N314 Med-Surgery HESI |Questions with 100%
Correct Answers
What types of medications should the nurse expect to administer to a client during an acute
respiratory distress episode?
A) Vasodilators and hormones.
B) Analgesics and sedatives.
C) Anticoagulants and expectorants.
D) Bronchodilators and steroids. - ✔️✔️D) Bronchodilators and steroids.
Feedback: CORRECT
Besides supplemental oxygen, the ARDS client needs medications to widen air passages,
increase air space, and reduce alveolar membrane inflammation, i.e., bronchodilators and
steroids (D). (A) would not help the condition. (B) would further depress the client and
compromise the ability to breathe. Anticoagulants would be contraindicated since clotting of the
blood is not yet a problem, and expectorants are not appropriate for this critically ill client (C).
A client who is sexually active with several partners requests an intrauterine device (IUD) as a
contraceptive method. Which information should the nurse provide?
A) Using an IUD offers no protection against sexually transmitted diseases (STD), which
increase the risk for pelvic inflammatory disease (PID).
B) Getting pregnant while using an IUD is common and is not the best contraceptive choice.
C) Relying on an IUD may be a safer choice for monogamous partners, but a barrier method
provides a better option in preventing STD transmission.
D) Selecting a contraceptive device should consider choosing a successful method used in the
past. - ✔️✔️A) Using an IUD offers no protection against sexually transmitted diseases (STD),
which increase the risk for pelvic inflammatory disease (PID).
Feedback: CORRECT
The use of an IUD provides the client with no protection from STDs (A). While pregnancy rates
with the use of an IUD are somewhat higher, (B) is not therapeutic, but judgmental. (C) is
judgmental and does not provide the client any information about use of an IUD. While talking
about contraceptives may include (D), it is does not provide the best information to maintain the
client's health.
The nurse should be correct in withholding a dose of digoxin in a client with congestive heart
failure without specific instruction from the healthcare provider if the client's
A) serum digoxin level is 1.5.
B) blood pressure is 104/68.
C) serum potassium level is 3.
D) apical pulse is 68/min. - ✔️✔️C) serum potassium level is 3.
Feedback:
,Hypokalemia (C) can precipitate digitalis toxicity in persons receiving digoxin which will
increase the chance of dangerous dysrhythmias (normal potassium level is 3.5 to 5.5 mEq/L).
The therapeutic range for digoxin is 0.8 to 2 ng/ml (toxic levels= >2 ng/ml); (A) is within this
range. (B) would not warrant the nurse withholding the digoxin. The nurse should withhold the
digoxin if the apical pulse is less than 60/min (D).
The healthcare provider prescribes aluminum and magnesium hydroxide (Maalox), 1 tablet PO
PRN, for a client with chronic renal failure who is complaining of indigestion. What intervention
should the nurse implement?
A) Administer 30 minutes before eating.
B) Evaluate the effectiveness 1 hour after administration.
C) Instruct the client to swallow the tablet whole.
D) Question the healthcare provider's prescription. - ✔️✔️D) Question the healthcare provider's
prescription.
Feedback: CORRECT
Magnesium agents are not usually used for clients with renal failure due to the risk of
hypermagnesemia, so this prescription should be questioned by the nurse (D). (A, B, and C) are
not recommended nursing actions for the administration of aluminum and magnesium hydroxide
(Maalox).
A client with heart disease is on a continuous telemetry monitor and has developed sinus
bradycardia. In determining the possible cause of the bradycardia, the nurse assesses the client's
medication record. Which medication is most likely the cause of the bradycardia?
A) Propanolol (Inderal).
B) Captopril (Capoten).
C) Furosemide (Lasix).
D) Dobutamine (Dobutrex). - ✔️✔️A) Propanolol (Inderal).
Feedback: CORRECT
Feedback:
Inderal (A) is a beta adrenergic blocking agent, which causes decreased heart rate and decreased
contractility. Neither (B), an ACE inhibitor, nor (C), a loop diuretic, causes bradycardia. (D) is a
sympathomimetic, direct acting cardiac stimulant, which would increase the heart rate.
A client is brought to the Emergency Center after a snow-skiing accident. Which intervention is
most important for the nurse to implement?
A) Review the electrocardiogram tracing.
B) Obtain blood for coagulation studies.
C) Apply a warming blanket.
D) Provide heated PO fluids. - ✔️✔️A) Review the electrocardiogram tracing.
