Med-Surg HESI Final Practice Questions and Answers Rated A
The nurse is assessing a client's laboratory values fol-
lowing administration of chemotherapy. Which lab value
leads the nurse to suspect that the client is experiencing B - Tumor lysis syndrome (TLS) results in hyperkalemia,
tumor lysis syndrome (TLS)? hypocalcemia, hyperuricemia, and hyperphosphatemia. A
a. Serum PTT of 10 seconds. serum calcium level of 5, which is low, is an indicator of
b. Serum calcium of 5 mg/dL. possible tumor lysis syndrome.
c. Oxygen saturation of 90%.
d. Hemoglobin of 10 g/dL
Which description of symptoms is characteristic of a client B - Trigeminal neuralgia is characterized by paroxysms of
diagnosed with trigeminal neuralgia (tic douloureux)? pain, similar to an electric shock, in the area innervated
a. Tinnitus, vertigo, and hearing diflculties. by one or more branches of the trigeminal nerve (5th cra-
b. Sudden, stabbing, severe pain over the lip and chin. nial). Women are more often afflicted with this condition
c. Facial weakness and paralysis. and generally occurs in clients over the age of 50 years
d. Diflculty in chewing, talking, and swallowing. old.
C - After a renal transplantation, acute rejection is a high
Which discharge instruction is most important for a client risk for several months. The organ recipient will have to
after a kidney transplant? take immunosuppressive therapy for the rest of their lives,
a. Weigh weekly. such as corticosteroids and azathioprine, to prevent organ
b. Report symptoms of secondary Candidiasis. transplant rejection. Discharge instructions include mea-
c. Use daily reminders to take immunosuppressants. sures such as daily reminders to ensure the client takes
d. Stop cigarette smoking. these medications regularly to prevent organ rejection
from occurring.
The nurse is providing dietary instructions to a
68-year-old client who is at high risk for development of
B - To reduce risk factors associated with coronary heart
coronary heart disease (CHD). Which information should
disease, the daily intake of soluble fiber should be in-
the nurse include?
creased to between 10 and 25 grams per day. According
a. Limit dietary selection of cholesterol to 300 mg per day.
to the American Heart Association, soluble fibers helps
b. Increase intake of soluble fiber to 10 to 25 grams per
reduce LDL cholesterol levels.
day.
c. Decrease plant stanols and sterols to less than 2
,Med-Surg HESI Final Practice Questions and Answers Rated A
grams/day.
d. Ensure saturated fat is less than 30% of total caloric
intake.
Two days postoperative, a male client reports aching pain
in his left leg. The nurse assesses redness and warmth
on the lower left calf. Which intervention would be most
helpful to this client? D - For a client exhibiting symptoms of deep vein throm-
a. Apply sequential compression devices (SCDs) bilateral- bosis (DVT), a complication of immobility, the initial care
ly. includes bedrest and elevation of the extremity.
b. Assess for a positive Homan's sign in each leg.
c. Pad all bony prominences on the attected leg.
d. Advise the client to remain in bed with the leg elevated.
A middle-aged male client with diabetes continues to
eat an abundance of foods that are high in sugar and
fat. According to the Health Belief Model, which event is
most likely to increase the client's willingness to become
compliant with the prescribed diet?
a. He visits his diabetic brother who just had surgery to A - The loss of a limb due to diabetes by a family member
amputate an infected foot. should be the strongest event or "cue to action" and is
b. He is provided with the most current information about most likely to increase the client's perceived seriousness
the dangers of untreated diabetes. of the disease.
c. He comments on the community service announce-
ments about preventing complications associated with
diabetes.
d. His wife expresses a sincere willingness to prepare
meals that are within his prescribed diet.
A 58-year-old client who has been post-menopausal for
five years is concerned about the risk for osteoporosis
because her mother has the condition. Which information
should the nurse otter?
a. Osteoporosis is a progressive genetic disease with no
,Med-Surg HESI Final Practice Questions and Answers Rated A
ettective treatment.
b. Calcium loss from bones can be slowed by increasing
B - Post-menopausal females are at risk for osteoporosis
calcium intake and exercise.
due to the cessation of estrogen secretion, but a regimen
c. Estrogen replacement therapy should be started to pre-
including calcium, vitamin D, and weight-bearing exercise
vent the progression osteoporosis.
can help prevent further bone loss.
d. Low-dose corticosteroid treatment ettectively halts the
course of osteoporosis.
The nurse notes that the only ECG for a 55-year-old male
client scheduled for surgery in two hours is dated two
years ago. The client reports that he has a history of
"heart trouble," but has no problems at present. Hospital
protocol requires that those over 50 years of age have a
recent ECG prior to surgery. Which nursing action is best B
for the nurse to implement?
a. Ask the client what he means by "heart trouble."
b. Call for an ECG to be performed immediately.
c. Notify surgery that the ECG is over two years old.
d. Notify the client's surgeon immediately.
