EVOLVE ELSEVIER HESI MED-SURG EXAM QUESTION BANK
ACTUAL EXAM WITH
QUESTIONS AND CORRECT DETAILED ANSWERS
An 81-year-old male client has emphysema. He lives at home with his cat and
manages self-care with no difficulty. When making a home visit, the nurse notices
that this client's tongue is somewhat cracked and his eyeballs appear sunken into
his head. Which nursing intervention is indicated?
A.Help the client determine ways to increase his fluid intake.
B.Obtain an appointment for the client to have an eye examination.
C.Instruct the client to use oxygen at night and increase the humidification.
D.Schedule the client for tests to determine his sensitivity to cat hair.
A
Clients with COPD should ingest 3 L of fluids daily but may experience a fluid
deficit because of shortness of breath. The nurse should suggest creative
methods to increase the intake of fluids (A), such as having fruit juices in
disposable containers readily available. (B) is not indicated. Humidified oxygen
will not effectively treat the client's fluid deficit, and there is no indication that
the client needs supplemental oxygen at night (C). These symptoms are not
indicative of (D) and may unnecessarily upset the client, who depends on his pet
for socialization.
,A postoperative client receives a Schedule II opioid analgesic for pain. Which
assessment finding requires the most immediate intervention by the nurse?
A.Hypoactive bowel sounds with abdominal distention
B.Client reports continued pain of 8 on a 10-point scale
C.Respiratory rate of 12 breaths/min, with O2 saturation of 85%
D.Client reports nausea after receiving the medication
C
Administration of a Schedule II opioid analgesic can result in respiratory
depression (C), which requires immediate intervention by the nurse to prevent
respiratory arrest. (A, B, and D) require action by the nurse but are of less
priority than (C).
Which instruction should the nurse teach a female client about the prevention of
toxic shock syndrome?
A."Get immunization against human papillomavirus (HPV)."
B."Change your tampon frequently."
C."Empty your bladder after intercourse."
D."Obtain a yearly flu vaccination."
B
,Certain strains of Staphylococcus aureus produce a toxin that can enter the
bloodstream through the vaginal mucosa. Changing the tampon frequently (B)
reduces the exposure to these toxins, which are the primary cause of toxic shock
syndrome. (A) helps prevent cervical cancer, not toxic shock syndrome. (C) can
lessen the incidence of urinary tract infection. (D) can help prevent some
individuals from contracting the flu and pneumonia, but no relationship to toxic
shock syndrome has been proven.
The nurse is caring for a critically ill client with cirrhosis of the liver who has a
nasogastric tube draining bright red blood. The nurse notes that the client's serum
hemoglobin and hematocrit levels are decreased. Which additional change in
laboratory data should the nurse expect?
A.Increased serum albumin level
B.Decreased serum creatinine
C.Decreased serum ammonia level
D.Increased liver function test results
C
The breakdown of glutamine in the intestine and the increased activity of
colonic bacteria from the digestion of proteins increase ammonia levels in
clients with advanced liver disease, so removal of blood, a protein source, from
the intestine results in a reduced level of ammonia (C). (A, B, and D) will not be
significantly affected by the removal of blood.
, A client is being discharged following radioactive seed implantation for prostate
cancer. What is the most important information that the nurse should provide to
this client's family?
A.Follow exposure precautions.
B.Encourage regular meals.
C.Collect all urine.
D.Avoid touching the client.
Clients being treated for prostate cancer with radioactive seed implants should be
instructed regarding the amount of time and distance needed to prevent
excessive exposure (A) that would pose a hazard to others. (B) is a good
suggestion to promote adequate nutrition but is not as important as (A). (C) is
unnecessary. Contact with the client (D) IS permitted but should be BRIEF to limit
radiation exposure.
An emaciated homeless client presents to the emergency department
complaining of a productive cough, with blood-tinged sputum and night sweats.
Which action is most important for the emergency department triage nurse to
implement for this client?
A.Initiate airborne infection precautions.
B.Place a surgical mask on the client.
C.Don an isolation gown and latex gloves.
