HESI MED-SURG PRACTICE EXAM QUESTIONS AND CORRECT ANSWERS

HESI MED-SURG PRACTICE EXAM
QUESTIONS AND CORRECT ANSWERS
An adult client who is hospitalized after surgery reports sudden onset of chest pain
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and dyspnea. The client appears anxious, restless, and mildly cyanotic. The nurse
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should further assess the client for which condition?
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vn Pulmonary embolism. vn vn


vn Heart failure. vn


vn Tuberculosis.
vn Bronchitis. - ANSWERS-Pulmonary embolism. vn vn vn vn




Post-
surgical clients are at an increased risk for deep vein thrombosis (DVT), which ma
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y result in pulmonary embolism if the clot breaks off and travels to the lungs. Signs
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and symptoms of pulmonary embolism include chest pain, dyspnea, anxiety, restle
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ssness, and - in severe cases - cyanosis.
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Jarvis, Physical Examination and Health Assessment, 7th ed., p.493
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Which information should the nurse obtain when performing an initial assessment
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of a client who presents to the emergency department with a painful ankle injury? (
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Select all that apply.) vn vn vn




Quality of the pain. vn vn vn vn


Signs of inflammation. vn vn


Ankle range of motion. vn vn vn vn


Muscle strength testing. vn vn


Visible deformities of the joint. - ANSWERS-Quality of the pain.
vn vn vn vn vn vn vn vn vn vn


Signs of inflammation. vn vn


Ankle range of motion. vn vn vn vn


Visible deformities of the joint.
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Initial assessment of a joint injury is performed to determine the extent of the dam
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age. The nurse's initial assessment of a painful ankle injury should include pain qu
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ality, the presence of deformities, evidence of inflammation, and range of motion.
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Jarvis Physical Examination and Health Assessment, 7th ed. p. 586-8
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Which description of pain is consistent with a diagnosis of rheumatoid arthritis?
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Joint pain is worse in the morning and involves symmetric joints.
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Joint pain is better in the morning and worsens throughout the day.
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Joint pain is consistent throughout the day and is relieved by pain medication.
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Joint pain is worse during the day and involves unilateral joints. - ANSWERS-
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Joint pain is worse in the morning and involves symmetric joints.
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,Rheumatoid arthritis (RA) is an autoimmune disease that causes joint pain and sw
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elling. RA is characterized by pain that is worse when arising and involves symmet
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ric joints.
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Jarvis. (2016), Physical Examination and Health Assessment, 7th Ed., Chapter 22;
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p. 586vn




Which physical assessment finding should the nurse anticipate in a client with long
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-term gastroesophagealreflux disease (GERD)?
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vn Hoarseness. vn


vn Dry mouth. vn


vn Mouth ulcers. vn


vn Weight loss. - ANSWERS-Hoarseness. vn vn vn vn




Dyspepsia and regurgitation are the main symptoms of gastroesophageal reflux dis
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ease (GERD); however, hoarseness is one of the most common long-
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term symptoms of GERD due to the irritation of the reflux of gastric secretions.
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Ignatavicius, (2016). Medical-surgical nursing: Patient- vn vn vn vn


centered collaborative care, eight edition., Ch. 49, p. 1111.
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A client presents with chronic venous insufficiency. Which assessment finding shou
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ld the nurse anticipate?
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vn Bilateral lower leg stasis dermatitis. vn vn vn vn vn


vn Clubbing of fingers and toes. vn vn vn vn


vn Intermittent claudication. vn


vn Peripheral cyanosis. - ANSWERS-Bilateral lower leg stasis dermatitis.
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Clients who suffer from chroninc venous insufficiency often develop statsis dermatit
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is in the lower extremities. Statis dermatitis appear as brownish-
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red discoloration on the lower extremities at the ankles which can develop into stas
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is ulcers due to the pooling of the venous blood flow back to the heart.
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Ignatavicius, (2013). Medical-surgical nursing: Patient- vn vn vn vn


centered collaborative care, 7th ed.., Ch. 33, p. 803.
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A client has been hospitalized with a femur fracture and is being treated with tracti
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on. Which action by the nurse is the priority when caring for this client?
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vn Assess neurovascular status. vn vn vn


vn Change the client's position. vn vn vn


vn Inspect the traction equipment. vn vn vn


vn Review pain medication orders. - ANSWERS-Assess neurovascular status.
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The use of traction for long bone fractures reduces the potential for damage to the
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nsurrounding tissues. Reports of increased pain may indicate circulatory compromis
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e or tissue damage (compartment syndrome). Assessing the client's neurovascular
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nstatus is the nurse's highest priority.
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Ignatavicius, (2016). Medical-surgical nursing: Patient- vn vn vn vn


centered collaborative care, eight edition., Ch. 51, pp. 1051-80.
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,Which statement made by a client with chronic pancreatitis indicates that further ed
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ucation is needed? vn vn




