MED SURG HESI EXAM QUESTIONS WITH All Answers Correct

MED SURG HESI EXAM QUESTIONS WITH All Answers Correct What instruction should the nurse include in the discharge teaching plan of a client who had a cataract extraction today? Light housekeeping is permitted but avoid heavy lifting A male adult comes to the urgent care clinic 5 days after being diagnose with influenza. He is short of breath, febrile, and coughing green colored sputum. Which intervention should the nurse implement first? Obtain a sputum sample for culture An elder male client tells the nurse that he is loosing sleep because he has to get up several times at night to go to the bathroom that he has trouble starting his urinary stream and that he does not feel like his bladder is ever completely empty. Which intervention should the nurse implement? palpate the bladder above the symphysis pubis An adult client is admitted with diabetic ketoacidosis (DKA) and a urinary tract infection (UTI) Prescriptions for intravenous antibiotics and insulin infusion are initiated. Which serum laboratory value warrants the most immediate intervention by the nurse? potassium of 2.5 meq/l A client with sickle cell anemia develops a fever during the last hour of administration of a unit of packed red blood cell. When notifying the healthcare provider what information should the nurse provide first using the SBAR communication process? explain specific reason for urgent notification An adult male client is admitted for pneumocystis carinil pneumonia (PCP) secondary to aids. While hospitalize he receives IV pentamidine isethionate therapy. In preparing this client for discharge what important aspect regarding his medication therapy should the nurse explain? It will be necessary to continue prophylactic doses of IV or aerosol pentamine every month A client subjective data includes dysuria, urgency, and urinary frequency. What action should the nurse implement next? collect a clean catch specimen A client tells the nurse that her biopsy results indicate that the cancer cells are well differentiated How should the nurse respond? ask the client in the healthcare provider has giving her any information about the classification of her cancer A client with a chronic kidney disease is treated on hemodialysis. During the 1 treatment clients blood pressure drops from 150/90 to 80/30 Which action should the nurse take first? stop dialysis treatment A client with deep vain thrombosis (DVT) is receiving a continues infusion of heparin sodium 25,000 unit in 5% dextrose injection 250ml. The prescription indicates the dosage should be increase 900 units/hr. The nurse should program the infusion pump to deliver how many ml/hr? 9 The nurse is obtaining the admission history for a client with suspected peptic ulcer disease (PUD). Which subjective data reported by the client supports this diagnosis? upper mid abdominal gnawing and burning pain The nurse is providing preoperative education for a jewish client schedule to receive a xenograft graft to promote burn healing. Which information should the nurse provide this client? the xenograft is taken from nonhuman sources A client who took a camping vacation two weeks ago in a country with a tropical climate comes to the clinic describing vague symptoms and diarrhea for the past week. Which finding is most important for the nurse to report? jaundice sclera During a home visit the nurse assesses the skin of a client with eczema who reports than an exacerbation of symptoms has occurred during the last week. Which information is most useful in determining the possible cause of the symptoms? a grandson and his new dog recently visited When explaining dietary guidelines to a client with acute glomerulonephritis (AGN) which instruction should the nurse include in the dietary teaching restrict sodium intake A male client who is 24hr post operative for an exploratory laparoctomy complains that he is starving because he has had no real food since before surgery. Prior to advancing his diet which intervention should the nurse implememt? Auscultate bowel sound in all four quadrants A client diagnose with stable angina secondary to ischemic heart disease has a prescription for sublingual (SL) nitroglycerin (NTG). The nurse should tell the client to follow which instructions if chest pain is not relieved after taking 3 NTG tables 5 min apart call 911 pain is unrelieved and chew a tablet of aspirin 325mg After taking orlistat (Xenical) for one week a femela client tells the home health nurse that she is experiencing increasingly frequent oily stools and flatus. What action should the nurse take? ask the client to describe her dietary intake history for the last several days Two days after an abscess of the chin was drained the client returns to the clinic with fever chills and a maculopapular rash with pruritis. The client has taken an oral antibiotic and cleansed the wound today with provide iodine (Betadine) solution. Which intervention should the nurse implement first? assess airway patency and oxygen saturation A client experiences an ABO incompatibility reaction after multiple blood