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Exam (elaborations)

(Complete 275 Q&A) Med-Surg II HESI Test Bank .pdf

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NURSING NR324 Med surg HESI exit exam latest 2022 test ban
g g g g g g g g g g


k with rationales complete Rated A+
g g g g g g




Thegmothergofgangadolescentgtellsgthegclinicgnurse,g"Mygsonghasgathlete'sgfoot,gIghav
egbeengapplyinggtriplegantibioticgointmentgforgtwogdays,gbutgthereghasgbeengnogimpro
vement."gWhatginstructiongshouldgthegnursegprovide?
(ANS-
gStopgusinggthegointmentgandgencouragegcompletegdryinggofgthegfeetgandg wearinggcl
eangsocks.

Ag26-year-
oldgfemalegclientgisgadmittedgtogtheghospitalgforgtreatmentgofgagsimpleggoiter,gandglev
othyroxinegsodiumg(Synthroid)gisgprescribed.gWhichgsymptomsgindicategtogthegnur
segthatgthegprescribedgdosagegisgtooghighgforgthisgclient?gThegclientgexperiences

Bradycardiagandgconstipationg
Lethargygandglackgofgappetite
Musclegcrampinggandgdry,gflushedgsking
Palpitationsgandgshortnessgofgbreath
(ANS-gPalpitationsgandgshortnessgofgbreath

Agclientgwithgaghistorygofgheartgfailuregpresentsgtogthegclinicgwithgnausea,gvomiting,g
yellowgvisiongandgpalpitations.gWhichgfindinggisgmostgimportantgforgthegnursegtogas
sessgtogthegclient?




(ANS-gObtaingaglistgofgmedicationsgtakengforgcardiacghistory

TheghealthcaregprovidergprescribesgangIVgsolutiongofgisoproterenolg(Isuprel)g1gmggi
ng250gmlgofgD5Wgatg300gmcg/hour.gThegnursegshouldgprogramgtheginfusiongpumpgto
gdeliverghowgmanygml/hour?g(Entergnumericgvaluegonly.)

(ANS-g75

Rationale:gConvertgmggtogmcggandgusegthegformulagD/HgxgQ.g300gmcg/hourg/g1,000g
mcggxg250gmlg=g3/1gxg25g=g75gml/hour

NURSING NR324 Med surg HESI exit exam latest 2022 test ban
g g g g g g g g g g


k with rationales complete Rated A+
g g g g g g

,NURSING NR324 Med surg HESI exit exam latest 2022 test ban
g g g g g g g g g g


k with rationales complete Rated A+
g g g g g g




Thegpathophysiologicalgmechanismsgthatgaregresponsiblegforgascitesgrelatedgtogliverg
failure?g(Selectgallgthatgapply)
(ANS-
gFluidgshiftsgfromgintravasculargtoginterstitialgareagduegtogdecreasedgserumgprotei
n
Increasedghydrostaticgpressuregingportalgcirculationgincreasesgfluidgshiftsgintogabdom
en
Increasedgcirculatinggaldosteroneglevelsgthatgincreasegsodiumgandgwatergretention

Thegnursegisgauscultatinggagclient'sgheartgsounds.gWhichgdescriptiongshouldgthe
nursegusegtogdocumentgthisgsound?g(Pleaseglistengtogthegaudiogfirstgtogselectgtheg
g

optiongthatgapplies)
(ANS-gMurmur

Rationale:gAgmurmurgisgauscultatedgasgagswishinggsoundgthatgisgassociatedgwithgtheg
bloodgturbulencegcreatedgbygthegheartgorgvalvulargdefect.

Theghealthcaregprovidergprescribesgceltazidimeg(Fortax)g35gmggeveryg8ghoursgIMgf
organginfant.gTheg500gmggvialgisglabeledgwithgtheginstructiongtogaddg5.3gmlgdiluentgto
gprovidegagconcentrationgofg100gmg/ml.gHowgmanygmlgshouldgthegnursegadminister

edgforgeachgdose?g(Entergnumericgvaluegonly.gIfgroundinggisgrequired,groundgtogtheg
nearestgtenth)
(ANS-g0.4

ationale:g35mg/100mggxg1g=g0.35g=g0.4gml



Thegnursegnotesgthatgagclientghasgbeengreceivingghydromorphoneg(Dilaudid)geverygsi
xghoursgforgfourgdays.gWhatgassessmentgisgmostgimportantgforgthegnursegtogcomplet
e?

Auscultategthegclient'sgbowelgsoundsgObser
vegforgedemagaroundgtheganklesgMeasuregt
hegclient'sgcapillarygglucoseglevel
Countgthegapicalgandgradialgpulsesgsimultaneouslyg
(ANS-gAuscultategthegclient'sgbowelgsounds
NURSING NR324 Med surg HESI exit exam latest 2022 test ban
g g g g g g g g g g


k with rationales complete Rated A+
g g g g g g

,NURSING NR324 Med surg HESI exit exam latest 2022 test ban
g g g g g g g g g g


k with rationales complete Rated A+
g g g g g g




Rationale:ghydromorphonegisgagpotentgopioidganalgesicgthatgslowsgperistalsisgandgfre
quentlygcausesgconstipation,gsogitgisgmostgimportantgtogAuscultategthegclient'sgbowe
lgsounds

Agfemalegclientgisgadmittedgwithgendgstagegpulmonarygdiseasegisgalert,goriented,gandg
complaininggofgshortnessgofgbreath.gThegclientgtellsgthegnursegthatgshegwantsg"nogher
oicgmeasures"gtakengifgshegstopsgbreathing,gandgshegasksgthegnursegtogdocumentgthis
ginghergmedicalgrecord.gWhatgactiongshouldgthegnursegimplement?

