalfhandfscrubfforfaf5fminutefduration
18. Whichfbreakfastfselectionfindicatesfthatfthefclientfunderstandsfthefnurse’sfinstructions
aboutfthefdietaryfmanagementfoffosteoporosis?
• Bagelfwithfjellyfandfskimfmilk
19. Thefchargefnursefoffafcriticalfcarefunitfisfinformedfatfthefbeginningfoffthefshiftfthatflessfthanft
hefoptimalfnumberfoffregisteredfnursesfwillfbefworkingfthatfshift.fInfplanningfassignments,f
whichfclientfshouldfreceivefthefmostfcarefhoursfbyfafregisteredfnursef(RN)?
• Anf82-year-oldfclientfwithfAlzheimer’sfdiseasefnewly-fracturesffemurfwhofhasfa
Foleyfcatheterfandfsoftfwristfrestrainsfapplied

,3
NSGf101fHEf
EXAM

20.fAfmotherfbringsfherf6-year-
oldfchild,fwhofhasfjustfsteppedfonfafrustyfnail,ftofthefpediatrician’sfoffice.fUponfinspection,ft
and fpierced
he nurse fthe
notes fbottom
that foffthe
the nail fchild’s
went ffoot.
through thefWhich
shoefactionfshouldfthefnursefimplementffirst?
• Cleanseftheffootfwithfsoapfandfwaterfandfapplyfanfantibioticfointment
• Providefteachingfaboutfthefneedfforfaftetanusfboosterfwithinfthefnextf72fhours.
• havefthefmotherfcheckfthefchild'sftemperaturefq4hfforfthefnextf24fhours
• transferfthefchildftofthefemergencyfdepartmentftofreceivefafgammafglobulinfinj
ection
21. Thefmotherfoffanfadolescentftellsfthefclinicfnurse,f“Myfsonfhasfathlete’sffoot,fIfhavefbeenfappl
yingftriplefantibioticfointmentfforftwofdays,fbutftherefhasfbeenfnofimprovement.”fWhatfinstr
uctionfshouldfthefnursefprovide?
• Stopfusingfthefointmentfandfencouragefcompletefdryingfofftheffeetfandfwearing
cleanfsocks.
22. Af26-year-
oldffemalefclientfisfadmittedftofthefhospitalfforftreatmentfoffafsimplefgoiter,fandflevothyro
xinefsodiumf(Synthroid)fisfprescribed.fWhichfsymptomsfindicateftofthefnursefthatfthefpre
scribedfdosagefisftoofhighfforfthisfclient?fThefclientfexperiences
• Bradycardiafandfconstipation
• Lethargyfandflackfoffappetite
• Musclefcrampingfandfdry,fflushedfskin
• Palpitationsfandfshortnessfoffbreath
23. Afclientfwithfafhistoryfoffheartffailurefpresentsftofthefclinicfwithfafnausea,fvomiting,fyellowfv
isionfandfpalpitations.fWhichffindingfisfmostfimportantfforfthefnurseftofassessftofthefclient?
• Obtainfaflistfoffmedicationsftakenfforfcardiacfhistory
24. ThefhealthcarefproviderfprescribesfanfIVfsolutionfoffisoproterenolf(Isuprel)f1fmgfinf250
mlfoffD5Wfatf300fmcg/hour.fThefnursefshouldfprogramfthefinfusionfpumpftofdeliverfhowfman
yfml/hour?f(Enterfnumericfvaluefonly.)
• 75
• Rationale:fConvertfmgftofmcgfandfusefthefformulafD/HfxfQ.f300fmcg/hourf/f1,0
00fmcgfxf250fmlf=f3/1fxf25f=f75fml/hour
25. Thefpathophysiologicalfmechanismfarefresponsiblefforfascitesfrelatedftofliverffailure?f(S
electfallfthatfapply)
• Fluidfshiftsffromfintravascularftofinterstitialfareafdueftofdecreasedfserumfprotein
• Increasedfhydrostaticfpressurefinfportalfcirculationfincreasesffluidfshiftsfinto
abdomen
• Increasedfcirculatingfaldosteroneflevelsfthatfincreasefsodiumfandfwaterfretention
26. Thefnursefisfauscultatingfafclient’sfheartfsounds.fWhichfdescriptionfshouldfthefnursefuse
tofdocumentfthisfsound?f(Pleaseflistenftofthefaudioffirstftofselectfthefoptionfthatfapplies)
• Murmur
• Rationale:fAfmurmurfisfauscultatedfasfafswishingfsoundfthatfisfassociatedfwithfthefblo
odfturbulencefcreatedfbyfthefheartforfvalvularfdefect.




