test bank
MED-SURG HESI EXIT TEST BANK NEWEST
2025 / HESI MED-SURG EXIT EXAM
COMPLETE test bank 270 QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) |ALREADY GRADED A+
1. When assessing a patient's nutritional-metabolic pattern related to hematologic health, the nurse would:
A. Inspect the skin for petechiae.
B. Ask the patient about joint pain.
C. Assess for vitamin C deficiency.
D. Determine if the patient can perform ADLs
. - ANS :A. Inspect the skin for petechiae. Any changes in the skin's texture or color should be explored when
assessing the patient's nutritional-metabolic pattern related to hematologic health. The presences of petechiae or
ecchymotic areas could be indicative of hematologic deficiencies related to poor nutritional intake or related causes.
2. When assessing lab values on a patient admitted with septicemia, the nurse would expect to find:
A. Increased platelets
B. Decreased red blood cells
C. Decreased erythrocyte sedimentation rate (ESR)
D. Increased bands in the WBC differential (shift to the left)
- ANS :D. Increased bands in the WBC differential (shift to the left) When infections are severe, such as in septicemia,
more granulocytes are released from the bone marrow as a compensatory mechanism. To meet the increased
demand, many young, immature polymorphonuclear neutrophils (bands) are released into circulation. WBCs are
usually reported in order of maturity, with the less mature forms on the left side of a written report. Hence, the term
"shift to the left" is used to denote an increase in the number of bands.
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3. When caring for a patient with metastatic cancer, the nurse notes a hemoglobin level of 8.7 g/dl and hematocrit of
26%. The nurse would place highest priority on initiating interventions that will reduce which of the following?
A. Fatigue
B. Thirst
C. Headache
D. Abdominal pain –
ANS :A. Fatigue The patient with a low hemoglobin and hematocrit (normal values approximately 13.5% to 17% and
40% to 54%, respectively) is anemic and would be most likely to experience fatigue. This symptom develops because
of the lowered oxygen-carrying capacity that leads to reduced tissue oxygenation to carry out cellular functions.
4. The nurse is caring for a patient who is to receive a transfusion of two units of packed red blood cells. After
obtaining the first unit from the blood bank, the nurse would ask which of the following health team members in the
nurses' station to assist in checking the unit before administration?
A. Unit secretary
B. Another registered nurse
C. A physician's assistant
D. A phlebotomist –
ANS :B. Another registered nurseBefore hanging a transfusion, the registered nurse must check the unit with
another RN or with a licensed practical (vocational) nurse, depending on agency policy.
5. Before starting a transfusion of packed red blood cells for an anemic patient, the nurse would arrange for a peer to
monitor his or her other assigned patients for how many minutes when the nurse begins the transfusion?
A. 60
B. 5
C. 30
D. 15
- ANS :D. 15 As part of standard procedure, the nurse remains with the patient for the first 15 minutes after hanging
a blood transfusion. Patients who are likely to have a transfusion reaction will more often exhibit signs within the first
15 minutes that the blood is infusing.
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6. When preparing to administer an ordered blood transfusion, the nurse selects which of the following intravenous
solutions to use when priming the blood tubing?
A. 5% dextrose in water
B. Lactated Ringer's
C. 0.9% sodium chloride
D. 0.45% sodium chloride –
ANS :C. 0.9% sodium chloride The blood set should be primed before the transfusion with 0.9% sodium chloride,
also known as normal saline. It is also used to flush the blood tubing after the infusion is complete to ensure the
patient receives blood that is left in the tubing when the bag is empty.
7. The nurse notes a physician's order written at 10:00 AM for 2 units of packed red blood cells to be administered to
a patient who is anemic secondary to chronic blood loss. If the transfusion is picked up at 11:30, the nurse should
plan to hang the unit no later than which of the following times?
A. 11:45 AM
B. 12:00 noon
C. 12:30 PM
D. 3:30 PM –
ANS :B. 12:00 noon The nurse must hang the unit of packed red blood cells within 30 minutes of signing them out
from the blood bank
8. The nurse receives a physician's order to transfuse fresh frozen plasma to a patient suffering from an acute blood
loss. Which of the following procedures is most appropriate for infusing this blood product?
A. Hand the fresh frozen plasma as a piggyback to a new bag of primary IV solution without KCl.
B. Infuse the fresh frozen plasma as rapidly as the patient will tolerate.
C. Hang the fresh frozen plasma as a piggyback to the primary IV solution.
D. Infuse the fresh frozen plasma as a piggyback to a primary solution of normal saline
. - ANS :B. Infuse the fresh frozen plasma as rapidly as the patient will tolerate. The fresh frozen plasma should be
administered as rapidly as possible and should be used within 2 hours of thawing. Fresh frozen plasma is infused
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using any straight-line infusion set. Any existing IV should be interrupted while the fresh frozen plasma is infused,
unless a second IV line has been started for the transfusion.
9. Before beginning a transfusion of RBCs, which of the following actions by the nurse would be of highest priority to
avoid an error during this procedure?
A. Check the identifying information on the unit of blood against the patient's ID bracelet.
B. Select new primary IV tubing primed with lactated Ringer's solution to use for the transfusion.
C. Add the blood transfusion as a secondary line to the existing IV and used the IV controller to maintain correct flow.
D. Remain with the patient for 60 minutes after beginning the transfusion to watch for signs of a transfusion
reaction. The patient's identifying information (name, date of birth, medical record number) on the identification
bracelet should exactly match the information on the blood bank tag that has been placed on the unit of blood. If
any information does not match, the transfusions should not be hung because of possible error and risk to the patie
–
ANS :A. The patient's identifying information (name, date of birth, medical record number) on the identification
bracelet should exactly match the information on the blood bank tag that has been placed on the unit of blood. If
any information does not match, the transfusions should not be hung because of possible error and risk to the
patient.
10. The blood bank notifies the nurse that the two units of blood ordered for an anemic patient are ready for pick
up. The nurse should take which of the following actions to prevent an adverse effect during this procedure?
A. Immediately pick up both units of blood from the blood bank.
B. Regulate the flow rate so that each unit takes at least 4 hours to transfuse.
C. Set up the Y-tubing of the blood set with dextrose in water as the flush solution.
D. Infuse the blood slowly for the first 15 minutes of the transfusion. –
ANS :D. Infuse the blood slowly for the first 15 minutes of the transfusion. Because a transfusion reaction is more
likely to occur at the beginning of a transfusion, the nurse should initially infuse the blood at a rate no faster than 2
ml/min and remain with the patient for the first 15 minutes after hanging a unit of blood.
1. A nurse is reviewing the hematologic test results for a patient in whom the hematocrit (Hct) is reported at a
reading of 30%. Based on this result, the nurse should interpret that the patient
A. is susceptible to bleeding disorders.
B. has fewer red blood cells than normal. C. is experiencing an inflammatory response.
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