Med Surg HESI Practice Questions And
Answers
Ao20-year-
oldofemaleoclientocallsotheonurseotooreportoaolumposheofoundoinoherobreast.oWhichorespons
eoisotheobestoforotheonurseotooprovide?
A)oCheckoitoagainoinooneomonth,oandoifoitoisostillothereoscheduleoanoappointment.o
B)oMostolumpsoareobenign,obutoitoisoalwaysobestotoocomeoinoforoanoexamination.o
C)oTryonototooworryotooomuchoaboutoit,obecauseousually,omostolumpsoareobenign.o
D)oIfoyouoareoinoyouromenstrualoperiodoitoisonotoaogoodotimeotoocheckoforolumps.o-
oCORRECTooANSWER-
B)oMostolumpsoareobenign,obutoitoisoalwaysobestotoocomeoinoforoanoexamination.o
(B)oprovidesotheobestoresponseobecauseoitoaddressesotheoclient'soanxietyomostoeffectively
oandoencouragesopromptoandoimmediateoactionoforoaopotentialoproblem.o(A)opostponesotr
eatmentoifotheolumpoisomalignant,oandodoesonotorelieveotheoclient'soanxiety.o(CoandoD)opro
videofalseoreassuranceoandodoonotohelporelieveoanxiety.
Ao32-year-
oldofemaleoclientocomplainsoofosevereoabdominalopainoeachomonthobeforeoheromenstrualo
period,opainfulointercourse,oandopainfulodefecation.oWhichoadditionalohistoryoshouldotheon
urseoobtainothatoisoconsistentowithotheoclient'socomplaints?
A)oFrequentourinaryotractoinfections.o
B)oInabilityotoogetopregnant.o
C)oPremenstrualosyndrome.o
D)oChronicouseoofolaxatives.o-oCORRECTooANSWER-B)oInabilityotoogetopregnant.o
Dysmenorrhea,odyspareunia,oandodifficultyooropainfulodefecationoareocommonosymptomso
ofoendometriosis,owhichoisotheoabnormalodisplacementoofoendometrialotissueoinotheodepe
ndentoareasoofotheopelvicoperitoneum.oAohistoryoofoinfertilityo(B)oisoanotherocommonofindin
goassociatedowithoendometriosis.oAlthougho(A,oC,oandoD)oareocommon,ononspecificogyne
cologicalocomplaints,otheomostocommonocomplaintsoofotheoclientowithoendometriosisoareo
painoandoinfertility.
Ao46-year-
oldofemaleoclientoisoadmittedoforoacuteorenalofailureosecondaryotoodiabetesoandohypertensi
on.oWhichotestoisotheobestoindicatoroofoadequateoglomerularofiltration?
A)oSerumocreatinine.o
B)oBloodoUreaoNitrogeno(BUN).o
C)oSedimentationorate.o
D)oUrineospecificogravity.o-oCORRECTooANSWER-A)oSerumocreatinine.o
,Creatinineo(A)oisoaoproductoofomuscleometabolismothatoisofilteredobyotheoglomerulus,oando
bloodolevelsoofothisosubstanceoareonotoaffectedobyodietaryoorofluidointake.oAnoelevatedocre
atinineostronglyoindicatesonephronoloss,oreducingofiltration.o(B)oisoalsooanoindicatorooforena
loactivity,obutoitocanobeoaffectedobyonon-
renalofactorsosuchoasohypovolemiaoandoincreasedoproteinointake.o(C)oisoaononspecificotest
oforoacuteoorochronicoinflammatoryoprocesses.o(D)oisousefuloinoassessingohydrationostatus,
obutonotoasousefuloinoassessingoglomerularofunction.
Ao49-year-
oldofemaleoclientoarrivesoatotheoclinicoforoanoannualoexamoandoasksotheonurseowhyosheobe
comesoexcessivelyodiaphoreticoandofeelsowarmoduringonighttime.oWhatoisotheonurse'sobes
toresponse?