Feedback:
Airway, breathing, and circulation are priorities in client assessment and treatment. Continuous
cardiac monitoring is indicated (A) because hypothermic clients have an increased risk for
dysrhythmias. Coagulations studies (A) and re-warming procedures (C and D) can be initiated
after a review of the ECG tracing (A).
, An elderly male client comes to the geriatric screening clinic complaining of pain in his left calf.
The nurse notices a reddened area on the calf of his right leg which is warm to the touch and
suspects it might be thrombophlebitis. Which type of pain should further confirm this suspicion?
A) Pain in the calf awakening him from a sound sleep.
B) Calf pain on exertion which stops when standing in one place.
C) Pain in the calf upon exertion which is relieved by rest and elevating the extremity.
D) Pain upon arising in the morning which is relieved after some stretching and exercise. -
✔️✔️C) Pain in the calf upon exertion which is relieved by rest and elevating the extremity.
Feedback:
Thrombophlebitis pain is relieved by rest and elevation of the extremity (C). It typically occurs
with exercise at the site of the thrombus, and is aggravated by placing the extremity in a
dependent position, such as standing in one place (B). (A and D) describe pain that is not
common with thrombophlebitis.
The nurse formulates the nursing diagnosis of, Urinary retention related to sensorimotor deficit
for a client with multiple sclerosis. Which nursing intervention should the nurse implement?
A) Teach the client techniques of intermittent self-catheterization.
B) Decrease fluid intake to prevent over distention of the bladder.
C) Use incontinence briefs to maintain hygiene with urinary dribbling.
D) Explain that anticholinergic drugs will decrease muscle spasticity. - ✔️✔️A) Teach the client
techniques of intermittent self-catheterization.
Feedback:
Bladder control is a common problem for clients with multiple sclerosis. A client with urinary
retention should receive instructions about self-catheterization (A) to prevent bladder distention.
Adequate hydration, not (B), is important to reduce the risk of urinary tract infections by
promoting elimination which reduces the time microorganisms spend in the bladder and by
diluting the number of microorganisms in the bladder. Self-catheterization helps prevent
dribbling, so (C) is unnecessary. Cholinergic drugs improve bladder muscle tone and help with
bladder emptying, not (D).
Which reaction should the nurse identify in a client who is responding to stimulation of the
sympathetic nervous system?
A) Pupil constriction.
B) Increased heart rate.
C) Bronchial constriction.
D) Decreased blood pressure. - ✔️✔️B) Increased heart rate.
Feedback:
Any stressor that is perceived as threatening to homeostasis acts to stimulate the sympathetic
nervous system and manifests as a flight-or-fight response, which includes an increase in heart
rate (B). (A, C, and D) are responses of the parasympathetic nervous system.
Correct Answers
What types of medications should the nurse expect to administer to a client during an acute
respiratory distress episode?
A) Vasodilators and hormones.
B) Analgesics and sedatives.
C) Anticoagulants and expectorants.
D) Bronchodilators and steroids. - ✔️✔️D) Bronchodilators and steroids.
Feedback: CORRECT
Besides supplemental oxygen, the ARDS client needs medications to widen air passages,
increase air space, and reduce alveolar membrane inflammation, i.e., bronchodilators and
steroids (D). (A) would not help the condition. (B) would further depress the client and
compromise the ability to breathe. Anticoagulants would be contraindicated since clotting of the
blood is not yet a problem, and expectorants are not appropriate for this critically ill client (C).
A client who is sexually active with several partners requests an intrauterine device (IUD) as a
contraceptive method. Which information should the nurse provide?
A) Using an IUD offers no protection against sexually transmitted diseases (STD), which
increase the risk for pelvic inflammatory disease (PID).
B) Getting pregnant while using an IUD is common and is not the best contraceptive choice.
C) Relying on an IUD may be a safer choice for monogamous partners, but a barrier method
provides a better option in preventing STD transmission.
D) Selecting a contraceptive device should consider choosing a successful method used in the
past. - ✔️✔️A) Using an IUD offers no protection against sexually transmitted diseases (STD),
which increase the risk for pelvic inflammatory disease (PID).
Feedback: CORRECT
The use of an IUD provides the client with no protection from STDs (A). While pregnancy rates
with the use of an IUD are somewhat higher, (B) is not therapeutic, but judgmental. (C) is
judgmental and does not provide the client any information about use of an IUD. While talking
about contraceptives may include (D), it is does not provide the best information to maintain the
client's health.
