MEDICAL SURGICAL HESI
2025/2026//EXAMINATION //GRADED A+
The nurse is assessing a client with a "moon-shaped" face and thinner arms and
legs. Which other assessment findings would the nurse suspect to be present in this
client? Select all that apply.
Weight loss
Gastric ulcer
Pain in bones
Poor appetite
Muscle weakness - ANSWER-Gastric ulcer
Pain in bones
Muscle weakness
Rationale
The presence of such symptoms as "moon" face and thinner arms and legs
indicates Cushing's syndrome. In Cushing's syndrome, the cortisol level rises
resulting in gastric ulcer formation caused by increased hydrochloric acid secretion
and decreased production of protective gastric mucus. Osteoporosis is common in
Cushing's syndrome; therefore, bone pain is common. Clients may also feel muscle
,weakness. Clients with Cushing's syndrome experience increased appetite and
weight gain, therefore, they display truncal obesity and a "buffalo hump."
The registered nurse is caring for a client hospitalized with syndrome of
inappropriate antidiuretic hormone. Which action performed by the nurse may
result in a positive outcome of the treatment?
Obtaining the client's weight weekly
Elevating the head of the bed to 20 degrees
Changing the position of the client frequently
Restricting the client's total fluid intake to 500 mL/day - ANSWER-Changing the
position of the client frequently
Rationale
Changing the position of the client frequently helps in maintaining skin integrity
and joint mobility. The head of the bed should not be elevated more than 10
degrees to enhance venous return to the heart. The client's weight should be
obtained daily to help assess fluid retention. In acute care settings, the client's fluid
intake should be no more than 800 to 1000 mL/day. Fluid intake is restricted to 500
mL/day in severe hyponatremia cases.
When preparing a client for a liver biopsy, the nurse explains that during the test
the client will be placed in what position?
, In the supine position, with the right arm raised behind the head
On the right side, with the left arm stretched up and over the head
On the left side, with the right arm extended out in front across the bed
In the prone position, with both elbows flexed and the hands resting on the pillow -
ANSWER-In the supine position, with the right arm raised behind the head
Rationale
The supine position with the right arm raised behind the head exposes the right
intercostal space, making the large right lobe of the liver accessible. The right side
with the left arm stretched up and over the head will not provide accessibility to the
liver; the small left lobe is not anatomically near the left chest wall. On the left side
with the right arm extended out in front across the bed, the liver will fall away
from the chest wall and be less accessible. The prone position with both elbows
flexed and the hands resting on the pillow will not provide accessibility to the liver.
A nurse is providing counseling to a client with the diagnosis of systemic lupus
erythematosus (SLE). Which recommendations are essential for the nurse to
include? Select all that apply.
"Wear a large-brimmed hat."
"Take your temperature daily."
"Balance periods of rest and activity."
2025/2026//EXAMINATION //GRADED A+
The nurse is assessing a client with a "moon-shaped" face and thinner arms and
legs. Which other assessment findings would the nurse suspect to be present in this
client? Select all that apply.
Weight loss
Gastric ulcer
Pain in bones
Poor appetite
Muscle weakness - ANSWER-Gastric ulcer
Pain in bones
Muscle weakness
Rationale
The presence of such symptoms as "moon" face and thinner arms and legs
indicates Cushing's syndrome. In Cushing's syndrome, the cortisol level rises
resulting in gastric ulcer formation caused by increased hydrochloric acid secretion
and decreased production of protective gastric mucus. Osteoporosis is common in
Cushing's syndrome; therefore, bone pain is common. Clients may also feel muscle
,weakness. Clients with Cushing's syndrome experience increased appetite and
weight gain, therefore, they display truncal obesity and a "buffalo hump."
The registered nurse is caring for a client hospitalized with syndrome of
inappropriate antidiuretic hormone. Which action performed by the nurse may
result in a positive outcome of the treatment?
Obtaining the client's weight weekly
Elevating the head of the bed to 20 degrees
Changing the position of the client frequently
Restricting the client's total fluid intake to 500 mL/day - ANSWER-Changing the
position of the client frequently
Rationale
Changing the position of the client frequently helps in maintaining skin integrity
and joint mobility. The head of the bed should not be elevated more than 10
degrees to enhance venous return to the heart. The client's weight should be
obtained daily to help assess fluid retention. In acute care settings, the client's fluid
intake should be no more than 800 to 1000 mL/day. Fluid intake is restricted to 500
mL/day in severe hyponatremia cases.
When preparing a client for a liver biopsy, the nurse explains that during the test
the client will be placed in what position?
, In the supine position, with the right arm raised behind the head
On the right side, with the left arm stretched up and over the head
On the left side, with the right arm extended out in front across the bed
In the prone position, with both elbows flexed and the hands resting on the pillow -
ANSWER-In the supine position, with the right arm raised behind the head
Rationale
The supine position with the right arm raised behind the head exposes the right
intercostal space, making the large right lobe of the liver accessible. The right side
with the left arm stretched up and over the head will not provide accessibility to the
liver; the small left lobe is not anatomically near the left chest wall. On the left side
with the right arm extended out in front across the bed, the liver will fall away
from the chest wall and be less accessible. The prone position with both elbows
flexed and the hands resting on the pillow will not provide accessibility to the liver.
A nurse is providing counseling to a client with the diagnosis of systemic lupus
erythematosus (SLE). Which recommendations are essential for the nurse to
include? Select all that apply.
"Wear a large-brimmed hat."
"Take your temperature daily."
"Balance periods of rest and activity."
