Med Surge HESI Real Exam 200 Questions Test
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The health care provider has prescribed a client sodium warfarin (Coumadin) while he is still
receiving intravenous heparin. Which is the nurse's best action?
A) Turn off the heparin before administering the warfarin.
B) Clarify the warfarin order with the nursing supervisor.
C) Administer both heparin and warfarin as prescribed.
D) Hold the warfarin dose until the heparin is discontinued. –
Correct Answer :C
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Although both heparin and warfarin are anticoagulants, they have different mechanisms of
action and onsets of action. Because warfarin has such a slow onset, it must be started while
the client is still receiving heparin. Once the warfarin is therapeutic, as evidenced by the
international normalized ratio (INR), the client's heparin can be safely discontinued. Effects of
heparin will be cleared from the client's bloodstream within a few hours.
Individuals of low socioeconomic status are at an increased risk for infection because of which
of the following? (Select all that apply.)
A) High cost of medications
B) Inadequate nutrition
C) Easy access to health screenings
D) Uninsured or underinsured status –
Correct Answer :A, B, D
Individuals of low socioeconomic status tend to be part of the underinsured or uninsured
population. Lack of insurance decreases accessibility to health care in general and health
screening services specifically. High costs of medication and nutritious food also make this
population at higher risk for infection.
The nurse is working on a plan of care with her patient which includes turning and positioning
and adequate nutrition to help the patient maintain intact skin integrity. The nurse helps the
patient to realize that this breaks the chain of infection by eliminating a:
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A) portal of entry.
B) host.
C) mode of transmission.
D) reservoir. –
Correct Answer :A
Broken or impaired skin creates a portal of entry for pathogens. By maintaining intact tissue,
the patient and the nurse have broken the chain of infection by eliminating a portal of entry.
Host is incorrect because you are not eliminating the person or organism. Intact tissue does
not eliminate the mode of transmission. Skin can still be used to transfer pathogens
regardless of it being intact or broken. Intact skin does not eliminate the location for
pathogens to live and grow.
The nurse is preparing to administer a prescribed IV antibiotic to a client admitted with a
serious infection. Which action by the nurse is most important?
A) Double check the "five rights."
B) Assess the client for allergies.
C) Teach the client about the drug.
D) Check the IV for patency. –
Correct Answer :B
All actions are appropriate and important before administering any medications. However,
client safety is the priority. The nurse should first assess the client for medication allergies by
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asking the client or checking the chart (or both). Ensuring a patent IV and checking the five
rights will not protect the client from an allergic reaction.
The nurse assesses a cut that is 24 hours old and finds that the site is swollen, red, and tender
to the touch. Which cell types are responsible for these assessment findings?
A) Natural killer cells
B) Basophils and eosinophils
C) Erythrocytes and platelets
D) Plasma cells and B-lymphocytes –
Correct Answer :B
Basophils and eosinophils release histamine, kinins, and other substances that cause the
manifestations of inflammation. Erythrocytes carry oxygen, and platelets help stop bleeding.
Plasma cells and B-lymphocytes produce antibodies to help fight infection, and natural killer
cells destroy invading bacteria.
A female client is admitted with an exacerbation of ulcerative colitis. Which laboratory value
does the nurse correlate with this condition?
A) Erythrocyte sedimentation rate (ESR), 55 mm/hr
B) Potassium, 5.5 mEq/L
C) Sodium, 144 mEq/L
D) Hemoglobin, 14.2 g/dL –
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