Med Surg HESI Practice Exam with Answers Rated A
Allow the client to sit with the bed in a high Fowler's
position.
Rationale
The nurse is assisting a client out of bed for the first time
after surgery. What action should the nurse do first? The first step is to raise the head of the bed to a high
Fowler's position, which allow venous return to compen-
sate from lying flat and the vasodilation ettects of periop-
erative drugs. This helps prevent the client from becoming
light-headed and decreases the chance of a client fall.
5 minutes before and 30 minutes after the next dose.
After the fourth dose of gentamicin sulfate (Garamycin) IV, Rationale
the nurse plans to draw blood samples to determine peak
and trough levels. When are the best times to draw these Peak drug serum levels are achieved 30 minutes after the
samples? completion of the IV infusion of gentamicin sulfate. The
best time to draw a trough is the closest time to the next
administration.
Sodium.
Rationale
In assessing a client diagnosed with primary hyperaldos- Clients with primary aldosteronism exhibit an increase
teronism, the nurse expects the laboratory test results to in serum sodium levels (hypernatremia) and have pro-
indicate an increased serum level of which substance? found decline in the serum levels of potassium (hy-
pokalemia)--hypertension is the most prominent and uni-
versal sign. Antidiuretic hormone is decreased with dia-
betes insipidus. Glucose is not attected by primary aldos-
teronism.
Which milestone indicates to the nurse successful
achievement of young adulthood?
,Completes education and becomes self-supporting.
Rationale
Transitioning through young adulthood is characterized
by establishing independence as an adult, and includes
developmental tasks such as completing education, be-
ginning a career, and becoming self-supporting (B). (A
and C) are characteristic of adolescence. Although strong
bonds with parents are an expected finding for this age
group, the need for support and approval (D) indicates
dependency, which is a developmental delay.
Normal skin coloring.
Rationale
The nurse is assessing a client who smokes cigarettes The ditterentiation between the "pink putter" and the
and has been diagnosed with emphysema. Which finding "blue bloater" is a well-known method of ditterentiating
would the nurse expect this client to exhibit? clients exhibiting symptoms of emphysema (normal color
but puflng respirations) from those exhibiting symptoms
of chronic bronchitis (edematous, cyanotic, shallow respi-
rations).
Alcohol consumption can cause erectile dysfunction.
Low testosterone levels attect sperm production.
A male client who smokes two packs of cigarettes a day Cessation of smoking improves general health and fertili-
states he understands that smoking cigarettes is con- ty.
tributing to the diflculty that he and his wife are having in
getting pregnant and wants to know if other factors could Rationale
be contributing to their diflculty. What information is best
for the nurse to provide? (Select all that apply.) Use of tobacco, alcohol, and marijuana may attect sperm
counts. Sperm count is also negatively attected by low
testerone levels and obesity.
The nurse working on a telemetry unit finds a client un-
conscious and in pulseless ventricular tachycardia (VT).
,Shock the client with 200 joules per hospital policy.
Rationale
The client must be externally shocked 200 joules per hos-
pital policy to restore an ettective cardiac rhythm. The
automatic defibrillator is obviously malfunctioning.
From a distance of 12 to 15 inches and slightly to the side,
shine the light into the client's pupil.
Rationale
What is the correct procedure for performing an opthal-
The client should focus on a distant object behind the
moscopic examination on a client's right retina?
examiner who should stand at 12-15 inches away and to
the side of his/her line of vision. The examiner should hold
the ophthalmoscope firmly against his/her face and then
direct it at the client's pupil.
May indicate pneumonia.
Rationale
During lung assessment, the nurse places a stethoscope This test (whispered pectoriloquy) demonstrates hyper-
on a client's chest and instructs him/her to say "99" each resonance and helps determine the clarity with which
time the chest is touched with the stethoscope. What spoken words are heard upon auscultation. Normally, the
would be the correct interpretation if the nurse hears the spoken word is not well transmitted through lung tissue,
spoken words "99" very clearly through the stethoscope? and is heard as a muffled or unclear transmission of the
spoken word. Increased clarity of a spoken word is indica-
tive of some sort of consolidation process (e. g., tumor,
pneumonia), and is not a normal finding.
Potassium.
Rationale
Clients with primary hyperaldosteronism exhibit a pro-
, found decline in the serum levels of potassium (hy-
pokalemia). Hypertension, along with the hypokalemia
In assessing a client diagnosed with primary hyperaldos-
are the most prominent and universal signs for this con-
teronism, the nurse expects the laboratory test results to
dition. If both of these findings are present, there is 50%
indicate a decreased serum level of which substance?
likelihood the client to be diagnosed with hyperaldostero-
nism.
Place a small book or magazine on the abdomen and
make it rise while inhaling deeply.
Rationale
When teaching diaphragmatic breathing to a client with
chronic obstructive pulmonary disease (COPD), which in- Diaphragmatic or abdominal breathing uses the di-
formation should the nurse provide? aphragm instead of accessory muscles to achieve maxi-
mum inhalation and to slow the respiratory rate. The client
should protrude the abdomen on inhalation and contract
it with exhalation, so placing a book or magazine, helps
the client visualize the rise and fall of the abdomen.
Advise the client to notify the healthcare provider for im-
mediate medical attention.
A female client taking oral contraceptives reports to the Rationale
nurse that she is experiencing calf pain. What action
should the nurse implement? Calf pain is indicative of thrombophlebitis, a serious,
life-threatening complication associated with the use of
oral contraceptives which requires further assessment and
possibly immediate medical intervention.
Increase intake of soluble fiber to 10 to 25 grams per day.
The nurse is providing dietary instructions to a Rationale
68-year-old client who is at high risk for development of
To reduce risk factors associated with coronary heart dis-
ease, the daily intake of soluble fiber should be increased
Allow the client to sit with the bed in a high Fowler's
position.
