HESI RN Medical-Surgical Assignment Exam with Explanations Graded A 2022

1. The nurse is assessing a middle-aged male client for risk factors related to chronic illness. Which finding should the nurse assess further? ○ Increase in abdominal fat deposits. i. An increase in the abdominal girth is a risk factor for the development of metabolic syndrome. According to the American Heart Association, men with a waist size 40 inches or larger and women 35 inches or larger double their risk factor of developing CAD and increase their chances 5Xs of developing DMII. 2. The nurse is caring for a client who is receiving chemotherapy for non-Hodgkin’s lymphoma. Laboratory results reveal a platelet count of 10,000/mL. Which action should the nurse implement? ○ Check stools for occult blood. i. Platelet counts less than 100,000/mm3 are indicative of thrombocytopenia, a common side effect of chemotherapy. A client with thrombocytopenia should be assessed frequently for occult bleeding in the emesis, sputum, feces, urine, nasogastric secretions, or wounds. 3. A 24-year-old female client diagnosed with a human papillomavirus infection (HPV) is angry at her ex-boyfriend and says she is not going to tell him that he is infected. What response is best for the nurse to provide? ○ "Even though you are angry, he should be told, so he can take precautions to prevent the spread of infection." i. Anger is a common emotional reaction when confronted with the diagnosis of a STI, and often lay blame and project this anger at the sexual partner. Although HPV is not a reportable disease in many states, all contacts should be informed of the infection, treatment, transmission, and precautions to minimize infecting others. 4. The registered nurse (RN) is caring for an older client who recently experienced a fractured pelvis from a fall. Which assessment finding is most important for the RN to report the healthcare provider? ○ Dyspnea i. A client with a large bone fracture is at risk for intramedullary fat leaking into the bloodstream and becoming embolic. Dyspnea is an indication of fat embolism to the lungs and should be reported to the healthcare provider immediately. 5. Which sexually transmitted infection (STI) should the nurse include in a client's teaching plan that increases the risk for cervical cancer? ○ Human papillomavirus. i. According to the CDC (2017), it is estimated at least 80% of all women who are sexually active will contract the Human papillomavirus (HPV) in their lifetime. Certain types of HPV have been suspected to cause cervical cancer and HPV strain 16 and 18 have been identified to cause 70% of cervical cancers. 6. A male client is admitted after falling from his bed. The healthcare provider (HCP) tells the family that he has an incomplete fracture of the humerus. The family ask the RN what this means. Which explanation by the nurse accurately describes the client's fracture? ○ A fracture that bends or splinters part of the bone i. An incomplete fracture occurs when part of the bone is splintered (broken) and it has not gone completely through the thickness of the bone. 7. The registered nurse (RN) is caring for a client who developed oliguria and was diagnosed with sepsis and dehydration 48 hours ago. Which assessment finding indicates to the RN that the client is stabilizing? ○ Urine output of 40 mL/hour. i. A decrease in urinary output is a sign of dehydration. When the urine output returns to a normal range, 40 mL/hour, the client's kidneys are perfusing adequately and indicates the client's status is stabilizing. 8. A man who smokes two packs of cigarettes a day wants to know if smoking is contributing to the difficulty that he and his wife are having getting pregnant. What information is best for the nurse to provide? (Select all that apply.) ○ Smoking can decrease the quantity and quality of sperm ○ The first semen analysis should be repeated to confirm sperm counts ○ Cessation of smoking improves general health and fertility i. The use of tobacco, alcohol, and marijuana may affect a man's sperm counts. 9. Which assessment is most important for the nurse to perform on a client who is hospitalized for Guillain-Barre syndrome that is rapidly progressing? ○ Respiratory Effect i. Guillain-Barre syndrome causes paralysis or weakness that typically starts at the feet and progresses upwards. As the condition progresses, the nurse must ensure that the client is able to breathe effectively. 10. The nurse is caring for a client after a transurethral resection of the prostate (TURP) and determines the client's urinary catheter is not draining. What should the nurse implement? ○ Irrigate the catheter. i. Obstruction urinary flow after a TURP is most often due to blood clots, and sterile irrigation should be implemented to remove the clots that are blocking the catheter.