(ANS-gAskgthegclientgtogdiscussg"dognotgresuscitate"gwithgherghealthcaregprovider

Agclientgisgreceivinggagfullgstrengthgcontinuousgenteralgtubegfeedinggatg50gml/hourga
ndghasgdevelopedgdiarrhea.gThegclientghasgagnewgprescriptiongtogchangegthegfeeding
gtoghalfgstrength.gWhatginterventiongshouldgthegnursegimplement?

(ANS-
gAddgequalgamountsgofgwatergandgfeedinggtogagfeedinggbaggandginfusegatg 50ml/hour

Agfemalegclientgreportsgthatgherghairgisgbecominggcoarsegandgbreakinggoff,gthatgtheg
outergpartgofghergeyebrowsghavegdisappeared,gandgthatghergeyesgaregallgpuffy.gWhichg
follow-upgquestiongisgbestgforgthegnursegtogask?
(ANS-gHavegyougnoticedganygchangesgingyourgfingernails?

Rationale:gThegpatterngofgreportedgmanifestationsgisgsuggestivegofghypothyroidism

Followinggdischargegteaching,gagmalegclientgwithgduodenalgulcergtellsgthegnursegtheg
hegwillgdrinkgplentygofgdairygproducts,gsuchgasgmilk,gtoghelpgcoatgandgprotectghisgul
cer.gWhatgisgthegbestgfollow-upgactiongbygthegnurse?
(ANS-
gReviewgwithgthegclientgthegneedgtogavoidgfoodsgthatgaregrichgingmilkgandg
cream

Agmalegclientgwithghypertension,gwhogreceivedgnewgantihypertensivegprescriptionsg
atghisglastgvisitgreturnsgtogthegclinicgtwogweeksglatergtogevaluateghisgbloodgpressureg(
BP).gHisgBPgisg158/106gandghegadmitsgthatgheghasgnotgbeengtakinggthegprescribedgm
edicationgbecausegthegdrugsgmakeghimg"feelgbad".gIngexplaininggthegneedgforghyper
tensiongcontrol,gthegnursegshouldgstressgthatgangelevatedgBPgplacesgthegclientgatgrisk
gforgwhichgpathophysiologicalgcondition?

(ANS-gStrokegsecondarygtoghemorrhage

NURSING NR324 Med surg HESI exit exam latest 2022 test ban
g g g g g g g g g g


k with rationales complete Rated A+
g g g g g g

, NURSING NR324 Med surg HESI exit exam latest 2022 test ban
g g g g g g g g g g


k with rationales complete Rated A+
g g g g g g




Thegnursegobservesgunlicensedgassistivegpersonnelg(UAP)gpositioninggagnewlygadm
ittedgclientgwhoghasgagseizuregdisorder.gThegclientgisgsupinegandgthegUAPgisgplacing
gsoftgpillowsgalonggthegsidegrails.gWhatgactiongshouldgthegnursegimplement?g(ANS-

gInstructgthegUAPgtogobtaingsoftgblanketsgtogsecuregtogthegsidegrailsginsteadgofg
pillow
s.

Angadolescentgwithgmajorgdepressivegdisorderghasgbeengtakinggduloxetineg(Cy
mbalta)gforgthegpastg12gdays.gWhichgassessmentgfindinggrequiresgimmediategfoll
ow-up?
(ANS-gDescribesglifegwithoutgpurpose

Ag60-year-
oldgfemalegclientgwithgagpositivegfamilyghistorygofgovariangcancerghasgdevelopedgan
gabdominalgmassgandgisgbeinggevaluatedgforgpossiblegovariangcancer.g HergPapanicol
aug(Pap)gsmeargresultsgaregnegative.gWhatginformationgshouldgthegnursegincludeging
thegclient'sgteachinggplan?
(ANS-gFurthergevaluationginvolvinggsurgerygmaygbegneeded




Agclientgwhogrecentlygunderweargagtracheostomygisgbeinggpreparedgforgdischargegtog
home.gWhichginstructionsgisgmostgimportantgforgthegnursegtogincludegingthegdischar
gegplan?
(ANS-gTeachgtrachealgsuctioninggtechniques

Ingassessinggangadultgclientgwithgagpartialgrebreathergmask,gthegnursegnotesgthatgtheg
oxygengreservoirgbaggdoesgnotgdeflategcompletelygduringginspirationgandgthegclient'sg
respiratorygrategisg14gbreathsg/gminute.gWhatgactiongshouldgthegnursegimplement?g(
ANS-gDocumentgthegassessmentgdata

Rationale:greservoirgbaggshouldgnotgdeflategcompletelygduringginspirationgandgthegcl
ient'sgrespiratorygrategisgwithingnormalglimits.

Duringgshiftgreport,gthegcentralgelectrocardiogramg(EKG)gmonitoringgsystemgalarms
.gWhichgclientgalarmgshouldgthegnurseginvestigategfirs?

NURSING NR324 Med surg HESI exit exam latest 2022 test ban
g g g g g g g g g g


k with rationales complete Rated A+
g g g g g g
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