MED-SURG II HESI RN ELABORATE EXAM QUESTIONS WITH DETAILED ANSWERS | ALREADY GRADED A+

MED-SURG II HESI RN ELABORATE EXAM QUESTIONS WITH DETAILED ANSWERS | ALREADY GRADED A+ 1. A nurse is caring for a client who is learning how to take care of a newly created colostomy. When observing a return demonstration of the colostomy irrigation, the nurse evaluates that more teaching is required when the client: - ANSWER Hangs the irrigation bag on the door clothes hook during fluid insertion 2. Following surgery, a client asks the nurse if he or she can help measure intake and output. What is the best nursing response? - ANSWER Assess the client's ability to measure the intake and output 3. A client with cancer of the pancreas has a pancreaticoduodenectomy (Whipple procedure). The nurse expects that the client will have which tube after surgery? - ANSWER Nasogastric 4. Before administering preoperative medication to a client, the nurse plans to: - ANSWER Verify the consent 5. A client is admitted to the hospital for a total hip replacement. The nurse is planning preoperative teaching about the nursing care to be delivered during the immediate postoperative period. Which is the most important factor that the nurse should focus on regarding immediate postoperative care? - ANSWER Abducting the operative hip 6. A client with a parotid tumor and enlarged lymph nodes in the neck is undergoing radiation therapy on an outpatient basis. For what physiological response to the radiation should the nurse assess the client during the return visit to the radiology department? - ANSWER Dysphagia 7. A client is admitted to the hospital with jaundiced skin and acute abdominal pain. What is the nurse's most therapeutic response when the client refuses all visitors? - ANSWER Listen to the client's fears 8. Each year, a client takes many trips to other countries. The client reports leg swelling during the long flights. The nurse should advise the client to, during the flights: - ANSWER Walk around at least every hour 9. A nurse is assessing a client with a diagnosis of early left ventricular heart failure. Specific to this type of heart failure, the nurse expects the client to state: - ANSWER "I have trouble breathing when I walk rapidly." 10. A client with a spontaneous pneumothorax asks, "Why did they put this tube into my chest?" The nurse explains that the purpose of the chest tube is to: - ANSWER Remove air from the pleural space 11. Following surgery in the inguinal area, the client complains of pain on the right side of the chest, becomes dyspneic, and begins to cough violently. The nurse suspects that a pulmonary embolus has occurred. What is the priority nursing action? - ANSWER Elevate the head of the bed 12. As an acute episode of rheumatoid arthritis subsides, active and passive range-of-motion exercises are taught to the client's spouse. The nurse should teach that direct pressure should not be applied to the client's joints because this may precipitate: - ANSWER Pain 13. A client is admitted to the hospital with the diagnosis of cancer of the thyroid and a thyroidectomy is scheduled. What is important for the nurse to consider when caring for this client during the postoperative period? - ANSWER Hoarseness and airway obstruction may result from laryngeal nerve damage. 14. A client is scheduled to have a cardiac catheterization via the femoral approach. The nurse teaches the client about post-procedure interventions that protect the catheter insertion site. The nurse instructs the client that the leg used for catheter insertion will be: - ANSWER Kept extended while on bed rest 15. A female client who has recurrent urinary tract infections (UTIs) is inquiring about the prevention of future UTIs. What information should the nurse include when teaching the client? (Select all that apply.) - ANSWER -Drink 8 to 10 glasses of water each day -Urinate immediately after sexual intercourse 16. A client is diagnosed with Cushing syndrome. Which clinical manifestation does the nurse expect to increase in a client with Cushing syndrome? - ANSWER Glucose level 17. A client with hepatic cirrhosis begins to develop slurred speech, confusion, drowsiness, and a flapping tremor. With this evidence of impending hepatic coma, which diet can the nurse expect will be prescribed for this client? - ANSWER 20 g of protein, 2000 calories 18. A nurse concludes that the anemia that accompanies chronic kidney disease should be treated because it contributes to: - ANSWER Chronic fatigue 19. A client is scheduled to receive general anesthesia during an upcoming surgery. The nurse provides education about common side effects of general anesthesia. The nurse concludes that the teaching has been effective when the client states, "Immediately after surgery I may experience: - ANSWER A sore throat." 20. A client has surgery for the creation of burr holes after sustaining head trauma. An early clinical manifestation of meningeal irritation for which the nurse assesses the client is: - ANSWER Kernig's sign 21. What therapeutic effect should the nurse identify as the reason for administration of neomycin sulfate to a client before colon surgery? - ANSWER Destroy intestinal bacteria 22. A client newly diagnosed with myasthenia gravis is concerned about fluctuations in physical condition and generalized weakness. When caring for this client it is most important for the nurse to plan to: - ANSWER Space activities throughout the day 23. A client is diagnosed with myasthenia gravis, and the anticholinesterase medication pyridostigmine (Mestinon) is prescribed. When teaching the client about this medication, the nurse explains that the desired effect is to increase: - ANSWER Contraction of skeletal muscles 24. A client with a history of a pulmonary embolus is to receive 3 mg of warfarin (Coumadin) daily. The client has blood drawn twice weekly to ascertain that the international normalized ratio (INR) stays within a therapeutic range. The nurse provides dietary teaching. Which food selected by the client indicates that further teaching is necessary? - ANSWER Spinach salad