C - There are ditterent recommendations from ditterent
Which information about mammograms is most impor- agnecies. For a client with no risk factors, the earliest
tant to provide a post-menopausal female client? breast screening recommendation is a yearly mammo-
a. Breast self-examinations are not needed if annual gram at the age 40 and till the age of 54. After that
mammograms are obtained. every two years. The American College of OB/GYN still
b. Radiation exposure is minimized by shielding the ab- recommend starting mammograms starting at the age
domen with a lead-lined apron. of 40 and yearly screeenings. The American Cancer So-
c. Yearly mammograms should be done regardless of ciety new guidelines recommend starting at the age of
previous normal x-rays. 45 and thereafter till the age of 54 years old, then every
d. Women at high risk should have annual routine and two years. The US Preventive Services Task Force Services
ultrasound mammograms (USPSTS) recommends starting at the age of 50 years old
and screenings every two years thereafter.
, Med-Surg HESI Final Practice Questions and Answers Rated A
The nurse is caring for a client with a continuous feeding
through a percutaneous endoscopic gastrostomy (PEG) B - Percutaneous endoscopic gastrostomy (PEG) tube
tube. Which intervention should the nurse include in the placement and residual volume should be checked every
plan of care? four hours for clients on continuous feeding. If the gastric
A. Flush the tube with 50 ml of water q 8 hours. residual is more than 200mL for an adult client; stop the
B. Check for tube placement and residual volume q4 feeding and re-check the gastric residual one hour later.
hours. If the residual still remains more than 200mL; continue to
C. Obtain a daily x- ray to verify tube placement. keep the feeding on hold and contact the client's health
D. Position on left side with head of bed elevated 45 care provider.
degrees
A 58-year-old client who has been post-menopausal for
five years is concerned about the risk for osteoporosis
because her mother has the condition. Which information
should the nurse otter?
A. Osteoporosis is a progressive genetic disease with no B - Post-menopausal females are at risk for osteoporosis
ettective treatment. due to the cessation of estrogen secretion, but a regimen
B. Calcium loss from bones can be slowed by increasing including calcium, vitamin D, and weight-bearing exercise
calcium intake and exercise. can help prevent further bone loss.
C. Estrogen replacement therapy should be started to
prevent the progression osteoporosis.
D. Low-dose corticosteroid treatment ettectively halts the
course of osteoporosis.
A client has undergone insertion of a permanent pace-
maker. When developing a discharge teaching plan, the
nurse writes a goal of, "The client will verbalize symptoms
of pacemaker failure." Which symptoms are most impor- D - Feelings of dizziness may occur as the result of a de-
tant to teach the client? creased heart rate, leading to a decreased cardiac output
A. Facial flushing. which may be an indication of pacemaker failure.
B. Fever.
C. Pounding headache.
D. Feelings of dizziness.
The nurse is assessing a client's laboratory values fol-
lowing administration of chemotherapy. Which lab value
leads the nurse to suspect that the client is experiencing B - Tumor lysis syndrome (TLS) results in hyperkalemia,
tumor lysis syndrome (TLS)? hypocalcemia, hyperuricemia, and hyperphosphatemia. A
a. Serum PTT of 10 seconds. serum calcium level of 5, which is low, is an indicator of
b. Serum calcium of 5 mg/dL. possible tumor lysis syndrome.
c. Oxygen saturation of 90%.
d. Hemoglobin of 10 g/dL
Which description of symptoms is characteristic of a client B - Trigeminal neuralgia is characterized by paroxysms of
diagnosed with trigeminal neuralgia (tic douloureux)? pain, similar to an electric shock, in the area innervated
a. Tinnitus, vertigo, and hearing diflculties. by one or more branches of the trigeminal nerve (5th cra-
b. Sudden, stabbing, severe pain over the lip and chin. nial). Women are more often afflicted with this condition
c. Facial weakness and paralysis. and generally occurs in clients over the age of 50 years
d. Diflculty in chewing, talking, and swallowing. old.
C - After a renal transplantation, acute rejection is a high
Which discharge instruction is most important for a client risk for several months. The organ recipient will have to
after a kidney transplant? take immunosuppressive therapy for the rest of their lives,
a. Weigh weekly. such as corticosteroids and azathioprine, to prevent organ
b. Report symptoms of secondary Candidiasis. transplant rejection. Discharge instructions include mea-
c. Use daily reminders to take immunosuppressants. sures such as daily reminders to ensure the client takes
d. Stop cigarette smoking. these medications regularly to prevent organ rejection
from occurring.
The nurse is providing dietary instructions to a
68-year-old client who is at high risk for development of
B - To reduce risk factors associated with coronary heart
coronary heart disease (CHD). Which information should
disease, the daily intake of soluble fiber should be in-
the nurse include?
creased to between 10 and 25 grams per day. According
a. Limit dietary selection of cholesterol to 300 mg per day.
to the American Heart Association, soluble fibers helps
b. Increase intake of soluble fiber to 10 to 25 grams per
reduce LDL cholesterol levels.
day.
c. Decrease plant stanols and sterols to less than 2
,Med-Surg HESI Final Practice Questions and Answers Rated A
grams/day.
d. Ensure saturated fat is less than 30% of total caloric
intake.
