HESI MEDSURG EXAM 2022 ACTUAL EXAM

HESI MEDSURG EXAM 2022 ACTUAL EXAM HESI MEDSURG EXAM 2022 ACTUAL EXAM 1. An adult client is diagnosed with restlessleg syndrome and isreferred to the sleep clinic. The healthcare provider prescribes ferrous sulfate 325 mg pO daily. Which laboratory values should the nurse monitor? a. Serum iron and ferritin b. Platelet count and hematocrit c. Neutrophils and eosinophils d. Serum electrolytes 2. The nurse is caring for a client who is newly diagnosed with adrenocortical insufficiency. The client is experiencing chronic fatigue and weakness. Which intervention should the nurse implement? a. Begin education about fluid restriction and waysto incorporate into ongoing therapy b. Explain that the hormone therapy will be needed for a time until adrenal glands are stimulated c. Provide encouragement that symptoms will rapidly improve as hormone therapy is initiated d. Advise the client to schedule energy intensive activities for later in the day 3. the nurse is caring for an immobile client after spinal surgery. Which action is most important for the nurse to take to prevent postoperative complications? a. Maintain intervascular infusion rate b. Progress diet slowly from ice chipsto clear liquid c. Apply intermittent pneumatic compression devices d. Obtain frequent pain level assessments 4. An adult client is admitted with flank pain and is diagnosed with acute pyelonephritis. What is the priority nursing action? a. Encourage turning and deep breathing b. Auscultate for presence of bowelsounds c. Administer IV antibiotics as prescribed d. Monitor hemoglobin and hematocrit 5. The nurse is obtaining a health history from a new client who has a history of kidney stones. Which statement by the client indicates an increased risk for renal calculi? a. Eats a vegetarian diet with cheese 2 to 3 times a day b. Experiences additional stresssince adopting a child c. Jogs more frequently than usual daily routine d. Drinksseveral bottles of carbonated water daily 6. A client with orthopnea expresses concern about the ability to “get enough air” during a scheduled thoracentesis. On which information should the nurse’s response be based on? a. Extra pillows can be used if needed to elevate the client’s head b. Orthopnea is frequently caused by a clients uncontrolled anxiety c. The procedure is performed with the client in an upright position d. A thoracentesis is a brief procedure that has minimal discomfort 7. The nurse is performing the postoperative assessment of a client with an abdominal aortic aneurysm. Which finding is most important for the nurse to provide in the preoperative report? a. Respirations 20 breaths/minute b. Diminished peripheral pulses c. Hypoactive bowel sounds d. S3 hear sound on auscultation 8. The nurse is providing teaching to a client with type 2 diabetes mellitus about managing care at home. Which information stated by the client indicates understanding? a. Avoid seasoning foods with salt and salt-containing spices b. Keep any wounds covered with an antibiotic ointment c. Check blood sugar levels every four to six hours every day d. Soak feet daily in hot water no longer than 10 minutes 9. The home health nurse providesteaching about insulin self-injecting to a client who was recently diagnosed with diabetes mellitus. When the client begins to perform a return demonstration of an insulin injection into the abdomen as seen in the video, which instruction should the nurse provide? a. Lie down flat for betterskin exposure b. Select a different injection site c. Keep the skin flat rather than bunched d. Continue with the insulin injection 10. The nurse is collecting information from a client with chronic pancreatitis who reports persistent gnawing abdominal pain. To help the client manage the pain, which assessment data is most important for the nurse to obtain? a. Color and consistency of feces b. Eating patterns and dietary intake c. Level and amount of physical activity d. Presence and activity of bowel sounds 11. A client with herpeszoster (shingles) on the thorax tellsthe nurse of having difficulty sleeping. Which is the probable etiology of this problem? a. Noctuia b. Dyspnea c. Frequent cough d. Pain 12. 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 medical diagnosis? a. Marked loss of weight and appetite over the last 3 or 4 months b. Upper mid-abdominal pain described as gnawing and burning c. Frequent use of chewable and liquid antacidsfor indigestion d. Severe abdominal cramps and diarrhea after eating spicy foods 13. An obese client with emphysema who smokes at least a pack of cigarettes daily is admitted after experiencing a sudden increase in dyspnea and activity intolerance. Oxygen therapy isinitiated and is determined that the client will be discharged with oxygen. Which information is most important for the nurse to emphasize in the discharge teaching plan? a. Methodsfor weight gain b. Guidelinesfor oxygen used c. Strategiesforsmoking cessation d. Approachesto conserve energy 14. A hospitalized client with peripheral arterial disease (PAD) isinstructed