transfusions. Which finding should the nurse report immediately to the health care provider? low back pain and hypotension 1.A young adult male who has had type 2 diabetes mellitus (DM) is admitted to the intensive care unit with hyperglycemic nonketotic syndrome (HHNS). A sliding scale protocol for an isotonic IV solution with regular insulin is prescribed based on the results of a continuous blood glucose monitoring device that is attached to the client's central venous catheter. When the client's respirations become labored and his lungs sound indicate crackles what action should the nurse take? decrease infusion rate to address fluid overload When preparing to apply a fentanyl (Duragesic) transdermal patch the nurse notes that the previously applied patch is intact on the client's upper back and the client denies pain. What action should the nurse take? Apply a new patch in a different location after removing the original patch A client who had a myocardial infarction is admitted to the coronary critical care unit (CCU) with a nitroglycerin drip infusing. The clients last blood pressure measurements was 78/36.What action should the nurse implement? reduce the rate of the nitroglycerin infusion An adolescent is admitted to the hospital because of a suicide attempt with an overdose of acetaminophen (Tylenol). Which blood values are most important for the nurse to monitor during the first 72 hours following ingestion of this overdose? LDH OR LD, SGOT OR ALT, SGPT OR AST An elderly post-operative female client is receiving morphine sulfate via a PCA pump. Which assessment finding should prompt a nurse to administer the prescribed PRN medication naloxone? her respiratory rate is 7 breath/minute Which assessment finding indicates to the nurse that the muscarinic agent bethanechol (Urecholine) is effective for a client diagnose with urinary retention? urinary output equal to intake Following involvement in a motor vehicle collision, a middle aged adult client is admitted to the hospital with multiple facial fractures. The client's blood alcohol level is high on admission. Which PRN prescription should be administer if the clients begins to exhibit signs and symptoms of delirium tremens (DT s)? Lorazepam (Ativan) 2mg IM Which instructions should the nurse include in the teaching plan of a client who is taking the diuretic spironolactone (Aldactone)? Take the medication in the morning A glucagon emergency kit is prescribed for a client with type 1 diabetes mellitus. When should the nurse instruct the client to take the glucagon? when recognized signs of severe hypoglycemia occur A client with hyperthyroidism is being treated with radioactive iodine (I-131). Which explanation should be included in preparing this client for this treatment? describe radioactive iodine as a tasteless, colorless medication administered by the healthcare provide A client is discharged with a prescription for warfarin (Coumadin). What discharge instructions should the nurse emphasize to the client? avoid going barefoot especially outside In caring for a client with diabetes insipidus who is receiving an antidiuretic hormone intranasal which serum lab test is most important for the nurse to monitor? osmolality After administering dihydroergotamine (Migranal) 1 mg subcutaneously to a client with a severe migraine headache the nurse should explain that relief can be expected within what time frame? 15 minutes A client with hypertension who has been taking labetalol for two weeks, reports a five pound (2.2 kg) weight gain. Which follow up assessment is most important for the nurse to obtain? breath sounds A male client is receiving pilocarpine hydrochloride (Isopto Carpine) ophthalmic drops for glaucoma. He calls the clinic and ask the nurse why he has difficulty seeing at night. What explanation should the nurse provide? The eye drops slow pupil response to accommodate for darkness A client who is taking and oral dose of tetracycline complains of gastrointestinal upset. What snack should the nurse instruct the client to take with the tetracycline? toasted wheat bread and jelly The therapeutic effect of insulin in treating type 1 diabetes mellitus is based on which physiologic action? Facilitates transport of glucose into the cell A female client is being treated for tuberculosis with rifampin (rifadin) which statement indicates that further teaching is needed? I will take my usual contraceptive for birth control The health care provider prescribe a medication for an older adult client who is complaining of insomnia. And instructs the client to return in 2 weeks. The nurse should question which prescription? Eszoplicone (Lunesta)10 mg orally at bed time A male client reports to the nurse that he is experiencing GI distress from high dose of a corticosteroid and is planning to stop taking the medication. In response to the client's statement what nursing action is most important for the nurse to take? Advice the client that the medication should be stopped gradually rather than abruptly Fifteen minutes after receiving sulfa athenozole. A male client report a burning sensation over his