Medical Surgical Practice HESI Exam

The practical nurse is reviewing pre-op instructions with a male client who is having surgery today. What question should the PN ask the client to best evaluate his understanding of the surgery? - What do you know about the surgery you are having? An adult client with otitis media has thick, yellow drainage from the right ear canal. What additional findings should the PN expect to identify? - Pain relief after ear drainage begins Which assessment is most important for the practical nurse to implement for a client who returns from surgery for an arthroscopic repair of the right knee? - Palpation of both pedal pulses A client who was hit in the head with a baseball is admitted to the hosp for observation. Which finding requires the PN to follow-up with further assessment? - Reports the hospital room is an office Which actions should the PN implement for a client whose fractured tibia is causing swelling of the lower leg? - Ice application and elevation A male client is admitted with lower right abdominal pain for the past two days. During the focused assessment, the PN observes that the client's abdomen is rigid with tense positioning. Which action should the PN implement? - Keep the client NPO for possible surgery An older female client with osteoporosis asks the PN to explain why she is now 2 inches shorter than when she was younger. What info is best for the PN to provide? - It is a combo of wear and tear and calcium loss that causes the damage During the daily assessment of a client with emphysema, the PN identifies that the client's chest is barrel-shaped and he is demonstrating pursed-lip breathing. Which additional finding requires follow up by the PN? - Rales auscultated bilaterally An older client who has had a cataract in the right eye for several years tells the PN, "Now i have lost the sight in my right eye because I waited too long for treatment." What info should the PN provide? - Surgery can restore vision with corrective lens implants or glasses While completing pre-op prep for a client is admitted for same-day surgery, what eval statement should the PN identify as an important outcome? - Asks questions regarding the surgical experience A client's prescription for warfarin (Coumadin) therapy was d/c 3 weeks ago and returns to the clinic for follow-up lab tests. Which results should indicate to the PN that the meds has been eliminated from the body? - International normalized ratio (INR) or 0.9 What info should the PN reinforce with a client who is recently diagnosed with DM? - Diabetes increase the risk for cardiovascular disease A male client returns to the surgical nursing unit after having a thyroidectomy. Which action is most important for the PN to implement? - Assess the client's resp status Which finding for a client who is 1-day post op for a partial thyroidectomy requires immediate follow-up by the PN? - High pitched expiratory sound A male client is one day post-op for surgical repair of a fractured femur when he suddenly experiences dyspnea, coughing, chest pain, and hemoptysis. Based on this data, what nursing diagnosis should the practical nurse address for this client? - Impaired gas exchanged R/T altered blood flow to alveoli A male client who has been taking a 4-drug regimen for TB tells the PN that he has finished the first drug, *isoniazid*, and will start taking *rifampin* next. How should the PN respond? - The 4 drug protocol should be taken concurrently The PN is performing a focused assessment for a post-op client who returns to the unit after receiving general anesthesia. Which finding should the PN identify as an indicator that the client is free of resp complication? - Breath sounds are clear bilaterally The PN is evaluating the self-care of a client who is recovering at home after a laryngectomy. Which finding indicates to the PN that the client needs additional info? - The salt water solution is dated 3 days ago Which findings should the PN identify in a client with anemia due to a vitamin B12 deficiency? - - Smooth, beefy-red oral cavity - Paresthesia of hands and feet Which client should the PN question the PRN prescription for *sumatriptan (Imitrax)* for migraine headaches? - 50-year-old with Prinzmetal's angina Which instruction should the PN reinforce with a female client about skin care after her first radiotherapy treatment? - Avoid using ice packs on the exposed area A male client who had a stroke is incontinent of urine