regarding leg and foot care. Which statement by the client indicates to the nurse that learning has occurred? a. “whenever I am sitting in a chair I will keep my legs up to reduce swelling” b. “I can use a mirror to check the bottoms of my feet for any signs of breakdown” c. “I will try to keep moving if leg pain occursto help promote good circulation” d. “I will use my swimming pool early in the day while the water is still very cool. 15. To reduce the risk for pulmonary complication for a client with amyotrophic lateral sclerosis (ALS), which interventions should the nurse implement? SATA a. Perform chest physiotherapy b. Initiate passive range of motion exercise e. Establish a regular bladder routine 16. An adult who was recently diagnosed with glaucoma tells the nurse, “It feels like I am driving through a tunnel”. The client expresses great concern about going blind. Which nursing instruction is most important for the nurse to provide this client? a. Wear prescription glasses b. Maintain prescribed eye drop regimen c. Avoid frequent eye pressure measurements d. Eat a diet high in carotene (vit C) 17. The nurse observes an increase number of blood clots in the drainage tubing of a client with continuous bladder irrigation following a trans-urethral resection of the prostate (TURP). What is the best initial nursing action? a. Provide additional oral fluid intake b. Administer a PRN dose of an antispasmodic agent c. Measure the clientsintake and output d. Increase the flow of bladder irrigation 18. The healthcare provider prescribes diagnostic test for a client whose chest xray indicates pneumonia. Which diagnostic test should the nurse review for implementation in the most therapeutic treatment of the pneumonia? a. Arterial blood gases (ABG) b. Sputum culture and sensitivity c. Computerized tomography (CT) of the chest d. Blood cultures 19. The family suspects that acquired immune deficiency syndrome (AIDS) dementia is occurring in their son who is human immunodeficiency virus (HIV) positive. Which symptom confirms their suspicions? a. He refusesto see any of his friends or to return their phone calls b. He has begun to sleep 19 out of 24 hours c. He exhibits angry outburst when the subject of dying is approached c. Encourage use of incentive spirometer d. Teach the client breathing exercises d. A change hasrecently occurred in his handwriting 20. The nurse is providing discharge instructions to a client who is receiving prednisone 5 mg PO daily for a rash due to contact with poison ivy. Which symptom should the nurse tell the client to report to the health care provider? a. Moon facies b. Gastric irritation c. Abdominal striae d. Rapid weight gain 21. The nurse is caring for a client in the post anesthesia care unit (PACU) who underwent a thoracotomy two hours ago. The nurse observesthe following vitalsigns: heart rate 140 breaths/minute, respirations 26 breaths/minute, and blood pressure 140/90 mmHG. Which intervention is most important for the nurse to implement? a. Medicate for pain and monitor vitalsigns according to protocol b. Administer intravenousfluid bolus as prescribed by the healthcare provider c. Apply oxygen at 10 L via non-rebreather mask and monitor pulse oximeter d. Encourage the client to splint the incision with a pillow to cough and deep breathe. 22. A client with lung cancer who wears a subcutaneous morphine sulfate patch for pain is short of breath and is difficult to arouse. When performing a head to toe assessment, the nurse discovers four analgesic patches on the client’s body. Which intervention should the nurse implement first? a. Remove all of the morphine patches b. Administer a narcotic antagonist c. Measure the clients blood pressure d. Apply oxygen per face mask 23. The nurse assess a client who is newly diagnosed with hyperthyroidism and observes that the clients eyeballs are protuberant, causing a wide-eyed appearance and eye discomfort. Based on thisfinding, which action should the nurse include in the clients plan of care? a. Assessfor signs of increased ICP b. Prepared to administer intravenouslevothyroxine c. Obtain a prescription for artificial tear drops d. Review the clients serum electrolyte value 24. A client with Cushing’ssyndrome isrecovering from an elective laparoscopic procedure. Which assessment finding warrants immediate intervention by the nurse? a. Purple marks on skin of the abdomen b. Pitting ankle edema c. Quartersize blood spot on dressing d. Irregular apical pulse 25. Four daysfollowing an abdominal aortic aneurysm repair, the client is exhibiting edema of both lower extremities and pedal pulses are not palpable. Which action should the nurse implement first? a. Wrap the feet with warmed blankets b. Elevate extremities on pillows c. Assess pulses with a vascular doppler d. Evaluate edema for pitting 26. A client with a history of asthma and bronchitis arrives at the clinic with shortness of breath, productive cough with thickened, tenacious mucous, and the inability to walk up a flight ofstairs without experiencing breathlessness. Which action is most important