Nightingale BSN 246 HESI-RN Med-Surg NEWEST
EXAM 2026 LATEST VERSION WITH REAL COMPLETE
QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES|| VERIFIED 100% ACTUAL FINAL
EXAM WITH VERIFIED ANSWERS & QUESTIONS ||
LATEST UPDATE 2026-2027
A family member was taught to suction a client's tracheostomy prior to
the client's discharge from the hospital. Which observation by the nurse
indicates that the family member is capable of correctly performing the
suctioning technique?
A.
Turns on the continuous wall suction to 190 mm Hg
B.
Inserts the catheter until resistance or coughing occurs
C.
Withdraws the catheter while maintaining suctioning
D.
Reclears the tracheostomy after suctioning the mouth
B
Rationale:Option B indicates correct technique for performing
suctioning. Suction pressure should be between 80 and 120 mm Hg,
not 190 mm Hg. The catheter should be withdrawn 1 to 2 cm at a time
with intermittent, not continuous, suction. Option D introduces
pathogens unnecessarily into the tracheobronchial tree.
,Which change in laboratory values indicates to the nurse that a client
with rheumatoid arthritis may be experiencing an adverse effect of
methotrexate therapy?
A.
Increase in rheumatoid factor
B.
Decrease in hemoglobin level
C.
Increase in blood glucose level
D.
Decrease in erythrocyte sedimentation rate (ESR; sed rate)
B
Rationale:Methotrexate is an immunosuppressant. A common side
effect is bone marrow depression, which would be reflected by a
decrease in the hemoglobin level. Option A indicates disease
progression but is not a side effect of the medication. Option C is not
related to methotrexate. Option D indicates that inflammation
associated with the disease has diminished.
,A client with alcohol-related liver disease is admitted to the unit. Which
prescription should the nurse call the health care provider about for
reverification for this client?
A.
Vitamin K1, 5 mg IM daily
B.
High-calorie, low-sodium diet
C.
Fluid restriction to 1500 mL/day
D.
Nembutal sodium at bedtime for rest
D
Rationale:Sedatives such as pentobarbital are contraindicated for
clients with liver damage and can have dangerous consequences.
Option A is often prescribed because the normal clotting mechanism is
damaged. Option B is needed to help restore energy to the debilitated
client. Sodium is often restricted because of edema. Fluids are
restricted to decrease ascites, which often accompanies cirrhosis,
particularly in the later stages of the disease.
, While at a home game, the mother of a 6-year-old is heard screaming,
"My child is having an asthma attack! Can anyone help?" The nurse
arrives and finds the child gasping for breath with circumoral cyanosis.
What are the nurse's next actions? (Select all that apply.)
A.
Yell, "Call 911."
B.
Ask the mother if she has the child's bronchodilator.
C.
Start cardiopulmonary respirations.
D.
Ask the mother if the child is allergic to bee stings.
E.
Stay with the child and mother until the ambulance arrives.
F.
Sit the child straight up in Fowler's position.
A, B, E, F
Rationale:CPR is not needed at this time as the child is still moving air.
An allergy to bee stings is related to anaphylactic shock, which is not
the situation here. The remaining actions are correct for asthma.
EXAM 2026 LATEST VERSION WITH REAL COMPLETE
QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES|| VERIFIED 100% ACTUAL FINAL
EXAM WITH VERIFIED ANSWERS & QUESTIONS ||
LATEST UPDATE 2026-2027
A family member was taught to suction a client's tracheostomy prior to
the client's discharge from the hospital. Which observation by the nurse
indicates that the family member is capable of correctly performing the
suctioning technique?
A.
Turns on the continuous wall suction to 190 mm Hg
B.
Inserts the catheter until resistance or coughing occurs
C.
Withdraws the catheter while maintaining suctioning
D.
Reclears the tracheostomy after suctioning the mouth
B
Rationale:Option B indicates correct technique for performing
suctioning. Suction pressure should be between 80 and 120 mm Hg,
not 190 mm Hg. The catheter should be withdrawn 1 to 2 cm at a time
with intermittent, not continuous, suction. Option D introduces
pathogens unnecessarily into the tracheobronchial tree.
,Which change in laboratory values indicates to the nurse that a client
with rheumatoid arthritis may be experiencing an adverse effect of
methotrexate therapy?
A.
Increase in rheumatoid factor
B.
Decrease in hemoglobin level
C.
Increase in blood glucose level
D.
Decrease in erythrocyte sedimentation rate (ESR; sed rate)
B
Rationale:Methotrexate is an immunosuppressant. A common side
effect is bone marrow depression, which would be reflected by a
decrease in the hemoglobin level. Option A indicates disease
progression but is not a side effect of the medication. Option C is not
related to methotrexate. Option D indicates that inflammation
associated with the disease has diminished.
,A client with alcohol-related liver disease is admitted to the unit. Which
prescription should the nurse call the health care provider about for
reverification for this client?
A.
Vitamin K1, 5 mg IM daily
B.
High-calorie, low-sodium diet
C.
Fluid restriction to 1500 mL/day
D.
Nembutal sodium at bedtime for rest
D
Rationale:Sedatives such as pentobarbital are contraindicated for
clients with liver damage and can have dangerous consequences.
Option A is often prescribed because the normal clotting mechanism is
damaged. Option B is needed to help restore energy to the debilitated
client. Sodium is often restricted because of edema. Fluids are
restricted to decrease ascites, which often accompanies cirrhosis,
particularly in the later stages of the disease.
, While at a home game, the mother of a 6-year-old is heard screaming,
"My child is having an asthma attack! Can anyone help?" The nurse
arrives and finds the child gasping for breath with circumoral cyanosis.
What are the nurse's next actions? (Select all that apply.)
A.
Yell, "Call 911."
B.
Ask the mother if she has the child's bronchodilator.
C.
Start cardiopulmonary respirations.
D.
Ask the mother if the child is allergic to bee stings.
E.
Stay with the child and mother until the ambulance arrives.
F.
Sit the child straight up in Fowler's position.
A, B, E, F
Rationale:CPR is not needed at this time as the child is still moving air.
An allergy to bee stings is related to anaphylactic shock, which is not
the situation here. The remaining actions are correct for asthma.