D.Start protective (reverse) isolation precautions.
ACTUAL EXAM WITH
QUESTIONS AND CORRECT DETAILED ANSWERS
An 81-year-old male client has emphysema. He lives at home with his cat and
manages self-care with no difficulty. When making a home visit, the nurse notices
that this client's tongue is somewhat cracked and his eyeballs appear sunken into
his head. Which nursing intervention is indicated?
A.Help the client determine ways to increase his fluid intake.
B.Obtain an appointment for the client to have an eye examination.
C.Instruct the client to use oxygen at night and increase the humidification.
D.Schedule the client for tests to determine his sensitivity to cat hair.
A
Clients with COPD should ingest 3 L of fluids daily but may experience a fluid
deficit because of shortness of breath. The nurse should suggest creative
methods to increase the intake of fluids (A), such as having fruit juices in
disposable containers readily available. (B) is not indicated. Humidified oxygen
will not effectively treat the client's fluid deficit, and there is no indication that
the client needs supplemental oxygen at night (C). These symptoms are not
indicative of (D) and may unnecessarily upset the client, who depends on his pet
for socialization.
,A postoperative client receives a Schedule II opioid analgesic for pain. Which
assessment finding requires the most immediate intervention by the nurse?
A.Hypoactive bowel sounds with abdominal distention
B.Client reports continued pain of 8 on a 10-point scale
C.Respiratory rate of 12 breaths/min, with O2 saturation of 85%
D.Client reports nausea after receiving the medication
C
Administration of a Schedule II opioid analgesic can result in respiratory
depression (C), which requires immediate intervention by the nurse to prevent
respiratory arrest. (A, B, and D) require action by the nurse but are of less
priority than (C).
Which instruction should the nurse teach a female client about the prevention of
toxic shock syndrome?
A."Get immunization against human papillomavirus (HPV)."
B."Change your tampon frequently."
C."Empty your bladder after intercourse."
D."Obtain a yearly flu vaccination."
B
,Certain strains of Staphylococcus aureus produce a toxin that can enter the
bloodstream through the vaginal mucosa. Changing the tampon frequently (B)
reduces the exposure to these toxins, which are the primary cause of toxic shock
syndrome. (A) helps prevent cervical cancer, not toxic shock syndrome. (C) can
lessen the incidence of urinary tract infection. (D) can help prevent some
individuals from contracting the flu and pneumonia, but no relationship to toxic
shock syndrome has been proven.
The nurse is caring for a critically ill client with cirrhosis of the liver who has a
nasogastric tube draining bright red blood. The nurse notes that the client's serum
hemoglobin and hematocrit levels are decreased. Which additional change in
laboratory data should the nurse expect?
A.Increased serum albumin level
B.Decreased serum creatinine
C.Decreased serum ammonia level
D.Increased liver function test results
C
The breakdown of glutamine in the intestine and the increased activity of
colonic bacteria from the digestion of proteins increase ammonia levels in
clients with advanced liver disease, so removal of blood, a protein source, from
the intestine results in a reduced level of ammonia (C). (A, B, and D) will not be
significantly affected by the removal of blood.
, A client is being discharged following radioactive seed implantation for prostate
cancer. What is the most important information that the nurse should provide to
this client's family?
A.Follow exposure precautions.
B.Encourage regular meals.
C.Collect all urine.
D.Avoid touching the client.
Clients being treated for prostate cancer with radioactive seed implants should be
instructed regarding the amount of time and distance needed to prevent
excessive exposure (A) that would pose a hazard to others. (B) is a good
suggestion to promote adequate nutrition but is not as important as (A). (C) is
unnecessary. Contact with the client (D) IS permitted but should be BRIEF to limit
radiation exposure.
An emaciated homeless client presents to the emergency department
complaining of a productive cough, with blood-tinged sputum and night sweats.
Which action is most important for the emergency department triage nurse to
implement for this client?
A.Initiate airborne infection precautions.
B.Place a surgical mask on the client.
C.Don an isolation gown and latex gloves.
D.Start protective (reverse) isolation precautions.