abdomen chest and groin. Which intervention is most important for the nurse to implement? a. Auscultate lung sounds for wheezing Review the clients list if drugs allergies Antibiotic resistant organism are a major infection control problems. To help minimize the emergence of resistant bacteria what instruction should the nurse provide to the clients? avoid using antibiotics when suffering from colds or the flu A client with symptoms of influenza that started the previous day ask the clinic nurse about taking oseltamivir (Tamiflu) to treat the infection. Which response should the nurse provide? Refer the client to the healthcare provider at the clinic to obtain a medication prescription Twenty minutes after the nurse starts a secondary IV infusion of cafepime (maxipime) 2 grams using an infusion pump to deliver the dose in one hour, the client reports feeling nauseated. What action should the nurse implement? Continue the infusion and administer a prn antiemetic prescription The nurse administer donepezil hydrochloride (Aricept) to a client with Alzheimer's disease as an intervention for which client problem? disturbed thought processes To prevent deep vein thrombosis following knee replacement surgery, an adult male client is receiving enoxaparin (Lovenox) subcutaneously daily. Which laboratory finding requires immediate action by the nurse? Platelet count of 100,000/mm3 or 100x10??/ L (SI) A client with type 2 diabetes mellitus is managed with metformin (Glucophage), an oral hypoglycemic agent. The primary health care provider prescribes ad additional medication injected exenatide (byetta). Which information is most important for the nurse to teach this client? Administer subcutaneously after meals A client is who is diagnose with schizophrenia receives a prescription for an atypical antipsychotic drug aripipazole (Abilify). Which assessment should the nurse perform to monitor for an adrenergic receptor antagonist side effect that commonly occurs atypical antipsychotic agents obtain the client finger stick glucose levels Pte takes allopurinol for what? Couple avoiding referrals Pte with trsnfusion sagre that reaction symptoms; Fever and Hypotension Pte with thoracosynthesis; sit aligned, erectile position good right Pte diabetic with an infested toe on one foot; see inside Shoes Pte in acidosis symptoms; Tachycardia Pte with urinary symptoms; collect sample Pte miastemia that begins with walking deficiency. cold unchained it Selective aply venous insufficiency; review color changes in the ankle, - the foot when sitting, or lying down, - Diet with protein and vitamin A and C PTE WITH traction of a limb after a fracture operation; AND vascular COMMITMENT with severe pain; NOTIFY the doctor Pte peritoneal dialysis; risk peritonitis Pte 500 neutrophils; INSOLATION CAUTION Pte fever 6h and some neck insolation precaution Pte with ulcer symptoms; exam ; pain in upper mild abdomen and burning. Pte operated cataract give; Laxative Pte with convulsions; ADDISON DISEASE TAKE CORTICOSTEROID MEDS-Prednisone Suprapubic prostatectomy concern? Urine leakage During a paracentesis, two liters of fluid are removed from the abdomen of a client with ascites. A drainage bag is placed, and 50 ml of clear, straw-colored fluid drains within the first hour. What action should the nurse implement? Continue to monitor the fluid output A male adult comes to the urgent care clinic 5 days after being diagnosed with influenza. He is short of breath, febrile, and coughing green colored sputum. Which intervention should the nurse implement first? Obtain a sputum sample for culture pt with urolithiasis in the right flank and hyperparathyroid urine test* pt with chemotherapy had pain in the mouth apply analgesic topical* Pt with nephrectomy and flank pain and abdominal distention auscultate bowel sounds Pt that inject insulin at 1630 what advise the nurse snack at bedtime* Pt with tracheostomy after noticing respiration outcome Absence of coarse crackles* Pt with metabolic syndrome-TCH triglyceride, cholesterol (high-density lipoprotein), hyperglycemia* pte with abdominal pain, projectile vomiting reports severe headache and photophobia and photosensitivity* osteoporosis restrict daytime exercise Patient with heart failure reduced work commode next to bed* dehydration blood occult in emesis CKD lab to report? K 6.5/9* regular insulin-humulin Eat before bedtime New diabetic with outcome A1C a los 3 months* risk of stroke carotid bruit Patient with TB results 5mml Document as normal Pt with hypothyroidism normal 135-145 sodium low 122* patient with ostomy Dark Whats priority for a patient who is allergic to bananas? Replace latex-no gloves After 3 days of persistent epigastric pain, a female client presents to the clinic she has been taking oral antacids without relief. Her vital signs are HR 122 beats/minute, respirations 16 breaths/minute, oxygen saturation 96% and blood pressure 116/70. The nurse obtains a 12-lead ECG. Which assessment finding is most critical ST elevation in three leads Patient with hypothyroidism flank pain urine culture NA 185 Patient with 3 surgery avoid coughing