A)oExplainotheoeffectoofotheofollicle-stimulatingoandoluteinizingohormones.o
B)oDiscussoperimenopauseoandorelatedocomfortomeasures.o
C)oAssessolungofieldsoandoforoaocoughoproductiveoofoblood-tingedomucous.o
D)oAskoifoaofeveroaboveo101ºoFohasooccurredoinotheolasto24ohours.o-
oCORRECTooANSWER-B)oDiscussoperimenopauseoandorelatedocomfortomeasures.o
Theoperimenopausaloperiodobeginsoabouto10oyearsobeforeomenopauseowithotheocessatio
noofomenstruationoatotheoaverageoagesoofo52otoo54.oLoweroestrogenolevelsocausesoFSHoa
ndoLHosecretionoinoburstso(surges),owhichotriggersovasomotoroinstability,onightosweats,oan
dohotoflashes,osoodiscussionsoaboutotheoperimenopausalobody'sochanges,ocomfortomeasu
reso(B),oandotreatmentooptionsoshouldobeoprovided.oIn-
depthopathophysiologyoofotheosymptomso(A)omayoonlyoconfuseotheoclient.oThereoisonooindi
cationothatotheoclientohasotuberculosisoandoanoinfection,osoo(CoandoD)oareonotoindicated.
Ao51-year-
oldotruckodriverowhoosmokesotwoopacksoofocigarettesoaodayoandoiso30opoundsooverweighto
isodiagnosedowithohavingoaogastricoulcer.oWhatocontentoisomostoimportantoforotheonurseoto
oincludeoinotheodischargeoteachingoforothisoclient?
A)oInformationoaboutosmokingocessation.o
B)oDietoinstructionsoforoaolow-residueodiet.o
C)oInstructionsoonoaoweight-lossoprogram.o
D)oTheoimportanceoofoincreasingomilkoinotheodiet.o-oCORRECTooANSWER-
A)oInformationoaboutosmokingocessation.o
Smokingohasobeenoassociatedowithoulceroformation,oandostoppingoorodecreasingotheonum
beroofocigarettesosmokedoperodayoisoanoimportantoaspectoofoulceromanagemento(A).oDieto
managementoincludesoaoreductionoinohigh-fiber/high-
roughageofoodsoasowelloasospicyofoods.o(B)owouldobeoindicatedoforoinflammatoryobowelodi
sease.oSodiumoandocaloricointakeoareonototheokeyoelementsoinoanoulcerodiet.oAlthoughothi
soclientodoesoneedo(C),otheomanagementoofohisoulceroisotheokeyofactoroatothisopoint.o(D)ow
ouldoactuallyoincreaseogastricoacidoproduction.
Ao57-year-oldomaleoclientoisoscheduledotoohaveoaostress-
thalliumotestotheofollowingomorningoandoisoNPOoafteromidnight.oAto0130,oheoisoagitatedobe
,causeoheocannotoeatoandoisodemandingofood.oWhichoresponseoisobestoforotheonurseotoopr
ovideotoothisoclient?
A)oI'mosorryosir,oyouohaveoaoprescriptionoforonothingobyomouthofromomidnightotonight.o
B)oIowilloletoyouohaveooneocracker,obutothatoisoalloyouocanohaveoforotheorestoofotonight.o
C)oWhatodidotheohealthcareoproviderotelloyouoaboutotheotestoyouoareohavingotomorrow?o
D)oTheotestoyouoareohavingotomorroworequiresothatoyouohaveonothingobyomouthotonight.o-
oCORRECTooANSWER-
D)oTheotestoyouoareohavingotomorroworequiresothatoyouohaveonothingobyomouthotonight.o
(D)oisotheomostotherapeuticostatementobecauseotheonurseoisorespondingotootheoclient'soqu
estion.o(A)oisonotoanoexplanationoandotheonurseoshouldoteachotheoclientowhyoeatingoisoproh
ibitedoafteromidnight,oratherothanoenforcingothisorequirementowithoutoanoexplanationoforoit.o
(B)omayoresultoinoanoinaccurateotestoresult,ooromayocauseotheotestotoobeocancelled,owhicho
couldoalsoodelayodiagnosisoandotreatment.o(C)odefersotheoresponsibilityoforoansweringothe
oclient'soquestionotootheohealthcareoprovider,owhenotheonurseocouldoaddressotheosituationo
throughoclientoteaching.
