Evolve: HESI Med Surg Practice Exam 475 Study Guide.
Which description of symptoms is characteristic of a client diagnosed with trigeminal
neuralgia (tic douloureux)? - B) Sudden, stabbing, severe pain over the lip and chin.
A 67-year-old woman who lives alone is admitted after tripping on a rug in her home and
fractures her hip. Which predisposing factor probably led to the fracture in the proximal end
of her femur? - C) Osteoporosis resulting from hormonal changes.
The nurse is assisting a client out of bed for the first time after surgery. What action should
the nurse do first? - D) Allow the client to sit with the bed in a high Fowler's position.
A 20-year-old female client calls the nurse to report a lump she found in her breast. Which
response is the best for the nurse to provide? - B) Most lumps are benign, but it is always
best to come in for an examination.
A female client is brought to the clinic by her daughter for a flu shot. She has lost significant
weight since the last visit. She has poor personal hygiene and inadequate clothing for the
weather. The client states that she lives alone and denies problems or concerns. What
action should the nurse implement? - D) Collect further data to determine whether self-
neglect is occurring.
A client is admitted to the medical intensive care unit with a diagnosis of myocardial
infarction. The client's history indicates the infarction occurred ten hours ago. Which
laboratory test result should the nurse expect this client to exhibit? - C) Elevated CK-MB.
A splint is prescribed for nighttime use by a client with rheumatoid arthritis. Which statement
by the nurse provides the most accurate explanation for use of the splints? - A) Prevention of
deformities.
The nurse should be correct in withholding a dose of digoxin in a client with congestive heart
failure without specific instruction from the healthcare provider if the client's - C) serum
potassium level is 3.
Despite several eye surgeries, a 78-year-old client who lives alone has persistent vision
problems. The visiting nurse is discussing painting the house with the client. The nurse
suggests that the edge of the steps should be painted which color?
, A) Black.
B) White.
C) Light green.
D) Medium yellow. - D) Medium yellow.
Yellow is the easiest for a person with failing vision to see (D). (A) will be almost impossible
to see at night because the shadows of the steps will be too difficult to determine, and would
pose a safety hazard. (B) is very hard to see with a glare from the sun and it could hurt the
eyes in the daytime to look at them. (C) is a pastel color and is difficult for elderly clients to
see.
During CPR, when attempting to ventilate a client's lungs, the nurse notes that the chest is
not moving. What action should the nurse take first? - B) Reposition the head to validate that
the head is in the proper position to open the airway.
The nurse is assessing a client with bacterial meningitis. Which assessment finding indicates
the client may have developed septic emboli?
. - A) Cyanosis of the fingertips.
In assessing a client diagnosed with primary hyperaldosteronism, the nurse expects the
laboratory test results to indicate a decreased serum level of which substance? - C)
Potassium.
A client with diabetes mellitus is experiencing polyphagia. Which outcome statement is the
priority for this client? - D) Adequate cellular nourishment.
Based on the analysis of the client's atrial fibrillation, the nurse should prepare the client for
which treatment protocol? - C) Anticoagulation therapy.
Which information about mammograms is most important to provide a post-menopausal
female client? - C) Yearly mammograms should be done regardless of previous normal x-
rays.
In assessing cancer risk, the nurse identifies which woman as being at greatest risk of
developing breast cancer? - B) A 50-year-old whose mother had unilateral breast cancer.
Which description of symptoms is characteristic of a client diagnosed with trigeminal
neuralgia (tic douloureux)? - B) Sudden, stabbing, severe pain over the lip and chin.
A 67-year-old woman who lives alone is admitted after tripping on a rug in her home and
fractures her hip. Which predisposing factor probably led to the fracture in the proximal end
of her femur? - C) Osteoporosis resulting from hormonal changes.
The nurse is assisting a client out of bed for the first time after surgery. What action should
the nurse do first? - D) Allow the client to sit with the bed in a high Fowler's position.
A 20-year-old female client calls the nurse to report a lump she found in her breast. Which
response is the best for the nurse to provide? - B) Most lumps are benign, but it is always
best to come in for an examination.
A female client is brought to the clinic by her daughter for a flu shot. She has lost significant
weight since the last visit. She has poor personal hygiene and inadequate clothing for the
weather. The client states that she lives alone and denies problems or concerns. What
action should the nurse implement? - D) Collect further data to determine whether self-
neglect is occurring.
A client is admitted to the medical intensive care unit with a diagnosis of myocardial
infarction. The client's history indicates the infarction occurred ten hours ago. Which
laboratory test result should the nurse expect this client to exhibit? - C) Elevated CK-MB.
A splint is prescribed for nighttime use by a client with rheumatoid arthritis. Which statement
by the nurse provides the most accurate explanation for use of the splints? - A) Prevention of
deformities.
The nurse should be correct in withholding a dose of digoxin in a client with congestive heart
failure without specific instruction from the healthcare provider if the client's - C) serum
potassium level is 3.
Despite several eye surgeries, a 78-year-old client who lives alone has persistent vision
problems. The visiting nurse is discussing painting the house with the client. The nurse
suggests that the edge of the steps should be painted which color?
, A) Black.
B) White.
C) Light green.
D) Medium yellow. - D) Medium yellow.
Yellow is the easiest for a person with failing vision to see (D). (A) will be almost impossible
to see at night because the shadows of the steps will be too difficult to determine, and would
pose a safety hazard. (B) is very hard to see with a glare from the sun and it could hurt the
eyes in the daytime to look at them. (C) is a pastel color and is difficult for elderly clients to
see.
During CPR, when attempting to ventilate a client's lungs, the nurse notes that the chest is
not moving. What action should the nurse take first? - B) Reposition the head to validate that
the head is in the proper position to open the airway.
The nurse is assessing a client with bacterial meningitis. Which assessment finding indicates
the client may have developed septic emboli?
. - A) Cyanosis of the fingertips.
In assessing a client diagnosed with primary hyperaldosteronism, the nurse expects the
laboratory test results to indicate a decreased serum level of which substance? - C)
Potassium.
A client with diabetes mellitus is experiencing polyphagia. Which outcome statement is the
priority for this client? - D) Adequate cellular nourishment.
Based on the analysis of the client's atrial fibrillation, the nurse should prepare the client for
which treatment protocol? - C) Anticoagulation therapy.
Which information about mammograms is most important to provide a post-menopausal
female client? - C) Yearly mammograms should be done regardless of previous normal x-
rays.
In assessing cancer risk, the nurse identifies which woman as being at greatest risk of
developing breast cancer? - B) A 50-year-old whose mother had unilateral breast cancer.