Two days postoperative, a male client reports aching pain
in his left leg. The nurse assesses redness and warmth
on the lower left calf. Which intervention would be most
helpful to this client? D - For a client exhibiting symptoms of deep vein throm-
a. Apply sequential compression devices (SCDs) bilateral- bosis (DVT), a complication of immobility, the initial care
ly. includes bedrest and elevation of the extremity.
b. Assess for a positive Homan's sign in each leg.
c. Pad all bony prominences on the attected leg.
d. Advise the client to remain in bed with the leg elevated.
A middle-aged male client with diabetes continues to
eat an abundance of foods that are high in sugar and
fat. According to the Health Belief Model, which event is
most likely to increase the client's willingness to become
compliant with the prescribed diet?
a. He visits his diabetic brother who just had surgery to A - The loss of a limb due to diabetes by a family member
amputate an infected foot. should be the strongest event or "cue to action" and is
b. He is provided with the most current information about most likely to increase the client's perceived seriousness
the dangers of untreated diabetes. of the disease.
c. He comments on the community service announce-
ments about preventing complications associated with
diabetes.
d. His wife expresses a sincere willingness to prepare
meals that are within his prescribed diet.
A 58-year-old client who has been post-menopausal for
five years is concerned about the risk for osteoporosis
because her mother has the condition. Which information
should the nurse otter?
a. Osteoporosis is a progressive genetic disease with no
,Med-Surg HESI Final Practice Questions and Answers Rated A
ettective treatment.
b. Calcium loss from bones can be slowed by increasing
B - Post-menopausal females are at risk for osteoporosis
calcium intake and exercise.
due to the cessation of estrogen secretion, but a regimen
c. Estrogen replacement therapy should be started to pre-
including calcium, vitamin D, and weight-bearing exercise
vent the progression osteoporosis.
can help prevent further bone loss.
d. Low-dose corticosteroid treatment ettectively halts the
course of osteoporosis.
The nurse notes that the only ECG for a 55-year-old male
client scheduled for surgery in two hours is dated two
years ago. The client reports that he has a history of
"heart trouble," but has no problems at present. Hospital
protocol requires that those over 50 years of age have a
recent ECG prior to surgery. Which nursing action is best B
for the nurse to implement?
a. Ask the client what he means by "heart trouble."
b. Call for an ECG to be performed immediately.
c. Notify surgery that the ECG is over two years old.
d. Notify the client's surgeon immediately.
C - There are ditterent recommendations from ditterent
Which information about mammograms is most impor- agnecies. For a client with no risk factors, the earliest
tant to provide a post-menopausal female client? breast screening recommendation is a yearly mammo-
a. Breast self-examinations are not needed if annual gram at the age 40 and till the age of 54. After that
mammograms are obtained. every two years. The American College of OB/GYN still
b. Radiation exposure is minimized by shielding the ab- recommend starting mammograms starting at the age
domen with a lead-lined apron. of 40 and yearly screeenings. The American Cancer So-
c. Yearly mammograms should be done regardless of ciety new guidelines recommend starting at the age of
previous normal x-rays. 45 and thereafter till the age of 54 years old, then every
d. Women at high risk should have annual routine and two years. The US Preventive Services Task Force Services
ultrasound mammograms (USPSTS) recommends starting at the age of 50 years old
and screenings every two years thereafter.
, Med-Surg HESI Final Practice Questions and Answers Rated A
The nurse is caring for a client with a continuous feeding
through a percutaneous endoscopic gastrostomy (PEG) B - Percutaneous endoscopic gastrostomy (PEG) tube
tube. Which intervention should the nurse include in the placement and residual volume should be checked every
plan of care? four hours for clients on continuous feeding. If the gastric
A. Flush the tube with 50 ml of water q 8 hours. residual is more than 200mL for an adult client; stop the
B. Check for tube placement and residual volume q4 feeding and re-check the gastric residual one hour later.
hours. If the residual still remains more than 200mL; continue to
C. Obtain a daily x- ray to verify tube placement. keep the feeding on hold and contact the client's health
D. Position on left side with head of bed elevated 45 care provider.
degrees
A 58-year-old client who has been post-menopausal for
five years is concerned about the risk for osteoporosis
because her mother has the condition. Which information
should the nurse otter?
A. Osteoporosis is a progressive genetic disease with no B - Post-menopausal females are at risk for osteoporosis
ettective treatment. due to the cessation of estrogen secretion, but a regimen
B. Calcium loss from bones can be slowed by increasing including calcium, vitamin D, and weight-bearing exercise
calcium intake and exercise. can help prevent further bone loss.
C. Estrogen replacement therapy should be started to
prevent the progression osteoporosis.
D. Low-dose corticosteroid treatment ettectively halts the
course of osteoporosis.
A client has undergone insertion of a permanent pace-
maker. When developing a discharge teaching plan, the
nurse writes a goal of, "The client will verbalize symptoms
of pacemaker failure." Which symptoms are most impor- D - Feelings of dizziness may occur as the result of a de-
tant to teach the client? creased heart rate, leading to a decreased cardiac output
A. Facial flushing. which may be an indication of pacemaker failure.
B. Fever.
C. Pounding headache.
D. Feelings of dizziness.