Ao58-year-oldoclientowhoohasobeenopost-
menopausaloforofiveoyearsoisoconcernedoaboutotheoriskoforoosteoporosisobecauseoheromot
herohasotheocondition.oWhichoinformationoshouldotheonurseooffer?
A)oOsteoporosisoisoaoprogressiveogeneticodiseaseowithonooeffectiveotreatment.o
B)oCalciumolossofromobonesocanobeoslowedobyoincreasingocalciumointakeoandoexercise.o
C)oEstrogenoreplacementotherapyoshouldobeostartedotoopreventotheoprogressionoosteopor
osis.o
D)oLow-doseocorticosteroidotreatmentoeffectivelyohaltsotheocourseoofoosteoporosis.o-
oCORRECTooANSWER-
B)oCalciumolossofromobonesocanobeoslowedobyoincreasingocalciumointakeoandoexercise.o
Post-
menopausalofemalesoareoatoriskoforoosteoporosisodueotootheocessationoofoestrogenosecret
ion,obutoaoregimenoincludingocalcium,ovitaminoD,oandoweight-
bearingoexerciseocanopreventofurtheroboneolosso(B).oOsteoporosisocanobeomanagedowitho
conservativeotherapy,osuchoasoboneometabolismoregulatorsoandoestrogenoreplacementoth
erapyo(ERT)otooimproveoboneodensity,obutoitoisonotoaogeneticodiseaseo(A).oAlthoughoERToi
soeffectiveoinomanagingoosteoporosis,oanoincreasedoriskoforocanceroandoheartodiseaseosh
ouldobeoconsideredoforoindividualoclients.oCorticosteroidotherapyopromotesoboneoresorptio
noandoisocounterproductiveoinomaintainingooroincreasingoboneodensityo(D).
Ao58-year-
oldoclient,owhoohasonoohealthoproblems,oasksotheonurseoaboutotheoPneumovaxovaccine.oT
heonurse'soresponseotootheoclientoshouldobeobasedoonowhichoinformation?
A)oTheovaccineoisogivenoannuallyobeforeotheofluoseasonotoothoseoovero50oyearsoofoage.o
B)oTheoimmunizationoisoadministeredoonceotooolderoadultsooropersonsowithoaohistoryoofoch
ronicoillness.o
C)oTheovaccineoisoforoalloagesoandoisogivenoprimarilyotoothoseopersonsotravelingooverseaso
tooareasoofoinfection.o
, D)oTheovaccineowillopreventotheooccurrenceoofopneumococcalopneumoniaoforoupotoofiveoy
ears.o-oCORRECTooANSWER-
B)oTheoimmunizationoisoadministeredoonceotooolderoadultsooropersonsowithoaohistoryoofoch
ronicoillness.o
Itoisousuallyorecommendedothatopersonsoovero65oyearsoofoageoandothoseowithoaohistoryoofo
chronicoillnessoreceiveotheovaccineoonceoinoaolifetimeo(B).o(Someoresourcesorecommendo
obtainingotheovaccineoato50oyearsoofoage.)oTheoinfluenzaovaccineoisogivenoonceoaoyear,on
ototheoPneumovaxo(A).oAlthoughotheovaccineomightobeogivenotooaopersonotravelingooverse
as,othatoisonototheomainorationaleoforoadministeringotheovaccineo(C).oItoisousuallyogivenoonc
eoinoaolifetimeo(D),obutowithoimmunosuppressedoclientsooroclientsowithoaohistoryoofopneum
oniaore-vaccinationoisosometimesorequired.
Ao67-year-
oldowomanowhoolivesoaloneoisoadmittedoafterotrippingoonoaorugoinoherohomeoandofractureso
herohip.oWhichopredisposingofactoroprobablyoledotootheofractureoinotheoproximaloendoofoher
ofemur?
A)oFailingoeyesightoresultingoinoanounsafeoenvironment.o
B)oRenaloosteodystrophyoresultingofromochronicorenalofailure.o
C)oOsteoporosisoresultingofromohormonalochanges.o
D)oCardiovascularochangesoresultingoinosmallostrokesowhichoimpairomentaloacuity.o-
oCORRECTooANSWER-C)oOsteoporosisoresultingofromohormonalochanges.o
Theomostocommonocauseoofoaofracturedohipoinoelderlyowomenoisoosteoporosis,oresultingofr
omoreducedocalciumoinotheobonesoasoaoresultoofohormonalochangesoinolaterolifeo(C).o(A)om
ayooromayonotohaveocontributedotootheoaccident,obutoitohadonothingotoodoowithotheohipobein
goinvolved.o(B)oisonotoaocommonoconditionoofotheoelderly;oitoisocommonoinochronicorenalofai
lure.o(D)omayooccuroinosomeopeople,obutodoesonotoaffectotheofragilityoofotheobonesoasooste
oporosisodoes.
Ao77-year-
oldofemaleoclientoisoadmittedotootheohospital.oSheoisoconfused,ohasonooappetite,oisonausea
tedoandovomiting,oandoisocomplainingoofoaoheadache.oHeropulseorateoiso43obeatsoperominu
te.oWhichoquestionoisoaopriorityoforotheonurseotooaskothisoclientooroherofamilyoonoadmission
?o"Doesotheoclient
A)ohaveoheroownoteethoorodentures?"o
B)otakeoaspirinoandoifoso,ohowomuch?"o
C)otakeonitroglycerin?"o
D)otakeodigitalis?"o-oCORRECTooANSWER-D)otakeodigitalis?"o
Elderlyopersonsoareoparticularlyosusceptibleotoodigitalisointoxicationo(D)owhichomanifestsoit
selfoinosuchosymptomsoasoanorexia,onausea,ovomiting,odiarrhea,oheadache,oandofatigue.o
Althoughoitoisoimportantotooobtainoaocompleteomedicationohistoryo(BoandoC),otheosymptom
sodescribedoareoclassicoforodigitalisotoxicity,oandoassessmentoofothisoproblemoshouldobeom
adeopromptly.o(A)oisoirrelevant.
Answers
Ao20-year-
oldofemaleoclientocallsotheonurseotooreportoaolumposheofoundoinoherobreast.oWhichorespons
eoisotheobestoforotheonurseotooprovide?
A)oCheckoitoagainoinooneomonth,oandoifoitoisostillothereoscheduleoanoappointment.o
B)oMostolumpsoareobenign,obutoitoisoalwaysobestotoocomeoinoforoanoexamination.o
C)oTryonototooworryotooomuchoaboutoit,obecauseousually,omostolumpsoareobenign.o
D)oIfoyouoareoinoyouromenstrualoperiodoitoisonotoaogoodotimeotoocheckoforolumps.o-
oCORRECTooANSWER-
B)oMostolumpsoareobenign,obutoitoisoalwaysobestotoocomeoinoforoanoexamination.o
(B)oprovidesotheobestoresponseobecauseoitoaddressesotheoclient'soanxietyomostoeffectively
oandoencouragesopromptoandoimmediateoactionoforoaopotentialoproblem.o(A)opostponesotr
eatmentoifotheolumpoisomalignant,oandodoesonotorelieveotheoclient'soanxiety.o(CoandoD)opro
videofalseoreassuranceoandodoonotohelporelieveoanxiety.
Ao32-year-
oldofemaleoclientocomplainsoofosevereoabdominalopainoeachomonthobeforeoheromenstrualo
period,opainfulointercourse,oandopainfulodefecation.oWhichoadditionalohistoryoshouldotheon
urseoobtainothatoisoconsistentowithotheoclient'socomplaints?
A)oFrequentourinaryotractoinfections.o
B)oInabilityotoogetopregnant.o
C)oPremenstrualosyndrome.o
D)oChronicouseoofolaxatives.o-oCORRECTooANSWER-B)oInabilityotoogetopregnant.o
Dysmenorrhea,odyspareunia,oandodifficultyooropainfulodefecationoareocommonosymptomso
ofoendometriosis,owhichoisotheoabnormalodisplacementoofoendometrialotissueoinotheodepe
ndentoareasoofotheopelvicoperitoneum.oAohistoryoofoinfertilityo(B)oisoanotherocommonofindin
goassociatedowithoendometriosis.oAlthougho(A,oC,oandoD)oareocommon,ononspecificogyne
cologicalocomplaints,otheomostocommonocomplaintsoofotheoclientowithoendometriosisoareo
painoandoinfertility.
