MED SURG II HESI ALL QUESTIONS AND ANSWERS
SURE A+
✔✔Which of the following clients is at risk for varicose veins?
1. A client who has had a cerebrovascular accident.
2. A client who has had anemia.
3. A client who has had thrombophlebitis.
4. A client who has had transient ischemic attacks. - ✔✔3. A client who has had
thrombophlebitis.
✔✔A client weighs 300 lbs (136 kg) and has a history of deep vein thrombosis and
thrombophlebitis. When reviewing a teaching plan with this client, the nurse determines
that the client has understood the nurse's instructions when the client states a
willingness to:
1. Avoid exercise.
2. Lose weight.
3. Perform leg lifts every 4 hours.
4. Wear support hose, using rubber bands to hold the stockings up. - ✔✔2. Lose weight.
✔✔Which instructions should the nurse include when developing a teaching plan for a
client being discharged from the hospital on anticoagulant therapy after having deep
vein thrombosis (DVT)? Select all that apply.
1. Checking urine for bright blood and a dark smoky color.
2. Walking daily as a good exercise.
3. Using garlic and ginger, which may decrease bleeding time.
4. Performing foot/leg exercises and walking around the airplane cabin when on long
flights.
5. Preventing DVT because of risk of pulmonary emboli.
6. Avoiding surface bumps because the skin is prone to injury. - ✔✔1. Checking urine
for bright blood and a dark smoky color.
, 2. Walking daily as a good exercise.
4. Performing foot/leg exercises and walking around the airplane cabin when on long
flights.
5. Preventing DVT because of risk of pulmonary emboli.
6. Avoiding surface bumps because the skin is prone to injury.
✔✔A client has an emergency embolectomy for an embolus in the femoral artery. After
the client returns from the recovery room, in what order, from first to last, should the
nurse provide care?
1. Administer pain medication.
2. Draw blood for laboratory studies.
3. Regulate the IV infusion.
4. Monitor the pulses.
5. Inspect the dressing. - ✔✔4. Monitor the pulses.
5. Inspect the dressing.
3. Regulate the IV infusion.
1. Administer pain medication.
2. Draw blood for laboratory studies.
The nurse should first monitor the popliteal and the pedal pulses in the affected
extremity after arterial embolectomy. Monitoring peripheral pulses below the site of
occlusion checks the arterial circulation in the involved extremity. The nurse should next
inspect the dressing to be sure that the client is not bleeding at the surgical site. The
nurse should next regulate the IV infusion to prevent fluid overload. Then the nurse
should assess pain and administer pain medications as prescribed. Last, the nurse can
obtain blood for laboratory studies.
✔✔The nurse is developing a discharge teaching plan for a client who underwent a
repair of abdominal aortic aneurysm 4 days ago. The nurse reviews the client's chart for
information about the client's history. Key findings are noted in the chart below. Based
on the data and expected outcomes, which should the nurse emphasize in the teaching
plan?
1. Food intake.
2. Fluid volume.
3. Skin integrity.
4. Tissue perfusion. - ✔✔4. Tissue perfusion.
✔✔A client is admitted with a 6.5-cm thoracic aneurysm. The nurse records findings
from the initial assessment in the client's chart, as shown below.
At 10:30 AM, the client has sharp mid-chest pain after having a bowel movement. What
should the nurse do first?
1. Assess the client's vital signs.
2. Administer a bolus of lactated Ringer's solution.
SURE A+
✔✔Which of the following clients is at risk for varicose veins?
1. A client who has had a cerebrovascular accident.
2. A client who has had anemia.
3. A client who has had thrombophlebitis.
4. A client who has had transient ischemic attacks. - ✔✔3. A client who has had
thrombophlebitis.
✔✔A client weighs 300 lbs (136 kg) and has a history of deep vein thrombosis and
thrombophlebitis. When reviewing a teaching plan with this client, the nurse determines
that the client has understood the nurse's instructions when the client states a
willingness to:
1. Avoid exercise.
2. Lose weight.
3. Perform leg lifts every 4 hours.
4. Wear support hose, using rubber bands to hold the stockings up. - ✔✔2. Lose weight.
✔✔Which instructions should the nurse include when developing a teaching plan for a
client being discharged from the hospital on anticoagulant therapy after having deep
vein thrombosis (DVT)? Select all that apply.
1. Checking urine for bright blood and a dark smoky color.
2. Walking daily as a good exercise.
3. Using garlic and ginger, which may decrease bleeding time.
4. Performing foot/leg exercises and walking around the airplane cabin when on long
flights.
5. Preventing DVT because of risk of pulmonary emboli.
6. Avoiding surface bumps because the skin is prone to injury. - ✔✔1. Checking urine
for bright blood and a dark smoky color.
, 2. Walking daily as a good exercise.
4. Performing foot/leg exercises and walking around the airplane cabin when on long
flights.
5. Preventing DVT because of risk of pulmonary emboli.
6. Avoiding surface bumps because the skin is prone to injury.
✔✔A client has an emergency embolectomy for an embolus in the femoral artery. After
the client returns from the recovery room, in what order, from first to last, should the
nurse provide care?
1. Administer pain medication.
2. Draw blood for laboratory studies.
3. Regulate the IV infusion.
4. Monitor the pulses.
5. Inspect the dressing. - ✔✔4. Monitor the pulses.
5. Inspect the dressing.
3. Regulate the IV infusion.
1. Administer pain medication.
2. Draw blood for laboratory studies.
The nurse should first monitor the popliteal and the pedal pulses in the affected
extremity after arterial embolectomy. Monitoring peripheral pulses below the site of
occlusion checks the arterial circulation in the involved extremity. The nurse should next
inspect the dressing to be sure that the client is not bleeding at the surgical site. The
nurse should next regulate the IV infusion to prevent fluid overload. Then the nurse
should assess pain and administer pain medications as prescribed. Last, the nurse can
obtain blood for laboratory studies.
✔✔The nurse is developing a discharge teaching plan for a client who underwent a
repair of abdominal aortic aneurysm 4 days ago. The nurse reviews the client's chart for
information about the client's history. Key findings are noted in the chart below. Based
on the data and expected outcomes, which should the nurse emphasize in the teaching
plan?
1. Food intake.
2. Fluid volume.
3. Skin integrity.
4. Tissue perfusion. - ✔✔4. Tissue perfusion.
✔✔A client is admitted with a 6.5-cm thoracic aneurysm. The nurse records findings
from the initial assessment in the client's chart, as shown below.
At 10:30 AM, the client has sharp mid-chest pain after having a bowel movement. What
should the nurse do first?
1. Assess the client's vital signs.
2. Administer a bolus of lactated Ringer's solution.