Rationale
The nurse is assisting a client out of bed for the first time
after surgery. What action should the nurse do first? The first step is to raise the head of the bed to a high
Fowler's position, which allow venous return to compen-
sate from lying flat and the vasodilation ettects of periop-
erative drugs. This helps prevent the client from becoming
light-headed and decreases the chance of a client fall.
5 minutes before and 30 minutes after the next dose.
After the fourth dose of gentamicin sulfate (Garamycin) IV, Rationale
the nurse plans to draw blood samples to determine peak
and trough levels. When are the best times to draw these Peak drug serum levels are achieved 30 minutes after the
samples? completion of the IV infusion of gentamicin sulfate. The
best time to draw a trough is the closest time to the next
administration.
Sodium.
Rationale
In assessing a client diagnosed with primary hyperaldos- Clients with primary aldosteronism exhibit an increase
teronism, the nurse expects the laboratory test results to in serum sodium levels (hypernatremia) and have pro-
indicate an increased serum level of which substance? found decline in the serum levels of potassium (hy-
pokalemia)--hypertension is the most prominent and uni-
versal sign. Antidiuretic hormone is decreased with dia-
betes insipidus. Glucose is not attected by primary aldos-
teronism.
Which milestone indicates to the nurse successful
achievement of young adulthood?
,Completes education and becomes self-supporting.
Rationale
Transitioning through young adulthood is characterized
by establishing independence as an adult, and includes
developmental tasks such as completing education, be-
ginning a career, and becoming self-supporting (B). (A
and C) are characteristic of adolescence. Although strong
bonds with parents are an expected finding for this age
group, the need for support and approval (D) indicates
dependency, which is a developmental delay.
Normal skin coloring.
Rationale
The nurse is assessing a client who smokes cigarettes The ditterentiation between the "pink putter" and the
and has been diagnosed with emphysema. Which finding "blue bloater" is a well-known method of ditterentiating
would the nurse expect this client to exhibit? clients exhibiting symptoms of emphysema (normal color
but puflng respirations) from those exhibiting symptoms
of chronic bronchitis (edematous, cyanotic, shallow respi-
rations).
Alcohol consumption can cause erectile dysfunction.
Low testosterone levels attect sperm production.
A male client who smokes two packs of cigarettes a day Cessation of smoking improves general health and fertili-
states he understands that smoking cigarettes is con- ty.
tributing to the diflculty that he and his wife are having in
getting pregnant and wants to know if other factors could Rationale
be contributing to their diflculty. What information is best
for the nurse to provide? (Select all that apply.) Use of tobacco, alcohol, and marijuana may attect sperm
counts. Sperm count is also negatively attected by low
testerone levels and obesity.
The nurse working on a telemetry unit finds a client un-
conscious and in pulseless ventricular tachycardia (VT).
,Shock the client with 200 joules per hospital policy.
Rationale
The client must be externally shocked 200 joules per hos-
pital policy to restore an ettective cardiac rhythm. The
automatic defibrillator is obviously malfunctioning.
From a distance of 12 to 15 inches and slightly to the side,
shine the light into the client's pupil.
Rationale
What is the correct procedure for performing an opthal-
The client should focus on a distant object behind the
moscopic examination on a client's right retina?
examiner who should stand at 12-15 inches away and to
the side of his/her line of vision. The examiner should hold
the ophthalmoscope firmly against his/her face and then
direct it at the client's pupil.
May indicate pneumonia.
Rationale
During lung assessment, the nurse places a stethoscope This test (whispered pectoriloquy) demonstrates hyper-
on a client's chest and instructs him/her to say "99" each resonance and helps determine the clarity with which
time the chest is touched with the stethoscope. What spoken words are heard upon auscultation. Normally, the
would be the correct interpretation if the nurse hears the spoken word is not well transmitted through lung tissue,
spoken words "99" very clearly through the stethoscope? and is heard as a muffled or unclear transmission of the
spoken word. Increased clarity of a spoken word is indica-
tive of some sort of consolidation process (e. g., tumor,
pneumonia), and is not a normal finding.
Potassium.
Rationale
Clients with primary hyperaldosteronism exhibit a pro-
, found decline in the serum levels of potassium (hy-
pokalemia). Hypertension, along with the hypokalemia
In assessing a client diagnosed with primary hyperaldos-
are the most prominent and universal signs for this con-
teronism, the nurse expects the laboratory test results to
dition. If both of these findings are present, there is 50%
indicate a decreased serum level of which substance?
likelihood the client to be diagnosed with hyperaldostero-
nism.
Place a small book or magazine on the abdomen and
make it rise while inhaling deeply.
Rationale
When teaching diaphragmatic breathing to a client with
chronic obstructive pulmonary disease (COPD), which in- Diaphragmatic or abdominal breathing uses the di-
formation should the nurse provide? aphragm instead of accessory muscles to achieve maxi-
mum inhalation and to slow the respiratory rate. The client
should protrude the abdomen on inhalation and contract
it with exhalation, so placing a book or magazine, helps
the client visualize the rise and fall of the abdomen.
Advise the client to notify the healthcare provider for im-
mediate medical attention.
A female client taking oral contraceptives reports to the Rationale
nurse that she is experiencing calf pain. What action
should the nurse implement? Calf pain is indicative of thrombophlebitis, a serious,
life-threatening complication associated with the use of
oral contraceptives which requires further assessment and
possibly immediate medical intervention.
Increase intake of soluble fiber to 10 to 25 grams per day.
The nurse is providing dietary instructions to a Rationale
68-year-old client who is at high risk for development of
To reduce risk factors associated with coronary heart dis-
ease, the daily intake of soluble fiber should be increased