for the nurse to instruct the client about self-care? a. Call the clinic if undesirable side effects of medication occur b. Increase the daily intake of oral fluids to liquefy secretions c. Teach anxiety reduction methodsforfeelings ofsuffocation d. Avoid crowded enclosed areasto reduce pathogen exposure 27. A client tellsthe clinic nurse about experiencing burning on urination, and assessment reveals that the client had sexual intercourse four days ago with a person who was casually met. Which action should the nurse implement? a. Observe the perineal area for chancroid like lesion b. Obtain a specimen of urethral drainage for culture c. Assessfor perineal itching, erythema, and excoriation d. Identify allsexual partners in the last 4 days 28. A client is hospitalized with heart failure (HF). Which intervention should the nurse implement to improve ventilation and reduce venous return? a. Place the client in high fowler position b. Perform passive range of motion exercises c. Increase the clients activity level d. Administer oxygen per nasal cannula 29. During spring break, a young adult presents to the urgent care clinic and reports a stiff neck, a fever for the past 6 hours and a headache. Which intervention is most important for the nurse to implement first? a. Draw blood cultures b. Administer an antipyretic c. Prepare for a lumbar puncture d. Initiate isolation precautions 30. The nurse is providing teaching to a client with type 2 diabetes mellitus and peripheral neuropathy. Which information should the nurse provide? a. Aching feet may be soaked in lukewarm water for one hour or more b. Family members can help with regular foot exams c. Heat pads are useful if on the lowestsetting d. Shoes should be worn outside the house, but it isfine to be barefoot inside 31. The nurse is planning care for an older adult client who experienced a cerebrovascular accident several weeks ago. The client has expressive aphasia and often becomes frustrated with the nursing staff. Which intervention should the nurse implement? a. Encourage clients use of picture charts b. Ask the client simple questions c. Speak slowly to the client d. Teach the client use of basic sign language 32. Which client hasthe highest risk for developing skin cancer? a. a 25 year old dark skinned client whose mother had skin cancer b. a 70 year old fair skinned client who works as a secretary c. a 65 year old fair skinned client who is a construction worker d. a 16 year old dark skinned client who tans in tanning beds once a week 33. The nurse is preparing a client for surgery who was admitted to the emergency center following a motor vehicle collision. The client has an open fracture of the femur and is bleeding moderately from the bone protrusion site. During the preoperative assessment, the nurse determines that client currently receives heparin sodium 5,000 units subcutaneously daily. What isthe priority nursing action? a. Notify the health care provider of the clients medication history b. Have the client sign the surgical and transfusion permits c. Observe the heparin injection sitesforsigns of bruising d. Ensure that the potential for bleeding is explain to the client. 34. What food is most important for the nurse to encourage a client with osteomalacia to include in a daily diet? a. Citrus fruits and juices b. Green leafy vegetables c. Fortified milk and cereals d. Red meats and eggs 35. While caring for a client with a full thickness burn covering 40% of the body, the nurse observes purulent drainage at the wound. Before reporting thisfinding to the healthcare provider, the nurse should review which of the client’s laboratory values? a. White blood cell (WBC) count b. Blood pH level c. Platelet count d. Hematocrit 36. A client with gout arthritisreports tenderness and swelling of the right ankle and great toe. The nurse observes the area of inflammation above the ankle area. The client receives prescription for colchicine and indomethacin. Which instruction should the nurse include in the discharge teaching? a. Encourage active range of motion to limitstiffness b. Drink at least 8 cups (1920 mL) of water per day c. Use electric heating pad when pain is at its worse d. Eat high protein foodsto achieve ideal body weight 37. A client with acute renal injury (AKI) weights 50 kg and has potassium level of 6.7 mEq/L is admitted to the hospital. Which prescribed medication should the nurse administer first? a. Sodium polystyrene sulfonate 15 grams by mouth b. Sevelamer one table by mouth c. Calcium acetate one tablet by mouth d. Epoetin alfa, recombinant 2,500 unit subcutaneously 38. While completing a health assessment for a client with migraine headaches, the nurse assesses bilateral weakness in the client’s hand grips. The client reports join pain and trouble twisting a doorknob due to weakness. Which action should the nurse take in response to these findings? a. Explain the relief of the migraine pain will reduce related symptoms b. Consult with the occupational therapist for a functional assessment c. Implement fall precautionsto reduce the client’srisk for injury d. Gather additional assessment data about the pain and weakness 39. The nurse assesses a client with petechiae and ecchymosisscattered across the arms and legs. Which laboratory result should the nurse review? a. Platelet count b. Red blood cell count c. White blood cell count d. Hemoglobin levels 40. An older client with long term type 2 diabetes mellitus (DM) is seen in the clinic for a routine health assessment. Which assessments would the nurse complete to determine if a patient with type 2 diabetes mellitus (DM) is experiencing long term complications? SATA a. Signs of respiratory tractinfection b. Serum creatine and blood urea nitrogen (BUN) c. Skin condition of lower extremities d. Sensation in feet and legs e. Visual acuity 41. A client in the operating room received succinylcholine. The client is experiencing muscle rigidity and has an extremely high temperature. Which action should the nurse implement? a. Call the PACU nurse to prepare for prolonged ventilatory support b. Hold a prescription for dantrolene until fever isreduced c. Prepare ice packs for placement in the client’s axillary area d. Determine if prescribed antibiotics were administered preoperatively 42. A client with chronic kidney disease is started on hemodialysis. During the first dialysis treatment, the clients blood pressure dropsfrom 150/90 mmHG to 80/30 mmHG. Which action should the nurse take first? a. Administer 5% albumin IV b. Monitor blood pressure q45 minutes c. Stop the dialysis treatment d. Lower the head of the chair and elevate feet 43. After three days of persistent epigastric pain, a female presents to the clinic, she has been taking oral antacids without relief. Her vitalsigns are heart rate 122 beats/minute, respirations 16 breaths/minute, oxygen saturation 96% and blood pressure 116/70 mmHG. The nurse obtains a 12-lead electrocardiogram (ECG). Which assessment finding is most critical? a. Complaint of radiating jaw pain b. Irregular pulse rate c. ST elevation in three leads d. Bile colored emesis 44. A nurse is caring for a client with diabetesinsipidus (DI). Which data warrants the most immediate intervention by the nurse? a. Serum sodium 185 mEq/L b. Apical rate of 110 beats per minute c. Dry skin with inelastic turgor d. Polyuria and excessive thirst 45. A client who had a C-5 spinal cord injury 2 years ago is admitted to the emergency department with the diagnosis of autonomic dysreflexia secondary to a full bladder. Which assessment finding should the nurse expect this client to exhibit? a. Profuse diaphoresis and severe, pounding headache b. Complaints of chest pain and shortness of breath c. Pain and a burning sensation upon urination and hematuria d. Hypotension and venous pooling in the extremities 46. The nurse observes pitting edema in both hands and all fingers of a client with diffuse systemic sclerosis (Scleroderma). Which action should the nurse include in the plan of care? a. Cover areasliberally with lubricant b. Examine skin for ulcerations c. Observe forscleral jaundice d. Apply cold packs as needed 47. When conducting discharge teaching for a client with diverticulosis, which diet instruction should the nurse include? a. Have small frequent meals and sit up for at least two hours after meals b. Eat a soft diet with increased intake of milk and milk products c. Eat a high-fiber diet and increase fluid intake d. Eat a bland diet and avoid spicy foods 48. An older client with a long history of chronic obstructive pulmonary disease (COPD) is admitted with progressive shortness of breath and a persistent cough. The client is anxious and is complaining of a dry mouth. Which intervention should the nurse implement? a. Administer a prescribed sedative b. Assist client to an upright position c. Apply a high-flow venturi mask d. Encourage client to drink water 49. A client with cholelithiasis is admitted with jaundice due to obstruction of the common bile duct. Which finding is most important for the nurse to report to the healthcare provider? a. Clay colored stool b. Radiating sharp pain in right shoulder c. Distended, hard and ridged abdomen d. Bile-stained emesis 50. The nurse assesses a client with cirrhosis and finds 4+ pitting edema of the feet and legs, and massive ascites. Which mechanism contributes to edema and ascites in clients with cirrhosis a. Decreased renin-angiotensin response related to an increase in renal blood flow b. Decreased portacaval pressure with greater collateral circulation c. Hyperaldosteronism causing an increased sodium reabsorption in renal tubules d. Hypoalbuminemia that results in decreased colloidal oncotic pressure 51. The nurse is caring for a client who is receiving teletherapy radiation for a malignant tumor. Which instruction regarding skin care of the portalsite should the nurse provide? a. Apply moisture lotions daily to the radiation portalsite b. Protect the skin of the radiation portalsite from sunlight exposure c. Avoid washing the skin inside the radiation portalsite d. Remove the ink marks of the portal after each radiation treatment. 52. MATH 53. MATH