EVOLVE ELSEVIER HESI MED SURG - EXAMINATION
COMPLETE QUESTIONS AND DETAILED SOLUTIONS
LATEST UPDATE THIS YEAR JUST RELEASED
Question 1: A middle-aged male client asks the nurse what findings
from his digital rectal examination (DRE) prompted the healthcare
provider to prescribe a repeat serum prostatic surface antigen
(PSA) level. What information should the nurse provide?
A. A uniformly enlarged prostate is benign prostatic hypertrophy that
occurs with aging.
B. The spongy or elastic texture of the prostate is normal and requires
no further testing.
C. An infection is usually present when the prostate indents when a
finger is pressed on it.
D. Stony, irregular nodules palpated on the prostate should be further
evaluated.
Answer:
Correct Answer(s): D
Question 2: * PSA levels are prescribed to screen for prostatic
cancer which is often detected by DRE and manifested as small,
hard, or stony, irregularly-shaped nodules on the surface of the
prostate (D). Although PSA levels are prescribed for routine
screening, the findings suggestive of BPH (A), normal texture (B) or
infection (C) do not suggest cancer of the prostate, which requires
further evaluation. What is the primary nursing diagnosis for a
client with asymptomatic primary syphilis?
A. Acute pain.
B. Risk for injury.
C. Sexual dysfunction.
, D. Deficient knowledge.
Answer:
Correct Answer(s): D
Question 3: An asymptomatic client with primary syphilis is most
likely unaware of this disease, so to prevent transmission to others
and recurrence in the client, the priority nursing diagnosis is
deficient knowledge (D). Asymptomatic primary syphilis is not
painful, so (A) is not applicable at this time. Although the client is at
risk for injury (B) and sexual dysfunction (C) related to
complications, teaching the client about transmission and
treatment is instrumental in preventing the progression to systemic
secondary or tertiary syphilis. The nurse is caring for a client with
human immunodeficiency virus (HIV) infection who develops
Mycobacterium avium complex (MAC). What is the most significant
desired outcome for this client?
A. Free from injury of drug side effects.
B. Return to pre-illness weight.
C. Adequate oxygenation.
D. Maintenance of intact perineal skin.
Answer:
Correct Answer(s): B
Question 4: * MAC is an opportunistic infection that presents as a
tuberculosis-like pulmonary process. MAC is a major contributing
factor to the development of wasting syndrome, so the most
significant desired outcome is the client's return to a pre-illness
weight (B) using oral, enteral, or parenteral supplementation as
needed. Drug schedules and side effects (A) remain a life long
management problem. Client outcomes for adequate oxygenation
(C) are often dependent on management of anemia, maintenance of
,activities without fatigue, and supplemental oxygen to prevent
hypoxia. Skin integrity (D) is dependent upon resolution of
diarrhea, which is not as significant as optimal nutrition. The nurse
is caring for a client receiving tamoxifen (Nolvadex) for the
treatment of breast cancer. Which action should the nurse include
in the client's plan of care?
A. Increase fluid intake.
B. Monitor sodium chloride intake.
C. Assist the client in coping with hot flashes.
D. Encourage milk products to increase calcium intake.
Answer:
Correct Answer(s): C
Question 5: * Tamoxifen, an estrogen receptor blocking agent, can
cause hot flashes, so (C) should be included in the plan of care.
Increasing fluid intake (A), monitoring sodium intake (B), and
encouraging milk products to increase calcium intake (D) are not
related to the care of a client receiving tamoxifen. A client in the
preoperative holding area receives a prescription for midazolam
(Versed) IV. The nurse determines that the surgical consent form
needs to be signed by the client. Which action should the nurse
implement?
A. Give the drug and allow the client to read and sign the consent
form.
B. Counter-sign the client's initials on the consent form after giving the
drug.
C. Withhold the drug until the client validates understanding of the
surgical procedure and signs the consent form.
D. Call the healthcare provider to explain the surgical procedure
before the client signs the consent.
Answer:
, Correct Answer(s): C
Question 6: * Midazolam, a benzodiazepine sedative, is commonly
used for conscious-sedation intraoperatively and interferes with
the client's cognition and level of consciousness, so the consent
form should be signed before the drug is administered (C). The
validity of legal documents will be in question if a client signs them
while under the influence of any central nervous
system-depressant drug (A and B). If indicated, (D) may need to be
implemented but should be determined before the client arrives to
the preoperative area. A client who is receiving the sixth unit of
packed red blood cell transfusion is demonstrating signs and
symptoms of a febrile, nonhemolytic reaction. What assessment
finding is most important for the nurse to identify?
A. Increased anxiety since the transfusion began.
B. Drowsiness after receiving diphenhydramine (Benadryl).
C. Complaints of feeling cold.
D. Flushed skin and headache.
Answer:
Correct Answer(s): D
Question 7: * The most common type of reaction is a febrile,
nonhemolytic blood transfusion reaction related to leukocyte
incompatibility, which causes chills, fever, headache, and flushing
(D). Some clients are anxious (A) about the risk of blood-borne
infections, but the client's response to the release of inflammatory
and immunologic mediators can potentially lead to bronchospasm
and circulatory collapse. Drowsiness (B) is an expected symptom
after diphenhydramine administration. (C) is often a sensory
response to environmental temperatures or the administration of
cold blood. A 48-year-old client with endometrial cancer is being
COMPLETE QUESTIONS AND DETAILED SOLUTIONS
LATEST UPDATE THIS YEAR JUST RELEASED
Question 1: A middle-aged male client asks the nurse what findings
from his digital rectal examination (DRE) prompted the healthcare
provider to prescribe a repeat serum prostatic surface antigen
(PSA) level. What information should the nurse provide?
