HESI MED SURG 1 EXAM QUESTIONS WITH VEFIED ANSWERS.docx

HESI MED SURG 1 EXAM QUESTIONS
WITH VEFIED ANSWERS
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Thegbnursegbobservesgbventriculargbfibrillationgbongbtelemetrygband,gbongbenteringgbthegb
client'sgbbathroom,gbfindsgbthegbclientgbunconsciousgbongbthegbfloor.gbWhichgbinterventio
ngbshouldgbthegbnursegbimplementgbfirst?
A.
Administergbangbantidysrhythmicgbmedication.
gbB.
Startgbcardiopulmonarygbresuscitation.
gbC.
Defibrillategbthegbclientgbatgb200gbJ.
gbD.
Assessgbthegbclient'sgbpulsegboximetry.gb-gbANS--B.
Startgbcardiopulmonarygbresuscitation.

Rationale:gb
Ventriculargbfibrillationgbisgbagblife-
threateninggbdysrhythmia,gbandgbCPRgbshouldgbbegbstartedgbimmediatelygb(B).gb(Agbandg
bC)gbaregbappropriate,gbbutgbCPRgbisgbthegbprioritygbaction.gbThegbclientgbisgbdying,gbandg
b(D)gbdoesgbnotgbaddressgbthegbseriousnessgbofgbthisgbsituation.


Thegbnursegbassessesgbagbclientgbwhogbhasgbbeengbprescribedgbfurosemidegb(Lasix)gbfor
gbcardiacgbdisease.gbWhichgbelectrocardiographicgbchangegbwouldgbbegbagbconcerngbforg
bagbclientgbtakinggbagbdiuretic?
gbA.
Tall,gbspikedgbTgbwaves
gbB.
AgbprolongedgbQTgbinterval
gbC.
AgbwideninggbQRSgbcomplex
gbD.
PresencegbofgbagbUgbwavegb-gbANS--D.
PresencegbofgbagbUgbwave

Rationale:
AgbUgbwavegb(D)gbisgbagbpositivegbdeflectiongbfollowinggbthegbTgbwavegbandgbisgboftengbpr
esentgbwithgbhypokalemiagb(lowgbpotassiumgblevel).gb(A,gbB,gbandgbC)gbaregballgbsignsgbo
fgbhyperkalemia.

Agb43-year-
oldgbhomeless,gbmalnourishedgbfemalegbclientgbwithgbagbhistorygbofgbalcoholismgbisgbtran

,sferredgbtogbthegbICU.gbShegbisgbplacedgbongbtelemetry,gbandgbthegbrhythmgbstripgbshown
gbisgbobtained.gbThegbnursegbpalpatesgbagbheartgbrategbofgb160gbbeats/
min,gbandgbthegbclient'sgbbloodgbpressuregbisgb90/54gbmmgbHg.gbBasedgbongbthesegbfindi
ngs,gbwhichgbIVgbmedicationgbshouldgbthegbnursegbadminister?
gbA.
Amiodaronegb(Cordarone)
gbB.
Magnesiumgbsulfate
gbC.
Lidocainegb(Xylocaine)
gbD.
Procainamidegb(Pronestyl)gb-gbANS--B.
Magnesiumgbsulfate

Rationale:
Becausegbthegbclientgbhasgbchronicgbalcoholism,gbshegbisgblikelygbtogbhavegbhypomagnes
emia.gb(B)gbisgbthegbrecommendedgbdruggbforgbtorsadesgbdegbpointes,gbwhichgbisgbagbfor
mgbofgbpolymorphicgbventriculargbtachycardiagb(VT)gbusuallygbassociatedgbwithgbagbprolo
ngedgbQTgbintervalgbthatgboccursgbwithgbhypomagnesemia.gb(AgbandgbD)gbincreasegbtheg
bQTgbinterval,gbwhichgbcangbcausegbthegbtorsadesgbtogbworsen.gb(C)gbisgbthegbantiarrhyth
micgbofgbchoicegbingbmostgbcasesgbofgbdrug-inducedgbmonomorphicgbVT,gbnotgbtorsades.

Whengbdevelopinggbagbdischargegbteachinggbplangbforgbagbclientgbaftergbthegbinsertiongbof
gbagbpermanentgbpacemaker,gbthegbnursegbwritesgbagbgoalgbofgb"Thegbclientgbwillgbverbali
zegbsymptomsgbofgbpacemakergbfailure."gbWhichgbbehaviorgbindicatesgbthatgbthegbgoalgbh
asgbbeengbmet?
A.
Thegbclientgbdemonstratesgbthegbproceduresgbtogbchangegbthegbrategbofgbthegbpacemake
rgbusinggbagbmagnet.
gbB.
Thegbclientgbcarriesgbagbcardgbingbhisgbwalletgbstatinggbthegbtypegbandgbserialgbnumbergbo
fgbthegbpacemaker.
gbC.
Thegbclientgbtellsgbthegbnursegbthatgbitgbisgbimportantgbtogbreportgbrednessgbandgbtendern
essgbatgbthegbinsertiongbsite.
D.
Thegbclientgbstatesgbthatgbchangesgbingbthegbpulsegbandgbfeelingsgbofgbdizzinessgbaregbsi
gnificantgbchanges.gb-gbANS--D.
Thegbclientgbstatesgbthatgbchangesgbingbthegbpulsegbandgbfeelingsgbofgbdizzinessgbaregbsi
gnificantgbchanges.

Rationale:
Changesgbingbpulsegbrategband/
orgbrhythmgbmaygbindicategbpacergbfailure.gbFeelingsgbofgbdizzinessgbmaygbbegbcausedgb
bygbagbdecreasedgbheartgbrate,gbleadinggbtogbdecreasedgbcardiacgboutputgb(D).gbThegbrat
egbofgbagbpacemakergbisgbnotgbchangedgbbygbagbclient,gbalthoughgbthegbclientgbmaygbbegb

,familiargbwithgbthisgbproceduregbasgbexplainedgbbygbhisgbhealthgbcaregbprovidergb(A).gb(B)
gbisgbangbimportantgbstepgbingbpreparinggbthegbclientgbforgbdischargegbbutgbdoesgbnotgbde
monstrategbknowledgegbofgbthegbsymptomsgbofgbpacergbfailure.gb(C)gbindicatesgbsympto
msgbofgbpossiblegbincisionalgbinfectiongborgbirritationgbbutgbdogbnotgbindicategbpacergbfailu
re.

Thegbnursegbteachesgbagbclientgbwithgbtypegb2gbdiabetesgbnutritionalgbstrategiesgbtogbdecr
easegbobesity.gbWhichgbfoodgbitem(s)gbchosengbbygbthegbclientgbindicatesgbunderstandin
ggbofgbthegbteaching?gb(Selectgballgbthatgbapply.)
A.
Whitegbbread
gbB.
Salmon
gbC.
Broccoli
gbD.
Wholegbmilk
gbE.
Bananagb-gbANS--B
Salmon

C
Broccoli

E.
Banana

Rationale:
(B,gbC,gbandgbE)gbprovidegbfreshgbfruits,gbleangbmeatsgbandgbfish,gbvegetables,gbwholegbg
rains,gbandgblow-
fatgbdairygbproducts.gbAllgbaregbrecommendedgbbygbthegbAmericangbDiabetesgbAssociatio
ngb(ADA)gbandgbaregbagbpartgbofgbthegbMygbPlategbguidelinesgbrecommendedgbbygbthegbU
.S.gbDepartmentgbofgbAgriculturegb(USDA).gbWholegbmilkgb(D)gbisgbhighgbingbfatgbandgbisg
bnotgbrecommendedgbbygbADA.gbWhitegbbreadgbisgbmilled,gbagbprocessgbthatgbremovesgb
thegbessentialgbnutrients.gbItgbshouldgbbegbavoidedgbforgbweightgblossgbandgbisgbagbpoorgb
choicegbforgbthegbclientgbwithgbdiabetesgb(A).

Agbclientgbdiagnosedgbwithgbanginagbpectorisgbcomplainsgbofgbchestgbpaingbwhilegbambul
atinggbingbthegbhallway.gbWhichgbactiongbshouldgbthegbnursegbimplementgbfirst?
A.
Supportgbthegbclientgbtogbagbsittinggbposition.
B.
Askgbthegbclientgbtogbwalkgbslowlygbbackgbtogbthegbroom.
C.
Administergbagbsublingualgbnitroglyceringbtablet.
gbD.

, Providegboxygengbviagbnasalgbcannula.gb-gbANS--A.
Supportgbthegbclientgbtogbagbsittinggbposition.

Rationale:
Thegbnursegbshouldgbsafelygbassistgbthegbclientgbtogbagbrestinggbpositiongb(A)gbandgbtheng
bperformgb(CgbandgbD).gbThegbclientgbmustgbceasegballgbactivitygbimmediately,gbwhichgbwi
llgbdecreasegbthegboxygengbrequirementgbofgbthegbmyocardialgbmuscle.gbAftergbthesegbint
erventionsgbaregbimplemented,gbthegbclientgbcangbbegbescortedgbbackgbtogbthegbroomgbvi
agbwheelchairgborgbstretchergb(B).

Aftergbattendinggbagbclassgbongbreducinggbcancergbriskgbfactors,gbagbclientgbselectsgbbran
gbflakesgbwithgb2%gbmilkgbandgborangegbslicesgbfromgbagbbreakfastgbmenu.gbIngbevaluatin
ggbthegbclient'sgblearning,gbthegbnursegbaffirmsgbthatgbthegbclientgbhasgbmadegbgoodgbchoi
cesgbandgbmakesgbwhatgbadditionalgbrecommendation?
gbA.
Switchgbtogbskimgbmilk.
gbB.
Switchgbtogborangegbjuice.
gbC.
Addgbagbsourcegbofgbprotein.
gbD.
Addgbherbalgbtea.gb-gbANS--A.
Switchgbtogbskimgbmilk.

Rationale:
Dietarygbrecommendationsgbtogbreducegbcancergbriskgbincludegbreducedgbconsumptiongb
ofgbfats,gbwithgbincreasedgbconsumptiongbofgbfruits,gbvegetables,gbandgbfiber.gb(A)gbprom
otesgbreducedgbfatgbconsumption.gbOrangegbslicesgbprovidegbmoregbfibergbthangborangeg
bjuicegb(B,gbC,gbandgbD)gbaregbnotgbstandardgbrecommendationsgbforgbreducinggbcancerg
brisk.


Agbnursegbisgbassistinggbangb82-year-
oldgbclientgbwithgbambulationgbandgbisgbconcernedgbthatgbthegbclientgbmaygbfall.gbWhichgb
areagbcontainsgbthegboldergbperson'sgbcentergbofgbgravity?
A.
Headgbandgbneck
gbB.
Uppergbtorso
gbC.
Bilateralgbarms
gbD.
Feetgbandgblegsgb-gbANS--B.
Uppergbtorso

Rationale: