BSN HESI 266 MED SURG EXAM
(LATEST 2023/ 2024 UPDATE)
QUESTIONS AND VERIFIED
ANSWERS
The nurse should explain to a client with lung cancer that pleurodesis is performed to
achieve which expected outcome?
A) Prevent the formation of effusion fluid.
B) Remove fluid from the intrapleural space.
C) Debulk tumor to maintain patency of air passages.
D) Relieve empyema after pneumonectomy. - correct answer✔✔Instillation of a
sclerosing agent to create pleurodesis (adherence of the parietal and visceral pleura) is
aimed at preventing the formation of pleural effusion fluid (A). (B) refers to
thoracentesis. (C) is achieved by surgical resection. (D) is treated by closed-chest
drainage.
A client with a markedly distended bladder is diagnosed with hydronephrosis and left
hydroureter after an IV pyelogram. The nurse catheterizes the client and obtains a
residual urine volume of 1650 ml. This finding supports which pathophysiological cause
of the client's urinary tract obstruction?
A) Obstruction at the urinary bladder neck.
Feedback: CORRECT
B) Ureteral calculi obstruction.
Feedback: INCORRECT
C) Ureteropelvic junction stricture.
Feedback: INCORRECT
D) Partial post-renal obstruction due to ureteral stricture. - correct
answer✔✔Hydroureter (dilation of the renal pelvis), vesicoureteral reflux (backward
movement of urine from the lower to upper urinary tracts), and hydronephrosis (dilation
or enlargement of the renal pelvis and calyces) result from post-renal obstruction which
can consequently result in chronic pyelonephritis and renal atrophy. Ascending urinary
reflux occurs when normal ureteral peristaltic pressure is met with an increase in urinary
pressure occurring during bladder filling if the urinary bladder neck is obstructed (A). A
large residual urine does not occur with (B, C, and D) because the urine can not get to
the bladder.
,A client is admitted to the hospital with a traumatic brain injury after his head violently
struck a brick wall during a gang fight. Which finding is most important for the nurse to
assess further?
A) A scalp laceration oozing blood.
B) Serosanguineous nasal drainage.
C) Headache rated 10 on a 0-10 scale.
D) Dizziness, nausea and transient confusion. - correct answer✔✔Any nasal discharge
should be evaluated (B) to determine the presence of cerebral spinal fluid which
indicates a tear in the dura making the client susceptible to meningitis. The scalp is
highly vascular and results in blood oozing from wounds (A). Pain is expected and can
be treated after further assessment of the presence of nasal discharge (C). Dizziness,
nausea, and transient confusion (D) are expected manifestations following a traumatic
brain injury and need ongoing monitoring, but (B) is most important.
A male client with sickle cell anemia, who has been hospitalized for another health
problem, tells the nurse he has had an erection for over 4 hours. What action should the
nurse implement first?
A) Notify the client's healthcare provider.
Feedback: CORRECT
B) Document the finding in the client record.
Feedback: INCORRECT
C) Prepare a warm enema solution for rectal instillation.
Feedback: INCORRECT
D) Obtain a large bore needle for aspiration of the corpora cavernosa. - correct
answer✔✔Priapism, a urologic emergency, is common during sickle cell crisis due to
sickle cells clogging the microcirculation in the penis, causing a reduction of blood flow
and oxygenation to the penis, so the healthcare provider should be notified immediately
(A). Documentation (B) is not the first action that should be taken. Treatment may
consist of noninvasive measures such as applying ice to the penis, instilling a warm
solution enema to increase outflow in the corpora cavernosa (C) and giving pain
medications, but (A) has priority. If noninvasive measures do not work, (D) is
implemented by the healthcare provider.
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.)
A) Only marijuana cigarettes affect sperm count.
Feedback: INCORRECT
B) Smoking can decrease the quantity and quality of sperm.
Feedback: CORRECT
C) The first semen analysis should be repeated to confirm sperm counts.
, Feedback: CORRECT
D) Cessation of smoking improves general health and fertility.
Feedback: CORRECT
E) Sperm specimens should be collected in 2 subsequent days. - correct
answer✔✔Correct selections are (B, C, and D). Use of tobacco, alcohol, and marijuana
may affect sperm counts (B). Sperm counts vary from day to day and are dependent on
emotional and physical status and sexual activity, so a single analysis may be
inconclusive (C). A minimum of two analyses should be performed several weeks apart
to assess male fertility, not (E). (A and D) contain inaccurate information.
When observing a client for symptoms of a large bowel obstruction, the nurse should
assess for which finding?
A) Distention of the lower abdomen.
B) Nausea with profuse vomiting.
C) Upper abdominal discomfort.
D) Fluid and electrolyte imbalances. - correct answer✔✔Among findings characteristic
of a large bowel obstruction is the distention of the lower abdomen (A). (B, C, and D)
are findings associated with small bowel obstruction.
The nurse is caring for a client with human immunodeficiency virus (HIV) infection who
develops Mycobacterium avium complex (MAC). What is the most significant desired
outcome for this client?
A) Free from injury of drug side effects.
Feedback: INCORRECT
B) Return to pre-illness weight.
Feedback: CORRECT
C) Adequate oxygenation.
Feedback: INCORRECT
D) Maintenance of intact perineal skin. - correct answer✔✔MAC is an opportunistic
infection that presents as a tuberculosis-like pulmonary process. MAC is a major
contributing factor to the development of wasting syndrome, so the most significant
desired outcome is the client's return to a pre-illness weight (B) using oral, enteral, or
parenteral supplementation as needed. Drug schedules and side effects (A) remain a
life long management problem. Client outcomes for adequate oxygenation (C) are often
dependent on management of anemia, maintenance of activities without fatigue, and
supplemental oxygen to prevent hypoxia. Skin integrity (D) is dependent upon resolution
of diarrhea, which is not as significant as optimal nutrition.
The nurse is caring for a client who is two days postoperative. - correct answer✔✔The
RRT should be called to intervene for a client with an acute life-threatening change,
such as (B). (A) indicates possible hemorrhage and needs further investigation and
(LATEST 2023/ 2024 UPDATE)
QUESTIONS AND VERIFIED
ANSWERS
The nurse should explain to a client with lung cancer that pleurodesis is performed to
achieve which expected outcome?
A) Prevent the formation of effusion fluid.
B) Remove fluid from the intrapleural space.
C) Debulk tumor to maintain patency of air passages.
D) Relieve empyema after pneumonectomy. - correct answer✔✔Instillation of a
sclerosing agent to create pleurodesis (adherence of the parietal and visceral pleura) is
aimed at preventing the formation of pleural effusion fluid (A). (B) refers to
thoracentesis. (C) is achieved by surgical resection. (D) is treated by closed-chest
drainage.
A client with a markedly distended bladder is diagnosed with hydronephrosis and left
hydroureter after an IV pyelogram. The nurse catheterizes the client and obtains a
residual urine volume of 1650 ml. This finding supports which pathophysiological cause
of the client's urinary tract obstruction?
A) Obstruction at the urinary bladder neck.
Feedback: CORRECT
B) Ureteral calculi obstruction.
Feedback: INCORRECT
C) Ureteropelvic junction stricture.
Feedback: INCORRECT
D) Partial post-renal obstruction due to ureteral stricture. - correct
answer✔✔Hydroureter (dilation of the renal pelvis), vesicoureteral reflux (backward
movement of urine from the lower to upper urinary tracts), and hydronephrosis (dilation
or enlargement of the renal pelvis and calyces) result from post-renal obstruction which
can consequently result in chronic pyelonephritis and renal atrophy. Ascending urinary
reflux occurs when normal ureteral peristaltic pressure is met with an increase in urinary
pressure occurring during bladder filling if the urinary bladder neck is obstructed (A). A
large residual urine does not occur with (B, C, and D) because the urine can not get to
the bladder.
,A client is admitted to the hospital with a traumatic brain injury after his head violently
struck a brick wall during a gang fight. Which finding is most important for the nurse to
assess further?
