HESI Med Surg Exit Exam question and answer 100% correct
1. While assessing a client with diabetes ANS: C
mellitus, the nurse observes an absence of Signs of chronic arterial insufficiency include decreased hair
hair growth growth in the legs and feet,
on the client's legs. What additional absent or decreased pedal pulses, infection in the foot, poor
assessment provides further data to support wound healing, thickened nails,
this and a shiny appearance of the skin (C). Femoral pulses (A)
finding? should still be palpable in the
a. Palpate for the presence of femoral diabetic with chronic arterial insufficiency. A positive Homan's
pulses bilaterally. sign is an indicator of deep
b. Assess for the presence of a positive vein thrombosis (B). (D) would probably not be affected
Homan's sign. significantly by chronic arterial
c. Observe the appearance of the skin on insufficiency.
the client's legs.
d. Watch the client's posture and balance
during ambulation
HESI Med Surg Exit Exam question and answer 100% correct
,HESI Med Surg Exit Exam question and answer 100% correct
2. The healthcare provider prescribes 15 ANS: C
mg/kg of Streptomycin for an infant 4 lbs / 2.2 = 1.8 kg. 1.8 x 15 = 27 mg (C).
weighing 4 pounds. NOTE, the fact that the drug is diluted in 25 ml of D5W, is not
The drug is diluted in 25 ml of D5W to run relevant to the calculation
over 8 hours. How much Streptomycin will requested
the
infant receive?
a. 9 mg.
b. 18 mg.
c. 27 mg.
d. 36 mg
In assessing a client with preeclampsia who ANS: C
is receiving magnesium sulfate, the nurse The client is exhibiting symptoms of magnesium sulfate
determines that her deep tendon reflexes toxicity--decreased reflexes (normal is
are 1+; respiratory rate is 12 breaths/minute; +2), a low normal respiratory rate (normal is 12 to 20
urinary output is 90 ml in 4 hours; breaths/min), a less than average
magnesium sulfate level is 9 mg/dl. Based urinary output (30 ml/hour is average), and a low magnesium
on these sulfate level (normal is 4 to
findings, what intervention should the nurse 8mg/dl). Based on these findings, the nurse should stop the
implement? infusion (C). (A) is
a. Continue the magnesium sulfate infusion contraindicated. (B) would not fully alleviate the magnesium
as prescribed. sulfate toxicity symptoms. (D)
b. Decrease the magnesium sulfate infusion (the antagonist for magnesium sulfate) would be indicated if
by one-half. the respiratory rate were less
c. Stop the magnesium sulfate infusion than 12 breaths/minute.
immediately.
d. Administer calcium gluconate
immediately.
A client is on a mechanical ventilator. Which ANS: A
client response indicates that the This medication causes paralysis (A) following intravenous
neuromuscular injection. Peak effects persist for
blocker tubocurarine chloride (Tubarine) is 35 to 60 minutes. (B and C) would not be possible if the
effective? medication is effective. The Glasgow
a. The client's expremities are paralyzed. coma scale is used to evaluate the neurological status of the
b. The peripheral nerve stimulator causes client and does not evaluate the
twitching. effectiveness (D) of this medication.
c. The client clinches fist upon command.
d. The client's Glagow Coma Scale score is
14
HESI Med Surg Exit Exam question and answer 100% correct
,HESI Med Surg Exit Exam question and answer 100% correct
5. An elderly female client comes to the ANS: B
clinic for a regular check-up. The client tells Frequent and/or large doses of acetaminophen can cause an
the nurse increase in liver enzymes,
that she has increased her daily doses of indicating possible liver damage (B). If the client reported
acetaminophen (Tylenol) for the past month unusual bleeding, or an increase in
to aspirin usage, it would be important for the nurse to assess for
control joint pain. Based on this client's increased bleeding and monitor
comment, what previous lab values should (A and/or C). (D) is not affected by increases in
the nurse acetaminophen doses.
compare with today's lab report?
a. Look at last quarter's hemoglobin and
hematocrit, expecting an increase today
due
to dehydration.
b. Look for an increase in today's LDH
compared to the previous one to assess
for possible liver damage. c. Expect to find
an increase in today's APTT as compared to
last quarter's due
to bleeding.
d. Determine if there is a decrease in serum
potassium due to renal compromise.
