MEDICAL SURGICAL
EVOLVE HESI MEDICAL SURGICAL
INTEGRATED TEST ACTUAL EXAM 5
VERIFIED QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED
RATIONALES) |ALREADY GRADED A+ BEST
DOCUMENT FOR FINAL EXAM
A client who is sexually active with several partners requests an intrauterine device (IUD) as a
contraceptive method. Which information should the nurse provide?
A) Using an IUD offers no protection against sexually transmitted diseases (STD), which
increase the risk for pelvic inflammatory disease (PID).
B) Getting pregnant while using an IUD is common and is not the best contraceptive choice.
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C) Relying on an IUD may be a safer choice for monogamous partners, but a barrier method
provides a better option in preventing STD transmission.
D) Selecting a contraceptive device should consider choosing a successful method used in the
past.
- Correct Answer :A) Using an IUD offers no protection against sexually transmitted diseases
(STD), which increase the risk for pelvic inflammatory disease (PID).
The use of an IUD provides the client with no protection from STDs (A). While pregnancy rates
with the use of an IUD are somewhat higher, (B) is not therapeutic, but judgmental. (C) is
judgmental and does not provide the client any information about use of an IUD. While
talking about contraceptives may include (D), it is does not provide the best information to
maintain the client's health.
A client reports unprotected sexual intercourse one week ago and is worried about HIV
exposure. An initial HIV antibody screen (ELISA) is obtained. The nurse teaches the client that
seroconversion to HIV positive relies on antibody production by B lymphocytes after exposure
to the virus. When should the nurse recommend the client return for repeat blood testing?
A) 6 to 18 months.
B) 1 to 12 months.
C) 1 to 18 weeks.
D) 6 to 12 weeks. –
Correct Answer :D) 6 to 12 weeks.
Although the HIV antigen is detectable approximately 2 weeks after exposure,
seroconversion to HIV positive may take up to 6 to 12 weeks (D) after exposure, so the client
should return to repeat the serum screen for the presence of HIV antibodies during that time
frame. (A) will delay treatment if the client tests positive. (B and C) may provide inaccurate
results because the time frame maybe too early to reevaluate the client.
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A 32-year-old female client complains of severe abdominal pain each month before her
menstrual period, painful intercourse, and painful defecation. Which additional history should
the nurse obtain that is consistent with the client's complaints?
A) Frequent urinary tract infections.
B) Inability to get pregnant.
C) Premenstrual syndrome.
D) Chronic use of laxatives. –
Correct Answer :B) Inability to get pregnant.
Dysmenorrhea, dyspareunia, and difficulty or painful defecation are common symptoms of
endometriosis, which is the abnormal displacement of endometrial tissue in the dependent
areas of the pelvic peritoneum. A history of infertility (B) is another common finding
associated with endometriosis. Although (A, C, and D) are common, nonspecific
gynecological complaints, the most common complaints of the client with endometriosis are
pain and infertility.
The nurse is completing an admission interview and assessment on a client with a history of
Parkinson's disease. Which question should provide information relevant to the client's plan
of care?
A) Have you ever experienced any paralysis of your arms or legs?
B) Have you ever sustained a severe head injury?
C) Have you ever been 'frozen' in one spot, unable to move?
D) Do you have headaches, especially ones with throbbing pain? –
Correct Answer :C) Have you ever been 'frozen' in one spot, unable to move?
Clients with Parkinson's disease frequently experience difficulty in initiating, maintaining, and
performing motor activities. They may even experience being rooted to the spot and unable
to move (C). Parkinson's disease does not cause (A). Parkinson's disease is not usually
associated with (B), nor does it typically cause (D).
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A female client requests information about using the calendar method of contraception.
Which assessment is most important for the nurse to obtain?
A) Amount of weight gain or weight loss during the previous year.
B) An accurate menstrual cycle diary for the past 6 to 12 months.
C) Skin pigmentation and hair texture for evidence of hormonal changes.
D) Previous birth-control methods and beliefs about the calendar method. –
Correct Answer :B) An accurate menstrual cycle diary for the past 6 to 12 months.
The fertile period, which occurs 2 weeks prior to the onset of menses, is determined using an
accurate record of the number of days of the menstrual cycles for the past 6 months, so it is
most important to emphasize to the client that accuracy and compliancy of a menstrual diary
(B) is the basis of the calendar method. (A and C) may be partially related to hormonal
fluctuations but are not indicators for using the calendar method. (D) may demonstrate client
understanding and compliancy but is not the most important aspect.
The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH),
which is manifested by which symptoms?
A) Loss of thirst, weight gain.
B) Dependent edema, fever.
C) Polydipsia, polyuria.
D) Hypernatremia, tachypnea. - Correct Answer :A) Loss of thirst, weight gain.
SIADH occurs when the posterior pituitary gland releases too much ADH, causing water
retention, a urine output of less than 20 ml/hour, and dilutional hyponatremia. Other
indications of SIADH are loss of thirst, weight gain (A), irritability, muscle weakness, and
decreased level of consciousness. (B) is not associated with SIADH. (C) is a finding associated
with diabetes insipidus (a water metabolism problem caused by an ADH deficiency), not
SIADH. The increase in plasma volume causes an increase in the glomerular filtration rate that
inhibits the release of rennin and aldosterone, which results in an increased sodium loss in
urine, leading to greater hyponatremia, not (D).