A) A scalp laceration oozing blood.
B) Serosanguineous nasal drainage.
C) Headache rated 10 on a 0-10 scale.
D) Dizziness, nausea and transient confusion. - correct answer✔✔Any nasal discharge
should be evaluated (B) to determine the presence of cerebral spinal fluid which
indicates a tear in the dura making the client susceptible to meningitis. The scalp is
highly vascular and results in blood oozing from wounds (A). Pain is expected and can
be treated after further assessment of the presence of nasal discharge (C). Dizziness,
nausea, and transient confusion (D) are expected manifestations following a traumatic
brain injury and need ongoing monitoring, but (B) is most important.
A male client with sickle cell anemia, who has been hospitalized for another health
problem, tells the nurse he has had an erection for over 4 hours. What action should the
nurse implement first?
A) Notify the client's healthcare provider.
Feedback: CORRECT
B) Document the finding in the client record.
Feedback: INCORRECT
C) Prepare a warm enema solution for rectal instillation.
Feedback: INCORRECT
D) Obtain a large bore needle for aspiration of the corpora cavernosa. - correct
answer✔✔Priapism, a urologic emergency, is common during sickle cell crisis due to
sickle cells clogging the microcirculation in the penis, causing a reduction of blood flow
and oxygenation to the penis, so the healthcare provider should be notified immediately
(A). Documentation (B) is not the first action that should be taken. Treatment may
consist of noninvasive measures such as applying ice to the penis, instilling a warm
solution enema to increase outflow in the corpora cavernosa (C) and giving pain
medications, but (A) has priority. If noninvasive measures do not work, (D) is
implemented by the healthcare provider.
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.)
A) Only marijuana cigarettes affect sperm count.
Feedback: INCORRECT
B) Smoking can decrease the quantity and quality of sperm.
Feedback: CORRECT
C) The first semen analysis should be repeated to confirm sperm counts.
, Feedback: CORRECT
D) Cessation of smoking improves general health and fertility.
Feedback: CORRECT
E) Sperm specimens should be collected in 2 subsequent days. - correct
answer✔✔Correct selections are (B, C, and D). Use of tobacco, alcohol, and marijuana
may affect sperm counts (B). Sperm counts vary from day to day and are dependent on
emotional and physical status and sexual activity, so a single analysis may be
inconclusive (C). A minimum of two analyses should be performed several weeks apart
to assess male fertility, not (E). (A and D) contain inaccurate information.
When observing a client for symptoms of a large bowel obstruction, the nurse should
assess for which finding?
A) Distention of the lower abdomen.
B) Nausea with profuse vomiting.
C) Upper abdominal discomfort.
D) Fluid and electrolyte imbalances. - correct answer✔✔Among findings characteristic
of a large bowel obstruction is the distention of the lower abdomen (A). (B, C, and D)
are findings associated with small bowel obstruction.
The nurse is caring for a client with human immunodeficiency virus (HIV) infection who
develops Mycobacterium avium complex (MAC). What is the most significant desired
outcome for this client?
A) Free from injury of drug side effects.
Feedback: INCORRECT
B) Return to pre-illness weight.
Feedback: CORRECT
C) Adequate oxygenation.
Feedback: INCORRECT
D) Maintenance of intact perineal skin. - correct answer✔✔MAC is an opportunistic
infection that presents as a tuberculosis-like pulmonary process. MAC is a major
contributing factor to the development of wasting syndrome, so the most significant
desired outcome is the client's return to a pre-illness weight (B) using oral, enteral, or
parenteral supplementation as needed. Drug schedules and side effects (A) remain a
life long management problem. Client outcomes for adequate oxygenation (C) are often
dependent on management of anemia, maintenance of activities without fatigue, and
supplemental oxygen to prevent hypoxia. Skin integrity (D) is dependent upon resolution
of diarrhea, which is not as significant as optimal nutrition.
The nurse is caring for a client who is two days postoperative. - correct answer✔✔The
RRT should be called to intervene for a client with an acute life-threatening change,
such as (B). (A) indicates possible hemorrhage and needs further investigation and
