EVOLVE ELSEVIER HESI MED SURG COMPREHENSIVE EXAM SCRIPT COMPLETE
QUESTIONS VERIFIED SOLUTIONS
Question:
Which instruction should the nurse teach a female client about the prevention of toxic shock
syndrome? A. "Get immunization against HPV B. "Change your tampon frequently" C. "Empty
your bladder after intercourse" D. "Obtain a yearly flu vaccination
Answer:
"Change your tampon frequently" Rationale: Certain strains of Staphylococcus aureus produce a
toxin that can enter the bloodstream through the vaginal mucosa. Changing the tampon frequently
reduces the exposure to these toxins, which are the primary cause of toxic shock syndrome. Option
A helps prevent cervical cancer, not toxic shock syndrome. Option C can lessen the incidence of
urinary tract infection. Option D can help prevent some individuals from contracting the flu and
pneumonia, but no relationship to toxic shock syndrome has been proven.
Question:
The home health nurse is assessing a male client being treated for Parkinson disease with
carbidopa-levodopa. The nurse observes that he does not demonstrate any apparent emotion when
speaking and rarely blinks. Which intervention should the nurse implement? A. Perform a complete
cranial nerve assessment B. Instruct the client that he may be experiencing medication toxicity C.
Document the presence of these assessment findings D. Advise the client to seek immediate medical
evaluation
Answer:
Document the presence of these assessment findings. Rationale: A masklike expression and
infrequent blinking are common clinical features of parkinsonism. The nurse should document these
expected findings. Signs of toxicity of levodopa-carbidopa include: dyskinesia, hallucinations, and
psychosis
Question:
A female client with a nasogastric tube attached to low suction states that she is nauseated. The
nurse assesses that there has been no drainage through the nasogastric tube in the last 2 hours.
, Which action should the nurse take first? A. Irrigate the nasogastric tube with sterile normal saline
B. Reposition the client on her side C. Advance the nasgastric tube 5cm D. Administer an
intravenous antiemetic as prescribed
Answer:
Reposition the client on her side Rationale: The immediate priority is to determine if the tube is
functioning correctly, which would then relieve the client's nausea. The least invasive intervention,
repositioning the client, should be attempted first, followed by options A and C, unless either of
these interventions is contraindicated. If these measures are unsuccessful, the client may require
option D.
Question:
The nurse teaches a client with type 2 diabetes nutritional strategies to decrease obesity. Which food
items chosen by the client indicate understanding of the teaching? (Select all that apply.) A. White
bread B. Salmon C. Broccoli D. Whole milk E. Banana
Answer:
Salmon, Broccoli, and Banana Rationale: Provides fresh fruits, lean meats and fish, vegetables,
whole grains, and low-fat dairy products.
Question:
Which condition should the nurse anticipate as a potential problem in a female client with a
neurogenic bladder? A. Stress incontinence B. Infection C. Painless gross hematuria D. Peritonitis
Answer:
Infection B. Infection is the major complication resulting from stasis of urine and subsequent
catheterization. Option A is the involuntary loss of urine through an intact urethra as a result of a
sudden increase in intraabdominal pressure. Option C is the most common symptom of bladder
cancer. Option D is the most common and serious complication of peritoneal dialysis.
Question:
A client on telemetry has a pattern of uncontrolled atrial fibrillation with a rapid ventricular
response. Based on this finding, the nurse anticipates assisting the physician with which treatment?
A. Administer lidocaine, 75mg IV push B. Perform synchronized cardioversion C. Defibrillate the
client as soon as possible D. Administer atropine, 0.4mg IV push
QUESTIONS VERIFIED SOLUTIONS
Question:
Which instruction should the nurse teach a female client about the prevention of toxic shock
syndrome? A. "Get immunization against HPV B. "Change your tampon frequently" C. "Empty
your bladder after intercourse" D. "Obtain a yearly flu vaccination
Answer:
"Change your tampon frequently" Rationale: Certain strains of Staphylococcus aureus produce a
toxin that can enter the bloodstream through the vaginal mucosa. Changing the tampon frequently
reduces the exposure to these toxins, which are the primary cause of toxic shock syndrome. Option
A helps prevent cervical cancer, not toxic shock syndrome. Option C can lessen the incidence of
urinary tract infection. Option D can help prevent some individuals from contracting the flu and
pneumonia, but no relationship to toxic shock syndrome has been proven.
Question:
The home health nurse is assessing a male client being treated for Parkinson disease with
carbidopa-levodopa. The nurse observes that he does not demonstrate any apparent emotion when
speaking and rarely blinks. Which intervention should the nurse implement? A. Perform a complete
cranial nerve assessment B. Instruct the client that he may be experiencing medication toxicity C.
Document the presence of these assessment findings D. Advise the client to seek immediate medical
evaluation
Answer:
Document the presence of these assessment findings. Rationale: A masklike expression and
infrequent blinking are common clinical features of parkinsonism. The nurse should document these
expected findings. Signs of toxicity of levodopa-carbidopa include: dyskinesia, hallucinations, and
psychosis
Question:
A female client with a nasogastric tube attached to low suction states that she is nauseated. The
nurse assesses that there has been no drainage through the nasogastric tube in the last 2 hours.
, Which action should the nurse take first? A. Irrigate the nasogastric tube with sterile normal saline
B. Reposition the client on her side C. Advance the nasgastric tube 5cm D. Administer an
intravenous antiemetic as prescribed
Answer:
Reposition the client on her side Rationale: The immediate priority is to determine if the tube is
functioning correctly, which would then relieve the client's nausea. The least invasive intervention,
repositioning the client, should be attempted first, followed by options A and C, unless either of
these interventions is contraindicated. If these measures are unsuccessful, the client may require
option D.
Question:
The nurse teaches a client with type 2 diabetes nutritional strategies to decrease obesity. Which food
items chosen by the client indicate understanding of the teaching? (Select all that apply.) A. White
bread B. Salmon C. Broccoli D. Whole milk E. Banana
Answer:
Salmon, Broccoli, and Banana Rationale: Provides fresh fruits, lean meats and fish, vegetables,
whole grains, and low-fat dairy products.
Question:
Which condition should the nurse anticipate as a potential problem in a female client with a
neurogenic bladder? A. Stress incontinence B. Infection C. Painless gross hematuria D. Peritonitis
Answer:
Infection B. Infection is the major complication resulting from stasis of urine and subsequent
catheterization. Option A is the involuntary loss of urine through an intact urethra as a result of a
sudden increase in intraabdominal pressure. Option C is the most common symptom of bladder
cancer. Option D is the most common and serious complication of peritoneal dialysis.
Question:
A client on telemetry has a pattern of uncontrolled atrial fibrillation with a rapid ventricular
response. Based on this finding, the nurse anticipates assisting the physician with which treatment?
A. Administer lidocaine, 75mg IV push B. Perform synchronized cardioversion C. Defibrillate the
client as soon as possible D. Administer atropine, 0.4mg IV push