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EVOLVE HESI MEDICAL SURGICAL
INTEGRATED TEST ACTUAL EXAM 5
VERIFIED QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED
RATIONALES) |ALREADY GRADED A+ BEST
DOCUMENT FOR FINAL EXAM
A client who is sexually active with several partners requests an intrauterine device (IUD) as a
contraceptive method. Which information should the nurse provide?
A) Using an IUD offers no protection against sexually transmitted diseases (STD), which
increase the risk for pelvic inflammatory disease (PID).
B) Getting pregnant while using an IUD is common and is not the best contraceptive choice.
1|Page
, MEDICAL SURGICAL
C) Relying on an IUD may be a safer choice for monogamous partners, but a barrier method
provides a better option in preventing STD transmission.
D) Selecting a contraceptive device should consider choosing a successful method used in the
past.
- Correct Answer :A) Using an IUD offers no protection against sexually transmitted diseases
(STD), which increase the risk for pelvic inflammatory disease (PID).
The use of an IUD provides the client with no protection from STDs (A). While pregnancy rates
with the use of an IUD are somewhat higher, (B) is not therapeutic, but judgmental. (C) is
judgmental and does not provide the client any information about use of an IUD. While
talking about contraceptives may include (D), it is does not provide the best information to
maintain the client's health.
A client reports unprotected sexual intercourse one week ago and is worried about HIV
exposure. An initial HIV antibody screen (ELISA) is obtained. The nurse teaches the client that
seroconversion to HIV positive relies on antibody production by B lymphocytes after exposure
to the virus. When should the nurse recommend the client return for repeat blood testing?
A) 6 to 18 months.
B) 1 to 12 months.
C) 1 to 18 weeks.
D) 6 to 12 weeks. –
Correct Answer :D) 6 to 12 weeks.
Although the HIV antigen is detectable approximately 2 weeks after exposure,
seroconversion to HIV positive may take up to 6 to 12 weeks (D) after exposure, so the client
should return to repeat the serum screen for the presence of HIV antibodies during that time
frame. (A) will delay treatment if the client tests positive. (B and C) may provide inaccurate
results because the time frame maybe too early to reevaluate the client.
2|Page
, MEDICAL SURGICAL
A 32-year-old female client complains of severe abdominal pain each month before her
menstrual period, painful intercourse, and painful defecation. Which additional history should
the nurse obtain that is consistent with the client's complaints?
A) Frequent urinary tract infections.
B) Inability to get pregnant.
C) Premenstrual syndrome.
D) Chronic use of laxatives. –
Correct Answer :B) Inability to get pregnant.
Dysmenorrhea, dyspareunia, and difficulty or painful defecation are common symptoms of
endometriosis, which is the abnormal displacement of endometrial tissue in the dependent
areas of the pelvic peritoneum. A history of infertility (B) is another common finding
associated with endometriosis. Although (A, C, and D) are common, nonspecific
gynecological complaints, the most common complaints of the client with endometriosis are
pain and infertility.
The nurse is completing an admission interview and assessment on a client with a history of
Parkinson's disease. Which question should provide information relevant to the client's plan
of care?
A) Have you ever experienced any paralysis of your arms or legs?
B) Have you ever sustained a severe head injury?
C) Have you ever been 'frozen' in one spot, unable to move?
D) Do you have headaches, especially ones with throbbing pain? –
Correct Answer :C) Have you ever been 'frozen' in one spot, unable to move?
Clients with Parkinson's disease frequently experience difficulty in initiating, maintaining, and
performing motor activities. They may even experience being rooted to the spot and unable
to move (C). Parkinson's disease does not cause (A). Parkinson's disease is not usually
associated with (B), nor does it typically cause (D).
3|Page
, MEDICAL SURGICAL
A female client requests information about using the calendar method of contraception.
Which assessment is most important for the nurse to obtain?
A) Amount of weight gain or weight loss during the previous year.
B) An accurate menstrual cycle diary for the past 6 to 12 months.
C) Skin pigmentation and hair texture for evidence of hormonal changes.
D) Previous birth-control methods and beliefs about the calendar method. –
Correct Answer :B) An accurate menstrual cycle diary for the past 6 to 12 months.
The fertile period, which occurs 2 weeks prior to the onset of menses, is determined using an
accurate record of the number of days of the menstrual cycles for the past 6 months, so it is
most important to emphasize to the client that accuracy and compliancy of a menstrual diary
(B) is the basis of the calendar method. (A and C) may be partially related to hormonal
fluctuations but are not indicators for using the calendar method. (D) may demonstrate client
understanding and compliancy but is not the most important aspect.
The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH),
which is manifested by which symptoms?
A) Loss of thirst, weight gain.
B) Dependent edema, fever.
C) Polydipsia, polyuria.
D) Hypernatremia, tachypnea. - Correct Answer :A) Loss of thirst, weight gain.
SIADH occurs when the posterior pituitary gland releases too much ADH, causing water
retention, a urine output of less than 20 ml/hour, and dilutional hyponatremia. Other
indications of SIADH are loss of thirst, weight gain (A), irritability, muscle weakness, and
decreased level of consciousness. (B) is not associated with SIADH. (C) is a finding associated
with diabetes insipidus (a water metabolism problem caused by an ADH deficiency), not
SIADH. The increase in plasma volume causes an increase in the glomerular filtration rate that
inhibits the release of rennin and aldosterone, which results in an increased sodium loss in
urine, leading to greater hyponatremia, not (D).
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