27. Thefhealthcarefproviderfprescribesfceltazidimef(Fortax)f35fmgfeveryf8fhoursfIMfforfan

, 4
NSGf101fHEf SIfReviewfoverf700fQUESTIONSfwithfAnswersf tofthef2016fandf2017fEXIT
EXAM

infant.fThef500fmgfvialfisflabeledfwithfthefinstructionftofaddf5.3fmlfdiluentftofprovidefafconce
ntrationfoff100fmg/ml.fHowfmanyfmlfshouldfthefnursefadministeredfforfeachfdose?f(Enterfnu
mericfvaluefonly.fIffroundingfisfrequired,froundftofthefnearestftenth)
• 0.4
• rationale:f35mg/100mgfxf1f=f0.35f=f0.4fml
28. Thefnursefnotesfthatfafclientfhasfbeenfreceivingfhydromorphonef(Dilaudid)feveryfsix
hoursfforffourfdays.fWhatfassessmentfisfmostfimportantfforfthefnurseftofcomplete?
• Auscultatefthefclient'sfbowelfsounds
• Observefforfedemafaroundfthefankles
• Measurefthefclient’sfcapillaryfglucoseflevel
• Countfthefapicalfandfradialfpulsesfsimultaneously
• Rationale:fhydromorphonefisfafpotentfopioidfanalgesicfthatfslowsfperistalsisfandffre
quentlyfcausesfconstipation,fsofitfisfmostfimportantftofAuscultatefthefclient's
bowelfsounds
29. Affemalefclientfisfadmittedfwithfendfstagefpulmonaryfdiseasefisfalert,foriented,fandfcompl
ainingfoffshortnessfoffbreath.fThefclientftellsfthefnursefthatfshefwantsf“nofheroicfmeasures
”ftakenfiffshefstopsfbreathing,fandfshefasksfthefnurseftofdocumentfthisfinfherfmedicalfrecor
d.fWhatfactionfshouldfthefnursefimplement?
• Askfthefclientftofdiscussf“dofnotfresuscitate”fwithfherfhealthcarefprovider
30. Afclientfisfreceivingfaffullfstrengthfcontinuousfenteralftubeffeedingfatf50fml/hourfandfhas
developedfdiarrhea.fThefclientfhasfafnewfprescriptionftofchangeftheffeedingftofhalffstrength.fW
hatfinterventionfshouldfthefnursefimplement?
• Addfequalfamountsfoffwaterfandffeedingftofaffeedingfbagfandfinfusefatf50ml/hour
31. Affemalefclientfreportsfthatfherfhairfisfbecomingfcoarsefandfbreakingfoff,fthatfthefouter
partfoffherfeyebrowsfhavefdisappeared,fandfthatfherfeyesfarefallfpuffy.fWhichffollow-
upfquestionfisfbestfforfthefnurseftofask?
• Havefyoufnoticedfanyfchangesfinfyourffingernails?
• Rationale:fThefpatternfoffreportedfmanifestationsfisfsuggestivefoffhypothyroidism
32. Afterfafthirdfhospitalizationf6fmonthsfago,fafclientfisfadmittedftofthefhospitalfwithfascites
andfmalnutrition.fThefclientfisfdrowsyfbutfrespondingftofverbalfstimulifandfreportsfrecentlyf
spittingfupfblood.fWhatfassessmentffindingfwarrantsfimmediatefinterventionfbyfthefnurse?
• Capillaryfrefillfoff8fseconds
• bruisesfonfarmsfandflegs
• roundfandftightfabdomen
• pittingfedemafinflowerflegs
33. Afterfthefnursefwitnessesfafpreoperativefclientfsignfthefsurgicalfconsentfform,fthefnurse
signsfthefformfasfafwitness.fWhatfareftheflegalfimplicationsfoffthefnurse’sfsignaturefonfthefclien
t’sfsurgicalfconsentfform?f(Selectfallfthatfapply)
• Thefclientfvoluntarilyfgrantsfpermissionfforfthefprocedureftofbefdone
• Thefclientfisfcompetentftofsignfthefconsentfwithoutfimpairmentfoffjudgment
• Thefclientfunderstandsfthefrisksfandfbenefitsfassociatedfwithfthefprocedure
34. Followingfsurgery,fafmalefclientfwithfantisocialfpersonalityfdisorderffrequentlyfrequests
thatfafspecificfnursefbefassignedftofhisfcarefandfisfbelligerentfwhenfanotherfnursefisfassigned.f
Whatfactionfshouldfthefchargefnursefimplement?
• Advisefthefclientfthatfassignmentsfarefnotfbasedfonfclientsfrequests
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