Ao46-year-
oldofemaleoclientoisoadmittedoforoacuteorenalofailureosecondaryotoodiabetesoandohypertensi
on.oWhichotestoisotheobestoindicatoroofoadequateoglomerularofiltration?
A)oSerumocreatinine.o
B)oBloodoUreaoNitrogeno(BUN).o
C)oSedimentationorate.o
D)oUrineospecificogravity.o-oCORRECTooANSWER-A)oSerumocreatinine.o
,Creatinineo(A)oisoaoproductoofomuscleometabolismothatoisofilteredobyotheoglomerulus,oando
bloodolevelsoofothisosubstanceoareonotoaffectedobyodietaryoorofluidointake.oAnoelevatedocre
atinineostronglyoindicatesonephronoloss,oreducingofiltration.o(B)oisoalsooanoindicatorooforena
loactivity,obutoitocanobeoaffectedobyonon-
renalofactorsosuchoasohypovolemiaoandoincreasedoproteinointake.o(C)oisoaononspecificotest
oforoacuteoorochronicoinflammatoryoprocesses.o(D)oisousefuloinoassessingohydrationostatus,
obutonotoasousefuloinoassessingoglomerularofunction.
Ao49-year-
oldofemaleoclientoarrivesoatotheoclinicoforoanoannualoexamoandoasksotheonurseowhyosheobe
comesoexcessivelyodiaphoreticoandofeelsowarmoduringonighttime.oWhatoisotheonurse'sobes
toresponse?
A)oExplainotheoeffectoofotheofollicle-stimulatingoandoluteinizingohormones.o
B)oDiscussoperimenopauseoandorelatedocomfortomeasures.o
C)oAssessolungofieldsoandoforoaocoughoproductiveoofoblood-tingedomucous.o
D)oAskoifoaofeveroaboveo101ºoFohasooccurredoinotheolasto24ohours.o-
oCORRECTooANSWER-B)oDiscussoperimenopauseoandorelatedocomfortomeasures.o
Theoperimenopausaloperiodobeginsoabouto10oyearsobeforeomenopauseowithotheocessatio
noofomenstruationoatotheoaverageoagesoofo52otoo54.oLoweroestrogenolevelsocausesoFSHoa
ndoLHosecretionoinoburstso(surges),owhichotriggersovasomotoroinstability,onightosweats,oan
dohotoflashes,osoodiscussionsoaboutotheoperimenopausalobody'sochanges,ocomfortomeasu
reso(B),oandotreatmentooptionsoshouldobeoprovided.oIn-
depthopathophysiologyoofotheosymptomso(A)omayoonlyoconfuseotheoclient.oThereoisonooindi
cationothatotheoclientohasotuberculosisoandoanoinfection,osoo(CoandoD)oareonotoindicated.
Ao51-year-
oldotruckodriverowhoosmokesotwoopacksoofocigarettesoaodayoandoiso30opoundsooverweighto
isodiagnosedowithohavingoaogastricoulcer.oWhatocontentoisomostoimportantoforotheonurseoto
oincludeoinotheodischargeoteachingoforothisoclient?
A)oInformationoaboutosmokingocessation.o
B)oDietoinstructionsoforoaolow-residueodiet.o
C)oInstructionsoonoaoweight-lossoprogram.o
D)oTheoimportanceoofoincreasingomilkoinotheodiet.o-oCORRECTooANSWER-
A)oInformationoaboutosmokingocessation.o
Smokingohasobeenoassociatedowithoulceroformation,oandostoppingoorodecreasingotheonum
beroofocigarettesosmokedoperodayoisoanoimportantoaspectoofoulceromanagemento(A).oDieto
managementoincludesoaoreductionoinohigh-fiber/high-
roughageofoodsoasowelloasospicyofoods.o(B)owouldobeoindicatedoforoinflammatoryobowelodi
sease.oSodiumoandocaloricointakeoareonototheokeyoelementsoinoanoulcerodiet.oAlthoughothi
soclientodoesoneedo(C),otheomanagementoofohisoulceroisotheokeyofactoroatothisopoint.o(D)ow
ouldoactuallyoincreaseogastricoacidoproduction.
Ao57-year-oldomaleoclientoisoscheduledotoohaveoaostress-
thalliumotestotheofollowingomorningoandoisoNPOoafteromidnight.oAto0130,oheoisoagitatedobe
,causeoheocannotoeatoandoisodemandingofood.oWhichoresponseoisobestoforotheonurseotoopr
ovideotoothisoclient?
A)oI'mosorryosir,oyouohaveoaoprescriptionoforonothingobyomouthofromomidnightotonight.o
B)oIowilloletoyouohaveooneocracker,obutothatoisoalloyouocanohaveoforotheorestoofotonight.o
C)oWhatodidotheohealthcareoproviderotelloyouoaboutotheotestoyouoareohavingotomorrow?o
D)oTheotestoyouoareohavingotomorroworequiresothatoyouohaveonothingobyomouthotonight.o-
oCORRECTooANSWER-
D)oTheotestoyouoareohavingotomorroworequiresothatoyouohaveonothingobyomouthotonight.o
(D)oisotheomostotherapeuticostatementobecauseotheonurseoisorespondingotootheoclient'soqu
estion.o(A)oisonotoanoexplanationoandotheonurseoshouldoteachotheoclientowhyoeatingoisoproh
ibitedoafteromidnight,oratherothanoenforcingothisorequirementowithoutoanoexplanationoforoit.o
(B)omayoresultoinoanoinaccurateotestoresult,ooromayocauseotheotestotoobeocancelled,owhicho
couldoalsoodelayodiagnosisoandotreatment.o(C)odefersotheoresponsibilityoforoansweringothe
oclient'soquestionotootheohealthcareoprovider,owhenotheonurseocouldoaddressotheosituationo
throughoclientoteaching.
Ao58-year-oldoclientowhoohasobeenopost-
menopausaloforofiveoyearsoisoconcernedoaboutotheoriskoforoosteoporosisobecauseoheromot
herohasotheocondition.oWhichoinformationoshouldotheonurseooffer?
A)oOsteoporosisoisoaoprogressiveogeneticodiseaseowithonooeffectiveotreatment.o
B)oCalciumolossofromobonesocanobeoslowedobyoincreasingocalciumointakeoandoexercise.o
C)oEstrogenoreplacementotherapyoshouldobeostartedotoopreventotheoprogressionoosteopor
osis.o
D)oLow-doseocorticosteroidotreatmentoeffectivelyohaltsotheocourseoofoosteoporosis.o-
oCORRECTooANSWER-
B)oCalciumolossofromobonesocanobeoslowedobyoincreasingocalciumointakeoandoexercise.o
Post-
menopausalofemalesoareoatoriskoforoosteoporosisodueotootheocessationoofoestrogenosecret
ion,obutoaoregimenoincludingocalcium,ovitaminoD,oandoweight-
bearingoexerciseocanopreventofurtheroboneolosso(B).oOsteoporosisocanobeomanagedowitho
conservativeotherapy,osuchoasoboneometabolismoregulatorsoandoestrogenoreplacementoth
erapyo(ERT)otooimproveoboneodensity,obutoitoisonotoaogeneticodiseaseo(A).oAlthoughoERToi
soeffectiveoinomanagingoosteoporosis,oanoincreasedoriskoforocanceroandoheartodiseaseosh
ouldobeoconsideredoforoindividualoclients.oCorticosteroidotherapyopromotesoboneoresorptio
noandoisocounterproductiveoinomaintainingooroincreasingoboneodensityo(D).
Ao58-year-
oldoclient,owhoohasonoohealthoproblems,oasksotheonurseoaboutotheoPneumovaxovaccine.oT
heonurse'soresponseotootheoclientoshouldobeobasedoonowhichoinformation?