A. A uniformly enlarged prostate is benign prostatic hypertrophy that
occurs with aging.
B. The spongy or elastic texture of the prostate is normal and requires
no further testing.
C. An infection is usually present when the prostate indents when a
finger is pressed on it.
D. Stony, irregular nodules palpated on the prostate should be further
evaluated.
Answer:
Correct Answer(s): D
Question 2: * PSA levels are prescribed to screen for prostatic
cancer which is often detected by DRE and manifested as small,
hard, or stony, irregularly-shaped nodules on the surface of the
prostate (D). Although PSA levels are prescribed for routine
screening, the findings suggestive of BPH (A), normal texture (B) or
infection (C) do not suggest cancer of the prostate, which requires
further evaluation. What is the primary nursing diagnosis for a
client with asymptomatic primary syphilis?
A. Acute pain.
B. Risk for injury.
C. Sexual dysfunction.
, D. Deficient knowledge.
Answer:
Correct Answer(s): D
Question 3: An asymptomatic client with primary syphilis is most
likely unaware of this disease, so to prevent transmission to others
and recurrence in the client, the priority nursing diagnosis is
deficient knowledge (D). Asymptomatic primary syphilis is not
painful, so (A) is not applicable at this time. Although the client is at
risk for injury (B) and sexual dysfunction (C) related to
complications, teaching the client about transmission and
treatment is instrumental in preventing the progression to systemic
secondary or tertiary syphilis. The nurse is caring for a client with
human immunodeficiency virus (HIV) infection who develops
Mycobacterium avium complex (MAC). What is the most significant
desired outcome for this client?
A. Free from injury of drug side effects.
B. Return to pre-illness weight.
C. Adequate oxygenation.
D. Maintenance of intact perineal skin.
Answer:
Correct Answer(s): B
Question 4: * MAC is an opportunistic infection that presents as a
tuberculosis-like pulmonary process. MAC is a major contributing
factor to the development of wasting syndrome, so the most
significant desired outcome is the client's return to a pre-illness
weight (B) using oral, enteral, or parenteral supplementation as
needed. Drug schedules and side effects (A) remain a life long
management problem. Client outcomes for adequate oxygenation
(C) are often dependent on management of anemia, maintenance of
,activities without fatigue, and supplemental oxygen to prevent
hypoxia. Skin integrity (D) is dependent upon resolution of
diarrhea, which is not as significant as optimal nutrition. The nurse
is caring for a client receiving tamoxifen (Nolvadex) for the
treatment of breast cancer. Which action should the nurse include
in the client's plan of care?
A. Increase fluid intake.
B. Monitor sodium chloride intake.
C. Assist the client in coping with hot flashes.
D. Encourage milk products to increase calcium intake.
Answer:
Correct Answer(s): C
Question 5: * Tamoxifen, an estrogen receptor blocking agent, can
cause hot flashes, so (C) should be included in the plan of care.
Increasing fluid intake (A), monitoring sodium intake (B), and
encouraging milk products to increase calcium intake (D) are not
related to the care of a client receiving tamoxifen. A client in the
preoperative holding area receives a prescription for midazolam
(Versed) IV. The nurse determines that the surgical consent form
needs to be signed by the client. Which action should the nurse
implement?
A. Give the drug and allow the client to read and sign the consent
form.
B. Counter-sign the client's initials on the consent form after giving the
drug.
C. Withhold the drug until the client validates understanding of the
surgical procedure and signs the consent form.
D. Call the healthcare provider to explain the surgical procedure
before the client signs the consent.
Answer:
, Correct Answer(s): C
Question 6: * Midazolam, a benzodiazepine sedative, is commonly
used for conscious-sedation intraoperatively and interferes with
the client's cognition and level of consciousness, so the consent
form should be signed before the drug is administered (C). The
validity of legal documents will be in question if a client signs them
while under the influence of any central nervous
system-depressant drug (A and B). If indicated, (D) may need to be
implemented but should be determined before the client arrives to
the preoperative area. A client who is receiving the sixth unit of
packed red blood cell transfusion is demonstrating signs and
symptoms of a febrile, nonhemolytic reaction. What assessment
finding is most important for the nurse to identify?
A. Increased anxiety since the transfusion began.
B. Drowsiness after receiving diphenhydramine (Benadryl).
C. Complaints of feeling cold.
D. Flushed skin and headache.
Answer:
Correct Answer(s): D
Question 7: * The most common type of reaction is a febrile,
nonhemolytic blood transfusion reaction related to leukocyte
incompatibility, which causes chills, fever, headache, and flushing
(D). Some clients are anxious (A) about the risk of blood-borne
infections, but the client's response to the release of inflammatory
and immunologic mediators can potentially lead to bronchospasm
and circulatory collapse. Drowsiness (B) is an expected symptom
after diphenhydramine administration. (C) is often a sensory
response to environmental temperatures or the administration of
cold blood. A 48-year-old client with endometrial cancer is being
