Med-Surg HESI Practice Q's exam with |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
correct answers |||\\\
The nurse would be correct in withholding a dose of digoxin in a client with CHF without
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
specific instruction from the healthcare provider if the client's:
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
A. Serum digoxin level is 1.5
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\
B. Blood pressure is 104/68
|||\\\ |||\\\ |||\\\ |||\\\
C. Serum Potassium level is 3
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
D. Apical pulse is 68/min - correct answer✔✔C. Hypokalemia can precipitate digitalis toxicity
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
in persons receiving digoxin which will increase the chance of dangerous dysrhythmias (normal
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
potassium level is 3.5 to 5.5 mEq/L). The therapeutic range for digoxin is 0.8 to 2 ng/ml (toxic
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
levels = >2 ng/ml); |||\\\ |||\\\ |||\\\ |||\\\
(A) is within range
|||\\\ |||\\\ |||\\\
(B) would not warrant the nurse withholding the digoxin
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
(D) the nurse should withhold the digoxin if the apical pulse is less than 60/min
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
The nurse assesses a client with advanced cirrhosis of the liver for signs of hepatic
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
encephalopathy. Which finding would the nurse consider an indication of progressive hepatic |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
encephalopathy?
,A. An increase in abdominal girth
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\
B. Hypertension and a bounding pulse
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\
C. Decreased bowel sounds
|||\\\ |||\\\ |||\\\
D. Difficulty in handwriting - correct answer✔✔D. A daily record in handwriting may provide
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
evidence of progression or reversal of hepatic encephalopathy leading to coma |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
(A) is a sign of ascites
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\
(B) are not seen with hepatic encephalopathy
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
(C) does not indicate an increase in serum ammonia level which is the primary cause of hepatic
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
encephalopathy
|||\\\
The healthcare provider prescribes aluminum magnesium hydroxide (Maalox), 1 tablet PO PRN,
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
for a client with chronic kidney disease (CKD) who is complaining of indigestion. What
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
intervention should the nurse implement? |||\\\ |||\\\ |||\\\ |||\\\
A. Administer 30 minutes before eating
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\
B. Evaluate the effectiveness 1 hour after administration
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
C. Instruct the client to swallow the table whole
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
D. Question the healthcare provider's prescription - correct answer✔✔D. Magnesium agents
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
are not usually used for clients with CKD due to the risk of hypermagnesemia, so this
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
prescription should be questioned by the nurse |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
, (A, B, and C) are not recommended nursing actions for the administration of aluminum and
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
magnesium hydroxide (Maalox) |||\\\ |||\\\
Two days postoperative, a male client reports aching pain in his left leg. The nurse assesses
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
redness and warmth on the lower left calf. What intervention would be most helpful to this
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
client?
A. Apply sequential devices (SCDs) bilaterally
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
B. Assess for a positive Homan's sign in each leg
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
C. Pad all bony prominences on the affected lef
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
D. Advise the client to remain in bed with the leg elevated - correct answer✔✔D. The client is
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
exhibiting symptoms of deep vein thrombosis (DVT), a complication of immobility. The initial |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
care includes bedrest and elevation of the extremity
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
(A) SCDs are used to prevent thrombophlebitis, not for treatment, when a clot might be
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
dislodged |||\\\
(B) Once a client has thrombophlebitis, this one is contraindicated because of the possibility of
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
dislodging a clot |||\\\ |||\\\
(C) Is indicated to prevent pressure ulcers, but is not a therapeutic action for thrombophlebitis
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
A client taking a thiazide diuretic for the past six months has a serum potassium level of 3. The
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
nurse anticipates which change inn prescription for the client?
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
correct answers |||\\\
The nurse would be correct in withholding a dose of digoxin in a client with CHF without
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
specific instruction from the healthcare provider if the client's:
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
A. Serum digoxin level is 1.5
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\
B. Blood pressure is 104/68
|||\\\ |||\\\ |||\\\ |||\\\
C. Serum Potassium level is 3
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
D. Apical pulse is 68/min - correct answer✔✔C. Hypokalemia can precipitate digitalis toxicity
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
in persons receiving digoxin which will increase the chance of dangerous dysrhythmias (normal
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
potassium level is 3.5 to 5.5 mEq/L). The therapeutic range for digoxin is 0.8 to 2 ng/ml (toxic
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
levels = >2 ng/ml); |||\\\ |||\\\ |||\\\ |||\\\
(A) is within range
|||\\\ |||\\\ |||\\\
(B) would not warrant the nurse withholding the digoxin
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
(D) the nurse should withhold the digoxin if the apical pulse is less than 60/min
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
The nurse assesses a client with advanced cirrhosis of the liver for signs of hepatic
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
encephalopathy. Which finding would the nurse consider an indication of progressive hepatic |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
encephalopathy?
,A. An increase in abdominal girth
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\
B. Hypertension and a bounding pulse
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\
C. Decreased bowel sounds
|||\\\ |||\\\ |||\\\
D. Difficulty in handwriting - correct answer✔✔D. A daily record in handwriting may provide
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
evidence of progression or reversal of hepatic encephalopathy leading to coma |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
(A) is a sign of ascites
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\
(B) are not seen with hepatic encephalopathy
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
(C) does not indicate an increase in serum ammonia level which is the primary cause of hepatic
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
encephalopathy
|||\\\
The healthcare provider prescribes aluminum magnesium hydroxide (Maalox), 1 tablet PO PRN,
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
for a client with chronic kidney disease (CKD) who is complaining of indigestion. What
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
intervention should the nurse implement? |||\\\ |||\\\ |||\\\ |||\\\
A. Administer 30 minutes before eating
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\
B. Evaluate the effectiveness 1 hour after administration
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
C. Instruct the client to swallow the table whole
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
D. Question the healthcare provider's prescription - correct answer✔✔D. Magnesium agents
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
are not usually used for clients with CKD due to the risk of hypermagnesemia, so this
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
prescription should be questioned by the nurse |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
, (A, B, and C) are not recommended nursing actions for the administration of aluminum and
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
magnesium hydroxide (Maalox) |||\\\ |||\\\
Two days postoperative, a male client reports aching pain in his left leg. The nurse assesses
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
redness and warmth on the lower left calf. What intervention would be most helpful to this
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
client?
A. Apply sequential devices (SCDs) bilaterally
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
B. Assess for a positive Homan's sign in each leg
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
C. Pad all bony prominences on the affected lef
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
D. Advise the client to remain in bed with the leg elevated - correct answer✔✔D. The client is
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
exhibiting symptoms of deep vein thrombosis (DVT), a complication of immobility. The initial |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
care includes bedrest and elevation of the extremity
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
(A) SCDs are used to prevent thrombophlebitis, not for treatment, when a clot might be
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
dislodged |||\\\
(B) Once a client has thrombophlebitis, this one is contraindicated because of the possibility of
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
dislodging a clot |||\\\ |||\\\
(C) Is indicated to prevent pressure ulcers, but is not a therapeutic action for thrombophlebitis
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
A client taking a thiazide diuretic for the past six months has a serum potassium level of 3. The
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
nurse anticipates which change inn prescription for the client?
|||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\ |||\\\