6. Aspirin is prescribed for a 9-year-old child ANS: C
with rheumatic fever to control the Ringing in the ears (tinnitus) (C) is an important sign of aspirin
inflammatory overdosage and should be
process, promote comfort, and reduce reported immediately. Though a tepid sponge bath may lower
fever. What intervention is most important the child's temperature, the
for the prescription for aspirin should not be held (A). Aspirin should
nurse to implement? be taken with at least eight
a. Instruct the parents to hold the aspirin ounces of water to completely wash the tablet into the
until the child has first had a tepid sponge stomach and to help prevent GI
bath. discomfort (B). Yellow halos are associated with Digoxin
b. Administer the aspirin with at least two toxicity, not aspirin (D)
ounces of water or juice.
c. Notify the healthcare provider if the child
complains of ringing in the ears.
d. Advise the parents to question the child
about seeing yellow halos around objects
7. Which signs or symptoms are ANS: D
characteristic of an adult client diagnosed The classic picture of Cushing's syndrome in the adult is
with Cushing's central-type obesity with thin
syndrome? extremities (D), along with a "buffalo hump" in the
a. Husky voice and complaints of supraclavicular area, heavy trunk, and
hoarseness. thin fragile skin. The symptoms described in (A) are clinical
b. Warm, soft, moist, salmon-colored skin. manifestations of
c. Visible swelling of the neck, with no pain. hypothyroidism, and in (B) of hyperthyroidism. (C) may
d. Central-type obesity, with thin extremities. indicate a goiter or a tumor of the
thyroid gland
HESI Med Surg Exit Exam question and answer 100% correct
, HESI Med Surg Exit Exam question and answer 100% correct
8. A charge nurse agrees to cover another ANS: D
nurse's assignment during a lunch break. A pulse oximeter reading of 90% indicates an arterial blood
Based on the gas of less than 80 to 100 and
status report provided by the nurse who is should be assessed immediately (D). (A) is an expected
leaving for lunch, which client should be finding. (B) is not an unusual finding.
checked (C) is an expected finding for this client.
first by the charge nurse? The client
a. admitted yesterday with diabetec
ketoacidosis whose blood glucose level
is now 195 mg/dl.
b. with an ileal conduit created two days
ago with a scant amount of blood in
the drainage pouch.
c. post-triple coronary bypass four days ago
who has serosanguinous drainage
in the chest tube.
d. with a pneumothorax secondary to a
gunshot wound with a current pulse
oximeter reading of 90%.
9. An outcome for treatment of peripheral ANS: A
vascular disease is, "The client will have Client behaviors indicating that the expected outcome of,
decreased "decreased venous congestion" has
venous congestion." What client behavior been met would include elevating the legs, increasing walking
would indicate to the nurse that this time, and an observable
outcome has decrease in edema of the lower extremities (A). (B and C)
been met? would be appropriate for outcomes
a. Avoids prolonged sitting or standing. for, "Attains or maintains tissue integrity." (D) would be an
b. Avoids trauma and irritation to skin. appropriate outcome for,
c. Wears protective shoes. "Demonstrates an increase in arterial blood supply to
d. Quits smoking extremities."
10. The healthcare provider performs a ANS: D
paracentesis on a client with ascites and 3 Life-threatening complications such as hypovolemia and
liters of fluid sepsis can occur following a
are removed. Which assessment parameter paracentesis, and measurement of vital signs (D) will provide
is most critical for the nurse to monitor assessment data that will help
following detect the occurrence of such complications. (A) might be
the procedure? assessed to check for circulation in
a. Pedal pulses. the lower extremities, but are not indicated for
b. Breath sounds. postparacentesis assessment. Reduction of (B)
c. Gag reflex. may occur as the result of decreased fluid in the peritoneal
d. Vital signs cavity, but is a desired outcome,
not a complication, of this procedure. (C) is not affected by a
paracentesis procedure
HESI Med Surg Exit Exam question and answer 100% correct
1. While assessing a client with diabetes ANS: C
mellitus, the nurse observes an absence of Signs of chronic arterial insufficiency include decreased hair
hair growth growth in the legs and feet,
on the client's legs. What additional absent or decreased pedal pulses, infection in the foot, poor
assessment provides further data to support wound healing, thickened nails,
this and a shiny appearance of the skin (C). Femoral pulses (A)
finding? should still be palpable in the
a. Palpate for the presence of femoral diabetic with chronic arterial insufficiency. A positive Homan's
pulses bilaterally. sign is an indicator of deep
b. Assess for the presence of a positive vein thrombosis (B). (D) would probably not be affected
Homan's sign. significantly by chronic arterial
c. Observe the appearance of the skin on insufficiency.
the client's legs.
d. Watch the client's posture and balance
during ambulation
HESI Med Surg Exit Exam question and answer 100% correct
,HESI Med Surg Exit Exam question and answer 100% correct
2. The healthcare provider prescribes 15 ANS: C
mg/kg of Streptomycin for an infant 4 lbs / 2.2 = 1.8 kg. 1.8 x 15 = 27 mg (C).
weighing 4 pounds. NOTE, the fact that the drug is diluted in 25 ml of D5W, is not
The drug is diluted in 25 ml of D5W to run relevant to the calculation
over 8 hours. How much Streptomycin will requested
the
infant receive?
a. 9 mg.
b. 18 mg.
c. 27 mg.
d. 36 mg
In assessing a client with preeclampsia who ANS: C
is receiving magnesium sulfate, the nurse The client is exhibiting symptoms of magnesium sulfate
determines that her deep tendon reflexes toxicity--decreased reflexes (normal is
are 1+; respiratory rate is 12 breaths/minute; +2), a low normal respiratory rate (normal is 12 to 20
urinary output is 90 ml in 4 hours; breaths/min), a less than average
magnesium sulfate level is 9 mg/dl. Based urinary output (30 ml/hour is average), and a low magnesium
on these sulfate level (normal is 4 to
findings, what intervention should the nurse 8mg/dl). Based on these findings, the nurse should stop the
implement? infusion (C). (A) is
a. Continue the magnesium sulfate infusion contraindicated. (B) would not fully alleviate the magnesium
as prescribed. sulfate toxicity symptoms. (D)
b. Decrease the magnesium sulfate infusion (the antagonist for magnesium sulfate) would be indicated if
by one-half. the respiratory rate were less
c. Stop the magnesium sulfate infusion than 12 breaths/minute.
immediately.
d. Administer calcium gluconate
immediately.
A client is on a mechanical ventilator. Which ANS: A
client response indicates that the This medication causes paralysis (A) following intravenous
neuromuscular injection. Peak effects persist for
blocker tubocurarine chloride (Tubarine) is 35 to 60 minutes. (B and C) would not be possible if the
effective? medication is effective. The Glasgow
a. The client's expremities are paralyzed. coma scale is used to evaluate the neurological status of the
b. The peripheral nerve stimulator causes client and does not evaluate the
twitching. effectiveness (D) of this medication.
c. The client clinches fist upon command.
d. The client's Glagow Coma Scale score is
14
HESI Med Surg Exit Exam question and answer 100% correct
,HESI Med Surg Exit Exam question and answer 100% correct
5. An elderly female client comes to the ANS: B
clinic for a regular check-up. The client tells Frequent and/or large doses of acetaminophen can cause an
the nurse increase in liver enzymes,
that she has increased her daily doses of indicating possible liver damage (B). If the client reported
acetaminophen (Tylenol) for the past month unusual bleeding, or an increase in
to aspirin usage, it would be important for the nurse to assess for
control joint pain. Based on this client's increased bleeding and monitor
comment, what previous lab values should (A and/or C). (D) is not affected by increases in
the nurse acetaminophen doses.
compare with today's lab report?
a. Look at last quarter's hemoglobin and
hematocrit, expecting an increase today
due
to dehydration.
b. Look for an increase in today's LDH
compared to the previous one to assess
for possible liver damage. c. Expect to find
an increase in today's APTT as compared to
last quarter's due
to bleeding.
d. Determine if there is a decrease in serum
potassium due to renal compromise.
6. Aspirin is prescribed for a 9-year-old child ANS: C
with rheumatic fever to control the Ringing in the ears (tinnitus) (C) is an important sign of aspirin
inflammatory overdosage and should be
process, promote comfort, and reduce reported immediately. Though a tepid sponge bath may lower
fever. What intervention is most important the child's temperature, the
for the prescription for aspirin should not be held (A). Aspirin should
nurse to implement? be taken with at least eight
a. Instruct the parents to hold the aspirin ounces of water to completely wash the tablet into the
until the child has first had a tepid sponge stomach and to help prevent GI
bath. discomfort (B). Yellow halos are associated with Digoxin
b. Administer the aspirin with at least two toxicity, not aspirin (D)
ounces of water or juice.
c. Notify the healthcare provider if the child
complains of ringing in the ears.
d. Advise the parents to question the child
about seeing yellow halos around objects
7. Which signs or symptoms are ANS: D
characteristic of an adult client diagnosed The classic picture of Cushing's syndrome in the adult is
with Cushing's central-type obesity with thin
syndrome? extremities (D), along with a "buffalo hump" in the
a. Husky voice and complaints of supraclavicular area, heavy trunk, and
hoarseness. thin fragile skin. The symptoms described in (A) are clinical
b. Warm, soft, moist, salmon-colored skin. manifestations of
c. Visible swelling of the neck, with no pain. hypothyroidism, and in (B) of hyperthyroidism. (C) may
d. Central-type obesity, with thin extremities. indicate a goiter or a tumor of the
thyroid gland
HESI Med Surg Exit Exam question and answer 100% correct
, HESI Med Surg Exit Exam question and answer 100% correct
8. A charge nurse agrees to cover another ANS: D
nurse's assignment during a lunch break. A pulse oximeter reading of 90% indicates an arterial blood
Based on the gas of less than 80 to 100 and
status report provided by the nurse who is should be assessed immediately (D). (A) is an expected
leaving for lunch, which client should be finding. (B) is not an unusual finding.
checked (C) is an expected finding for this client.
first by the charge nurse? The client
a. admitted yesterday with diabetec
ketoacidosis whose blood glucose level
is now 195 mg/dl.
b. with an ileal conduit created two days
ago with a scant amount of blood in
the drainage pouch.
c. post-triple coronary bypass four days ago
who has serosanguinous drainage
in the chest tube.
d. with a pneumothorax secondary to a
gunshot wound with a current pulse
oximeter reading of 90%.
9. An outcome for treatment of peripheral ANS: A
vascular disease is, "The client will have Client behaviors indicating that the expected outcome of,
decreased "decreased venous congestion" has
venous congestion." What client behavior been met would include elevating the legs, increasing walking
would indicate to the nurse that this time, and an observable
outcome has decrease in edema of the lower extremities (A). (B and C)
been met? would be appropriate for outcomes
a. Avoids prolonged sitting or standing. for, "Attains or maintains tissue integrity." (D) would be an
b. Avoids trauma and irritation to skin. appropriate outcome for,
c. Wears protective shoes. "Demonstrates an increase in arterial blood supply to
d. Quits smoking extremities."
10. The healthcare provider performs a ANS: D
paracentesis on a client with ascites and 3 Life-threatening complications such as hypovolemia and
liters of fluid sepsis can occur following a
are removed. Which assessment parameter paracentesis, and measurement of vital signs (D) will provide
is most critical for the nurse to monitor assessment data that will help
following detect the occurrence of such complications. (A) might be
the procedure? assessed to check for circulation in
a. Pedal pulses. the lower extremities, but are not indicated for
b. Breath sounds. postparacentesis assessment. Reduction of (B)
c. Gag reflex. may occur as the result of decreased fluid in the peritoneal
d. Vital signs cavity, but is a desired outcome,
not a complication, of this procedure. (C) is not affected by a
paracentesis procedure
HESI Med Surg Exit Exam question and answer 100% correct