A)oTheovaccineoisogivenoannuallyobeforeotheofluoseasonotoothoseoovero50oyearsoofoage.o
B)oTheoimmunizationoisoadministeredoonceotooolderoadultsooropersonsowithoaohistoryoofoch
ronicoillness.o
C)oTheovaccineoisoforoalloagesoandoisogivenoprimarilyotoothoseopersonsotravelingooverseaso
tooareasoofoinfection.o
, D)oTheovaccineowillopreventotheooccurrenceoofopneumococcalopneumoniaoforoupotoofiveoy
ears.o-oCORRECTooANSWER-
B)oTheoimmunizationoisoadministeredoonceotooolderoadultsooropersonsowithoaohistoryoofoch
ronicoillness.o
Itoisousuallyorecommendedothatopersonsoovero65oyearsoofoageoandothoseowithoaohistoryoofo
chronicoillnessoreceiveotheovaccineoonceoinoaolifetimeo(B).o(Someoresourcesorecommendo
obtainingotheovaccineoato50oyearsoofoage.)oTheoinfluenzaovaccineoisogivenoonceoaoyear,on
ototheoPneumovaxo(A).oAlthoughotheovaccineomightobeogivenotooaopersonotravelingooverse
as,othatoisonototheomainorationaleoforoadministeringotheovaccineo(C).oItoisousuallyogivenoonc
eoinoaolifetimeo(D),obutowithoimmunosuppressedoclientsooroclientsowithoaohistoryoofopneum
oniaore-vaccinationoisosometimesorequired.
Ao67-year-
oldowomanowhoolivesoaloneoisoadmittedoafterotrippingoonoaorugoinoherohomeoandofractureso
herohip.oWhichopredisposingofactoroprobablyoledotootheofractureoinotheoproximaloendoofoher
ofemur?
A)oFailingoeyesightoresultingoinoanounsafeoenvironment.o
B)oRenaloosteodystrophyoresultingofromochronicorenalofailure.o
C)oOsteoporosisoresultingofromohormonalochanges.o
D)oCardiovascularochangesoresultingoinosmallostrokesowhichoimpairomentaloacuity.o-
oCORRECTooANSWER-C)oOsteoporosisoresultingofromohormonalochanges.o
Theomostocommonocauseoofoaofracturedohipoinoelderlyowomenoisoosteoporosis,oresultingofr
omoreducedocalciumoinotheobonesoasoaoresultoofohormonalochangesoinolaterolifeo(C).o(A)om
ayooromayonotohaveocontributedotootheoaccident,obutoitohadonothingotoodoowithotheohipobein
goinvolved.o(B)oisonotoaocommonoconditionoofotheoelderly;oitoisocommonoinochronicorenalofai
lure.o(D)omayooccuroinosomeopeople,obutodoesonotoaffectotheofragilityoofotheobonesoasooste
oporosisodoes.
Ao77-year-
oldofemaleoclientoisoadmittedotootheohospital.oSheoisoconfused,ohasonooappetite,oisonausea
tedoandovomiting,oandoisocomplainingoofoaoheadache.oHeropulseorateoiso43obeatsoperominu
te.oWhichoquestionoisoaopriorityoforotheonurseotooaskothisoclientooroherofamilyoonoadmission
?o"Doesotheoclient
A)ohaveoheroownoteethoorodentures?"o
B)otakeoaspirinoandoifoso,ohowomuch?"o
C)otakeonitroglycerin?"o
D)otakeodigitalis?"o-oCORRECTooANSWER-D)otakeodigitalis?"o
Elderlyopersonsoareoparticularlyosusceptibleotoodigitalisointoxicationo(D)owhichomanifestsoit
selfoinosuchosymptomsoasoanorexia,onausea,ovomiting,odiarrhea,oheadache,oandofatigue.o
Althoughoitoisoimportantotooobtainoaocompleteomedicationohistoryo(BoandoC),otheosymptom
sodescribedoareoclassicoforodigitalisotoxicity,oandoassessmentoofothisoproblemoshouldobeom
adeopromptly.o(A)oisoirrelevant.