I vn will cut back on smoking cigarettes daily.
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I vn will avoid drinking caffeinated beverages.
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I vn will rest frequently and avoid vigorous exercise.
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I vn will eat a bland, low-fat, high-protein diet. - ANSWERS-
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I vn will cut back on smoking cigarettes daily.
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To prevent exacerbations of chronic pancreatitis, clients should be instructed to av
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oid nicotine entirely. Additional teaching includes avoiding caffeinated beverages, r
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esting frequently as needed, and eating a bland diet low fat and high in protein.Ign
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atavicius, (2016). Medical-surgical nursing: Patient-
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centered collaborative care, 8th ed., Ch. 59, pp. 1084-98.
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The nurse is teaching a female client who uses a contraceptive diaphragm about r
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educing the risk for toxic shock syndrome (TSS). Which information should the nur
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se include? (Select all that apply.)
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Remove the diaphragm immediately after intercourse.
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Wash the diaphragm with an alcohol solution.
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Use the diaphragm to prevent conception during the menstrual cycle.
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Do not leave the diaphragm in place longer than 8 hours after intercourse.
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Replace the old diaphragm every 3 months. - ANSWERS-
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Do not leave the diaphragm in place longer than 8 hours after intercourse.
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Replace the old diaphragm every 3 months.
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The diaphragm needs to remain against the cervix for 6 to 8 hours to prevent preg
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nancy but should not remain for longer than 8 hours to avoid the risk of toxic shoc
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k syndrome. The diaphragm should be replaced every 3 months to maintain integri
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ty.

A male client who smokes two packs of cigarettes a day states he understands tha
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t smoking cigarettes is contributing to the difficulty that he and his wife are having i
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n getting pregnant and wants to know if other factors could be contributing to their
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difficulty. What information is best for the nurse to provide? (Select all that apply.)
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Marijuana cigarettes do not affect sperm count.
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Alcohol consumption can cause erectile dysfunction.
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Low testosterone levels affect sperm production.
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Cessation of smoking improves general health and fertility.
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Obesity has no effect on sperm production. - ANSWERS-
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Alcohol consumption can cause erectile dysfunction.
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Low testosterone levels affect sperm production.
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Cessation of smoking improves general health and fertility.
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Use of tobacco, alcohol, and marijuana may affect sperm counts. Sperm count is a
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lso negatively affected by low testerone levels and obesity.
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, Twenty four hours after a client returns from surgical gastric bypass, the registered
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nurse (RN) observes large amounts of blood in the nasogastric tube (NGT) cannist
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er. Which assessment finding should the RN report as early signs of hypovolemic
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shock?

vn Faint pedal pulses.
vn vn


vn Decrease in blood pressure. vn vn vn vn


vn Lethargy. vn


vn Slow breathing. - ANSWERS-Lethargy.
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One of the early signs of hypovolemic shock is changes in the client's level of cons
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ciousness due to the decrease perfusion to the brain which can manifests as lethar
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gy or confusion.
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The registered nurse (RN) is assessing a male client who arrives at the clinic with
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severe abdominal cramping, pain, tenesmus, and dehydration. The RN discovers t
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hat the client has had 14 to 20 loose stools with rectal bleeding. When taking the c
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lient's medical history, which information is most for the nurse to obtain?
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vn Irritable bowel syndrome. vn vn


vn Diverticulitis.
vn Crohn's disease. vn


vn Ulcerative colitis. - ANSWERS-Ulcerative colitis.
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The RN should ask the client if he has a history of ulcerative colitis, which is chara
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cterized by severe abdominal cramping, pain, tenesmus, and dehydration .
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A client is newly diagnosed with diverticulosis. The registered nurse (RN) is assess
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ing the client's basic knowledge about the disease process. Which statement by th
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e client conveys an understanding of the etiology of diverticula?
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Over use of laxatives for bowel regularity result in loss of peristaltic tone.
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Inflammation of the colon mucosa cause growths that protrude into the colon lume
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n.
Diverticulosis is the result of high fiber diet and sedentary life style.
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Chronic constipation causes weakening of colon wall which result in out-
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pouching sacs. - ANSWERS- vn vn vn


Chronic constipation causes weakening of colon wall which result in out-
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pouching sacs. vn vn




A client who has chronic constipation often strains to pass constipated stool which
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increases intestinal pressure that weakens the intestinal walls and causes out-
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pouching sacs, called diverticula which commonly occur in the sigmoid.
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The registered nurse (RN) is assessing a client who was discharged home after m
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anagement of chronic hypertension. Which equipment should the RN instruct the cl
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ient to use at home?
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