MEDSURG-HESI CERTIFICATION EXAM QUESTIONS AND ANSWERS

MEDSURG-HESI CERTIFICATION EXAM QUESTIONS AND ANSWERS 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? A) You do not have to tell him because this is not a reportable disease. B) Because there is no cure for this disease, telling him is of no benefit to him or to you. C) Even though you are angry, he should be told, so he can take precautions to prevent the spread of infection. D) You should tell him, so he can feel as guilty and miserable as you do now, knowing that you have this disease. -Answer-Correct Answer(s): C * 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 (C). (A and B) provide false information and increase the risk of complications and transmission. (D) is not therapeutic. The nurse is caring for a client who is two days postoperative. Which observation should alert the nurse to call the Rapid Response Team (RRT)? A) Fresh bleeding noted on abdominal surgical wound dressing. B) Pulse change from 85 to160 beats/minute lasting more than 10 minutes. C) Temperature of 103.1° F and white blood cell (WBC) count of 16,000 mm3. D) Weakness, diaphoresis, complaints of feeling faint. BP 100/56 mm Hg. -Answer-Correct Answer(s): B * 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 monitoring. (B) indicates an infection and (D) may indicate post operative diuresis with corresponding hypotension. Although these symptoms needs prompt collaborative attention, they can be dealt with through normal channels such providing supportive care and calling the healthcare provider. A client with Ménière's disease is incapacitated by vertigo and is lying in bed grasping the side rails and staring at the television. Which nursing intervention should the nurse implement? A) Encourage fluids to 3000 ml per day. B) Change the client's position every two hours. C) Keep the head of the bed elevated 30 degrees. D) Turn off the television and darken the room. -Answer-Correct Answer(s): D * To decrease the client's vertigo during an acute attack of Ménière's disease, any visual stimuli or rotational movement, such as sudden head movements or position changes, should be minimized. Turning off the television and darkening the room (D) minimize fluorescent lights, flickering television lights, and distracting sound. (A, B, and C) are Which preexisting diagnosis places a client at greatest risk of developing superior vena cava syndrome? A) Carotid stenosis. B) Steatosis hepatitis. C) Metastatic cancer. D) Clavicular fracture. -Answer-Correct Answer(s): C * Superior vena cava syndrome occurs when the superior vena cava (SVC) is compressed by outside structures, such as a growing tumor that impedes the return blood flow to the heart. Superior vena cava syndrome is likely to occur with metastatic cancer (C) from a primary tumor in the upper lobe of the right lung that compresses the superior vena cava. (A, B, and D) do not result in SVC syndrome. A client with osteoarthritis receives a prescription for Naproxen (Naprosyn). Which potential side effect should the nurse provide to the client about this medication? A) Sensitivity to sunlight. B) Muscle fasciculations. C) Increased urinary frequency. D) Gastrointestinal disturbance. -Answer-Correct Answer(s): D * Prostaglandin synthesis inhibitors such as naproxen can have gastrointestinal side effects such as nausea and gastric burning (D). It is recommended that this drug be taken with food to avoid gastrointestinal upset. Naproxen (Naprosyn) does not cause sensitivity to sunlight (A), muscle fasciculations (B), or urinary frequency (C). What information should the nurse include in a teaching plan about the onset of menopause? (Select all that apply). A) Smoking. B) Oophorectomy with hysterectomy. C) Early menarche. D) Cardiac disease. E) Genetic influence. F) Chemotherapy exposure. -Answer-Correct Answer(s): A, B, C, E, F * Menopausal symptoms are related to the cessation of ovarian function. Factors influencing the onset of menopause include smoking (A), genetic influences (E), early menarche (C), surgical removal (B), and exposure to chemotherapy agents and radiation (F). Cardiovascular disease (D) is unrelated. The nurse is caring for a client with a small bowel obstruction. The client is vomiting foul smelling fecal-like material. What action should the nurse implement? A) Administer antiemetics every 2 to 3 hours. B) Position on the left side with knees drawn up. C) Encourage ice chips sparingly. D) Give IV fluids with electrolytes. -Answer-Correct Answer(s): D * When the bowel is obstructed, electrolytes and fluids are not absorbed, so parenteral fluids with sodium chloride, bicarbonate, and potassium should be administered (D). (A and C) are contraindicated. (B) may or may not be a position of comfort for the client. The nurse should implement (D). Shingles select all that apply questions is -Answer-pain, skin, functional mobility The nurse is providing pre-operative education for a Jewish client scheduled to receive a xenograft graft to promote burn healing. Which information should the nurse provide this client? a. the xenograft is taken from nonhuman sources. b. grafting increases the risk for bacterial infection c. grafts are later removed by a debriding procedure d. as the burn heals, the graft permantly attaches -Answer-a. the xenograft is taken from nonhuman sources. A client brought to the ER who had a heart attack and received CPR. He is getting oxygen via the ambu bag. The nurse notes that he is cold, diaphoretic and cyanotic. What should the nurse do? -Answer-Access breath sounds A patient with ALS -Answer-decreased cough GERD patient: _________________, elevate the head of the bed and try to lose weight -Answer-wear loose clothing (avoid wearing tight/constrictive clothing) A client who went camping in a tropical island came back to the US with diarrhea. What is the infection? -Answer-Gastrocenteritis both viral and bacterial. A client that went camping in a tropical island came back to the US with diarrhea, What other symptoms are associated with Traveler's diarrhea? -Answer-Nausea, vomiting, anorexia, fever, tenesmus (straining defecation) due to abdominal distension by increased fluid content and undigested food. Abdominal pain, cramping and borboygmi (hyperactive bowel sounds) may occur from gas released from undigested food, irritation of the bowel mucosa, and distention of the intestines. People at highest risk for cancer. -Answer-fair skin construction worker Dosage question for heparin, a patient weighs 175lbs, order reads 80 units/kg. The heparin comes in 2mL vial at the pharmacy. There is 10000 units/mL. How much mL should the nurse administer? -Answer-0.6 mL Dosage questions: the order reads 135mg. The medication comes in 150,g/mL. How many mL should the nurse administer? -Answer-0.9mL Herberden's nodes that are painful. What should a nurse do? -Answer- Discharge teaching for patients with a foley bag. -Answer-Hang bag below bladder level at home a patient with HTN was given IV anti-hypertensive medication. What should the nurse do? -Answer-Automatic BP to monitor hypotension A client experiences an ABO incompatibility reaction after multiple blood transfusions. Which finding should the nurse report immediately to the healthcare provider? a. low back pain and hypotension b. rhinitis and nasal stiffness c. delayed painful rash with urticaria d. arthritic joint changes and chronic pain. -Answer-a. low back pain and hypotension Cushing syndrome -Answer-Irregular apical pulse due to hypokalemia addison's disease -Answer-Monitor glucose levels (hypoglycemia) Congestive heart failure -Answer-daily weights sputum culture -Answer-observe for color, quantity and consistency SIADH -Answer-difficulty swallowing Nephrotic syndrome -Answer-monitor for weight A patient with diabetes complains that he is unable to sleep at night because of cold feet. What should the nurse advise? -Answer-Apply warm blankets to the feet. Carpal tunnel syndrom -Answer-Compression of median nerve LAD, CAD, another artery that supply the heart have blockage of 95%, 99% and 99%, How should the nurse explain this to the client: -Answer-Use layman/simple terms and state only 1-5% of the blood is getting to your heart Emphysema client teaching -Answer-Deep breathing and pursed lips NG tube -Answer-Fowler's position, 30-90 degress sitting position paracentesis procedure -Answer-sitting upright during procedure finger stick glucose check with milking -Answer-check radial pulse During a home visit the nurse assesses the skin of a client with eczema who reports than an exacerbation of symptoms has occurred during the last week. Which information is most useful in determining the possible cause of the symptoms? a. an old friend with eczema came for visit b. recently received an influenza immunization c. corticosteroid cream was applied to eczema d. a grandson and his new dog recently visited -Answer-d. a grandson and his new dog recently visited