MED SURG II HESI UPDATED COMPREHENSIVE
QUESTIONS AND ANSWERS SURE A+
✔✔A client is scheduled for an elective splenectomy. Immediately before the client goes
to surgery, the nurse should determine that the client has:
1. Voided completely.
2. Signed the consent.
3. Vital signs recorded.
4. Name band on wrist - ✔✔3. Vital signs recorded.
✔✔When receiving a client from the post anesthesia care unit after a splenectomy,
which should the nurse assess next after obtaining vital signs?
1. Nasogastric drainage.
2. Urinary catheter.
3. Dressing.
4. Need for pain medication. - ✔✔3. Dressing.
✔✔The client's family asks why the client who had a splenectomy has a nasogastric
(NG) tube. An NG tube is used to:
1. Move the stomach away from where the spleen was removed.
2. Irrigate the operative site.
3. Decrease abdominal distention.
4. Assess for the gastric pH as peristalsis returns. - ✔✔3. Decrease abdominal
distention.
✔✔A client is admitted with an acute onset of shortness of breath. A diagnosis of
pulmonary embolism is made. One common cause of pulmonary embolism is:
1. Arteriosclerosis.
2. Aneurysm formation.
, 3. Deep vein thrombosis (DVT).
4. Varicose veins. - ✔✔3. Deep vein thrombosis (DVT).
✔✔A client with a cerebral embolus is receiving streptokinase. The nurse should
evaluate the client for which of the following expected outcomes of this drug therapy?
1. Improved cerebral perfusion.
2. Decreased vascular permeability.
3. Dissolved emboli.
4. Prevention of cerebral hemorrhage. - ✔✔3. Dissolved emboli.
✔✔A client who weighs 187 lb (85 kg) has a prescription to receive enoxaparin
(Lovenox) 1 mg/kg. This drug is available in a concentration of 30 mg/0.3 mL. What
dose would the nurse administer in milliliters?
_________________ mL. - ✔✔0.85 mL
The physician's prescription is for the client to receive enoxaparin (Lovenox) 1 mg/kg.
Therefore, the client is to receive 85 mg. The desired dose in milliliters then can
be calculated by using the formula of desired dose (D) divided by dose or strength of
dose on hand (H) times volume (V).
✔✔A client is on complete bed rest. The nurse should assess the client for risk for
developing which of the following complications?
1. Air embolus.
2. Fat embolus.
3. Stress fractures.
4. Thrombophlebitis. - ✔✔4. Thrombophlebitis.
✔✔Knee-high sequential compression devices have been prescribed for a newly
admitted client. The client reports new pain localized in the right calf area that is noted
to be slightly reddened and warm to touch upon initial assessment. The nurse should
first:
1. Offer analgesics as prescribed and apply the compression devices.
2. Leave the compression devices off and contact the physician to report the
assessment findings.
3. Massage the area of discomfort before applying the compression devices.
4. Leave the compression devices off and report assessment findings to the oncoming
shift. - ✔✔2. Leave the compression devices off and contact the physician to report the
assessment findings.
✔✔A client is receiving an IV infusion of 5% dextrose in water (D5W). The skin
around the IV insertion site is red, warm to touch, and painful. The nurse should first:
QUESTIONS AND ANSWERS SURE A+
✔✔A client is scheduled for an elective splenectomy. Immediately before the client goes
to surgery, the nurse should determine that the client has:
1. Voided completely.
2. Signed the consent.
3. Vital signs recorded.
4. Name band on wrist - ✔✔3. Vital signs recorded.
✔✔When receiving a client from the post anesthesia care unit after a splenectomy,
which should the nurse assess next after obtaining vital signs?
1. Nasogastric drainage.
2. Urinary catheter.
3. Dressing.
4. Need for pain medication. - ✔✔3. Dressing.
✔✔The client's family asks why the client who had a splenectomy has a nasogastric
(NG) tube. An NG tube is used to:
1. Move the stomach away from where the spleen was removed.
2. Irrigate the operative site.
3. Decrease abdominal distention.
4. Assess for the gastric pH as peristalsis returns. - ✔✔3. Decrease abdominal
distention.
✔✔A client is admitted with an acute onset of shortness of breath. A diagnosis of
pulmonary embolism is made. One common cause of pulmonary embolism is:
1. Arteriosclerosis.
2. Aneurysm formation.
, 3. Deep vein thrombosis (DVT).
4. Varicose veins. - ✔✔3. Deep vein thrombosis (DVT).
✔✔A client with a cerebral embolus is receiving streptokinase. The nurse should
evaluate the client for which of the following expected outcomes of this drug therapy?
1. Improved cerebral perfusion.
2. Decreased vascular permeability.
3. Dissolved emboli.
4. Prevention of cerebral hemorrhage. - ✔✔3. Dissolved emboli.
✔✔A client who weighs 187 lb (85 kg) has a prescription to receive enoxaparin
(Lovenox) 1 mg/kg. This drug is available in a concentration of 30 mg/0.3 mL. What
dose would the nurse administer in milliliters?
_________________ mL. - ✔✔0.85 mL
The physician's prescription is for the client to receive enoxaparin (Lovenox) 1 mg/kg.
Therefore, the client is to receive 85 mg. The desired dose in milliliters then can
be calculated by using the formula of desired dose (D) divided by dose or strength of
dose on hand (H) times volume (V).
✔✔A client is on complete bed rest. The nurse should assess the client for risk for
developing which of the following complications?
1. Air embolus.
2. Fat embolus.
3. Stress fractures.
4. Thrombophlebitis. - ✔✔4. Thrombophlebitis.
✔✔Knee-high sequential compression devices have been prescribed for a newly
admitted client. The client reports new pain localized in the right calf area that is noted
to be slightly reddened and warm to touch upon initial assessment. The nurse should
first:
1. Offer analgesics as prescribed and apply the compression devices.
2. Leave the compression devices off and contact the physician to report the
assessment findings.
3. Massage the area of discomfort before applying the compression devices.
4. Leave the compression devices off and report assessment findings to the oncoming
shift. - ✔✔2. Leave the compression devices off and contact the physician to report the
assessment findings.
✔✔A client is receiving an IV infusion of 5% dextrose in water (D5W). The skin
around the IV insertion site is red, warm to touch, and painful. The nurse should first:
