Evolve Elsevier HESI Med Surg
Exam Questions and Answers
Verified Solutions Latest Update
Question:
D) apical pulse is 68/min.
Answer:
C) serum potassium level is 3. Hypokalemia (C) can precipitate digitalis toxicity in
persons receiving digoxin which will increase the chance of dangerous dysrhythmias
(normal potassium level is 3.5 to 5.5 mEq/L). The therapeutic range for digoxin is 0.8 to
2 ng/ml (toxic levels= >2 ng/ml); (A) is within this range. (B) would not warrant the
nurse withholding the digoxin. The nurse should withhold the digoxin if the apical pulse
is less than 60/min (D). In assessing a client diagnosed with primary
hyperaldosteronism, the nurse expects the laboratory test results to indicate a
decreased serum level of which substance? A) Sodium. B) Antidiuretic hormone. C)
Potassium. D) Glucose. -✓✓C) Potassium. Clients with primary aldosteronism exhibit a
profound decline in the serum levels of potassium (C) (hypokalemia)--hypertension is
the most prominent and universal sign. (A) is normal or elevated, depending on the
amount of water reabsorbed with the sodium. (B) is decreased with diabetes insipidus.
(D) is not affected by primary aldosteronism. Based on the analysis of the client's atrial
fibrillation, the nurse should prepare the client for which treatment protocol? A)
Diuretic therapy. B) Pacemaker implantation. C) Anticoagulation therapy. D) Cardiac
catheterization. -✓✓C) Anticoagulation therapy. The client is experiencing atrial
fibrillation, and the nurse should prepare the client for anticoagulation therapy (C)
which should be prescribed before rhythm control therapies to prevent cardioembolic
events which result from blood pooling in the fibrillating atria. (A, B, and D) are not
indicated. Which information about mammograms is most important to provide a
post-menopausal female client? A) Breast self-examinations are not needed if annual
mammograms are obtained. B) Radiation exposure is minimized by shielding the
abdomen with a lead-lined apron. C) Yearly mammograms should be done regardless
of previous normal x-rays. D) Women at high risk should have annual routine and
ultrasound mammograms. -✓✓C) Yearly mammograms should be done regardless of
previous normal x-rays. The current breast screening recommendation is a yearly
mammogram after age 40 (C). Breast self-exam (A) continues to be a priority
recommendation for all women because a small lump (or tumor) is often first felt by a
woman before a mammogram is obtained. The radiation exposure from a mammogram
is low, so (B) is not normally provided. The frequency of using routine and ultrasound
mammograms (D) in women with high-risk variables, such as a history of breast
, cancer, the presence of BRC1 and BRC2 genes, or 2 first-degree relatives with breast
cancer, should be recommended and followed closely by the healthcare provider. In
assessing cancer risk, the nurse identifies which woman as being at greatest risk of
developing breast cancer? A) A 35-year-old multipara who never breastfed. B) A
50-year-old whose mother had unilateral breast cancer. C) A 55-year-old whose
mother-in-law had bilateral breast cancer. D) A 20-year-old whose menarche occurred
at age 9. -✓✓B) A 50-year-old whose mother had unilateral breast cancer. The most
predictive risk factors for development of breast cancer are over 40 years of age and a
positive family history (occurrence in the immediate family, i.e., mother or sister).
Other risk factors include nulliparity, no history of breastfeeding, early menarche and
late menopause. Although all of the women described have one of the risk factors for
developing breast cancer, (B) has the greater risk over (A, C, and D). Which reaction
should the nurse identify in a client who is responding to stimulation of the sympathetic
nervous system? A) Pupil constriction. B) Increased heart rate. C) Bronchial
constriction. D) Decreased blood pressure. -✓✓B) Increased heart rate. Any stressor
that is perceived as threatening to homeostasis acts to stimulate the sympathetic
nervous system and manifests as a flight-or-fight response, which includes an increase
in heart rate (B). (A, C, and D) are responses of the parasympathetic nervous system. A
client receiving cholestyramine (Questran) for hyperlipidemia should be evaluated for
what vitamin deficiency? A) K. B) B12. C) B6. D) C. -✓✓A) K. Clients should be
monitored for an increased prothrombin time and prolonged bleeding times which
would alert the nurse to a vitamin K deficiency (A). These drugs reduce absorption of
the fat soluble (lipid) vitamins A, D, E, and K. (B, C, and D) are not fat soluble vitamins.
A client experiencing uncontrolled atrial fibrillation is admitted to the telemetry unit.
What initial medication should the nurse anticipate administering to the client? A)
Xylocaine (Lidocaine). B) Procainamide (Pronestyl). C) Phenytoin (Dilantin). D) Digoxin
(Lanoxin). -✓✓D) Digoxin (Lanoxin). Digoxin (Lanoxin) (D) is administered for
uncontrolled, symptomatic atrial fibrillation resulting in a decreased cardiac output.
Digoxin slows the rate of conduction by prolonging the refractory period of the AV
node, thus slowing the ventricular response, decreasing the heart rate, and effecting
cardiac output. (A, B, and C) are not indicated in the initial treatment of uncontrolled
atrial fibrillation. What instruction should the nurse give a client who is diagnosed with
fibrocystic changes of the breast? A) Observe cyst size fluctuations as a sign of
malignancy. B) Use estrogen supplements to reduce breast discomfort. C) Notify the
healthcare provider if whitish nipple discharge occurs. D) Perform a breast self-exam
(BSE) procedure monthly. -✓✓D) Perform a breast self-exam (BSE) procedure monthly.
Fibrocystic changes in the breast are related to excess fibrous tissue, proliferation of
mammary ducts and cyst formation that cause edema and nerve irritation. These
changes obscure typical diagnostic tests, such as mammography, due to an increased
breast density. Women with fibrocystic breasts should be instructed to carefully
perform monthly BSE (D) and consider changes in any previous "lumpiness."
Fibrocystic disease does not increase the risk of breast cancer (A). Cyst size fluctuates
with the menstrual cycle, and typically lessens after menopause, and responds with a
heightened sensitivity to circulating estrogen (B), which is not indicated. Nipple
Exam Questions and Answers
Verified Solutions Latest Update
Question:
D) apical pulse is 68/min.
Answer:
C) serum potassium level is 3. Hypokalemia (C) can precipitate digitalis toxicity in
persons receiving digoxin which will increase the chance of dangerous dysrhythmias
(normal potassium level is 3.5 to 5.5 mEq/L). The therapeutic range for digoxin is 0.8 to
2 ng/ml (toxic levels= >2 ng/ml); (A) is within this range. (B) would not warrant the
nurse withholding the digoxin. The nurse should withhold the digoxin if the apical pulse
is less than 60/min (D). In assessing a client diagnosed with primary
hyperaldosteronism, the nurse expects the laboratory test results to indicate a
decreased serum level of which substance? A) Sodium. B) Antidiuretic hormone. C)
Potassium. D) Glucose. -✓✓C) Potassium. Clients with primary aldosteronism exhibit a
profound decline in the serum levels of potassium (C) (hypokalemia)--hypertension is
the most prominent and universal sign. (A) is normal or elevated, depending on the
amount of water reabsorbed with the sodium. (B) is decreased with diabetes insipidus.
(D) is not affected by primary aldosteronism. Based on the analysis of the client's atrial
fibrillation, the nurse should prepare the client for which treatment protocol? A)
Diuretic therapy. B) Pacemaker implantation. C) Anticoagulation therapy. D) Cardiac
catheterization. -✓✓C) Anticoagulation therapy. The client is experiencing atrial
fibrillation, and the nurse should prepare the client for anticoagulation therapy (C)
which should be prescribed before rhythm control therapies to prevent cardioembolic
events which result from blood pooling in the fibrillating atria. (A, B, and D) are not
indicated. Which information about mammograms is most important to provide a
post-menopausal female client? A) Breast self-examinations are not needed if annual
mammograms are obtained. B) Radiation exposure is minimized by shielding the
abdomen with a lead-lined apron. C) Yearly mammograms should be done regardless
of previous normal x-rays. D) Women at high risk should have annual routine and
ultrasound mammograms. -✓✓C) Yearly mammograms should be done regardless of
previous normal x-rays. The current breast screening recommendation is a yearly
mammogram after age 40 (C). Breast self-exam (A) continues to be a priority
recommendation for all women because a small lump (or tumor) is often first felt by a
woman before a mammogram is obtained. The radiation exposure from a mammogram
is low, so (B) is not normally provided. The frequency of using routine and ultrasound
mammograms (D) in women with high-risk variables, such as a history of breast
, cancer, the presence of BRC1 and BRC2 genes, or 2 first-degree relatives with breast
cancer, should be recommended and followed closely by the healthcare provider. In
assessing cancer risk, the nurse identifies which woman as being at greatest risk of
developing breast cancer? A) A 35-year-old multipara who never breastfed. B) A
50-year-old whose mother had unilateral breast cancer. C) A 55-year-old whose
mother-in-law had bilateral breast cancer. D) A 20-year-old whose menarche occurred
at age 9. -✓✓B) A 50-year-old whose mother had unilateral breast cancer. The most
predictive risk factors for development of breast cancer are over 40 years of age and a
positive family history (occurrence in the immediate family, i.e., mother or sister).
Other risk factors include nulliparity, no history of breastfeeding, early menarche and
late menopause. Although all of the women described have one of the risk factors for
developing breast cancer, (B) has the greater risk over (A, C, and D). Which reaction
should the nurse identify in a client who is responding to stimulation of the sympathetic
nervous system? A) Pupil constriction. B) Increased heart rate. C) Bronchial
constriction. D) Decreased blood pressure. -✓✓B) Increased heart rate. Any stressor
that is perceived as threatening to homeostasis acts to stimulate the sympathetic
nervous system and manifests as a flight-or-fight response, which includes an increase
in heart rate (B). (A, C, and D) are responses of the parasympathetic nervous system. A
client receiving cholestyramine (Questran) for hyperlipidemia should be evaluated for
what vitamin deficiency? A) K. B) B12. C) B6. D) C. -✓✓A) K. Clients should be
monitored for an increased prothrombin time and prolonged bleeding times which
would alert the nurse to a vitamin K deficiency (A). These drugs reduce absorption of
the fat soluble (lipid) vitamins A, D, E, and K. (B, C, and D) are not fat soluble vitamins.
A client experiencing uncontrolled atrial fibrillation is admitted to the telemetry unit.
What initial medication should the nurse anticipate administering to the client? A)
Xylocaine (Lidocaine). B) Procainamide (Pronestyl). C) Phenytoin (Dilantin). D) Digoxin
(Lanoxin). -✓✓D) Digoxin (Lanoxin). Digoxin (Lanoxin) (D) is administered for
uncontrolled, symptomatic atrial fibrillation resulting in a decreased cardiac output.
Digoxin slows the rate of conduction by prolonging the refractory period of the AV
node, thus slowing the ventricular response, decreasing the heart rate, and effecting
cardiac output. (A, B, and C) are not indicated in the initial treatment of uncontrolled
atrial fibrillation. What instruction should the nurse give a client who is diagnosed with
fibrocystic changes of the breast? A) Observe cyst size fluctuations as a sign of
malignancy. B) Use estrogen supplements to reduce breast discomfort. C) Notify the
healthcare provider if whitish nipple discharge occurs. D) Perform a breast self-exam
(BSE) procedure monthly. -✓✓D) Perform a breast self-exam (BSE) procedure monthly.
Fibrocystic changes in the breast are related to excess fibrous tissue, proliferation of
mammary ducts and cyst formation that cause edema and nerve irritation. These
changes obscure typical diagnostic tests, such as mammography, due to an increased
breast density. Women with fibrocystic breasts should be instructed to carefully
perform monthly BSE (D) and consider changes in any previous "lumpiness."
Fibrocystic disease does not increase the risk of breast cancer (A). Cyst size fluctuates
with the menstrual cycle, and typically lessens after menopause, and responds with a
heightened sensitivity to circulating estrogen (B), which is not indicated. Nipple