The nurse should be correct in withholding a dose of digoxin in a client with congestive heart
failure without specific instruction from the healthcare provider if the client's
A) serum digoxin level is 1.5.
B) blood pressure is 104/68.
C) serum potassium level is 3.
D) apical pulse is 68/min. - ✔️✔️C) serum potassium level is 3.
Feedback:
,Hypokalemia (C) can precipitate digitalis toxicity in persons receiving digoxin which will
increase the chance of dangerous dysrhythmias (normal potassium level is 3.5 to 5.5 mEq/L).
The therapeutic range for digoxin is 0.8 to 2 ng/ml (toxic levels= >2 ng/ml); (A) is within this
range. (B) would not warrant the nurse withholding the digoxin. The nurse should withhold the
digoxin if the apical pulse is less than 60/min (D).
The healthcare provider prescribes aluminum and magnesium hydroxide (Maalox), 1 tablet PO
PRN, for a client with chronic renal failure who is complaining of indigestion. What intervention
should the nurse implement?
A) Administer 30 minutes before eating.
B) Evaluate the effectiveness 1 hour after administration.
C) Instruct the client to swallow the tablet whole.
D) Question the healthcare provider's prescription. - ✔️✔️D) Question the healthcare provider's
prescription.
Feedback: CORRECT
Magnesium agents are not usually used for clients with renal failure due to the risk of
hypermagnesemia, so this prescription should be questioned by the nurse (D). (A, B, and C) are
not recommended nursing actions for the administration of aluminum and magnesium hydroxide
(Maalox).
A client with heart disease is on a continuous telemetry monitor and has developed sinus
bradycardia. In determining the possible cause of the bradycardia, the nurse assesses the client's
medication record. Which medication is most likely the cause of the bradycardia?
A) Propanolol (Inderal).
B) Captopril (Capoten).
C) Furosemide (Lasix).
D) Dobutamine (Dobutrex). - ✔️✔️A) Propanolol (Inderal).
Feedback: CORRECT
Feedback:
Inderal (A) is a beta adrenergic blocking agent, which causes decreased heart rate and decreased
contractility. Neither (B), an ACE inhibitor, nor (C), a loop diuretic, causes bradycardia. (D) is a
sympathomimetic, direct acting cardiac stimulant, which would increase the heart rate.
A client is brought to the Emergency Center after a snow-skiing accident. Which intervention is
most important for the nurse to implement?
A) Review the electrocardiogram tracing.
B) Obtain blood for coagulation studies.
C) Apply a warming blanket.
D) Provide heated PO fluids. - ✔️✔️A) Review the electrocardiogram tracing.
Feedback:
Airway, breathing, and circulation are priorities in client assessment and treatment. Continuous
cardiac monitoring is indicated (A) because hypothermic clients have an increased risk for
dysrhythmias. Coagulations studies (A) and re-warming procedures (C and D) can be initiated
after a review of the ECG tracing (A).
, An elderly male client comes to the geriatric screening clinic complaining of pain in his left calf.
The nurse notices a reddened area on the calf of his right leg which is warm to the touch and
suspects it might be thrombophlebitis. Which type of pain should further confirm this suspicion?
A) Pain in the calf awakening him from a sound sleep.
B) Calf pain on exertion which stops when standing in one place.
C) Pain in the calf upon exertion which is relieved by rest and elevating the extremity.
D) Pain upon arising in the morning which is relieved after some stretching and exercise. -
✔️✔️C) Pain in the calf upon exertion which is relieved by rest and elevating the extremity.
Feedback:
Thrombophlebitis pain is relieved by rest and elevation of the extremity (C). It typically occurs
with exercise at the site of the thrombus, and is aggravated by placing the extremity in a
dependent position, such as standing in one place (B). (A and D) describe pain that is not
common with thrombophlebitis.
The nurse formulates the nursing diagnosis of, Urinary retention related to sensorimotor deficit
for a client with multiple sclerosis. Which nursing intervention should the nurse implement?
A) Teach the client techniques of intermittent self-catheterization.
B) Decrease fluid intake to prevent over distention of the bladder.
C) Use incontinence briefs to maintain hygiene with urinary dribbling.
D) Explain that anticholinergic drugs will decrease muscle spasticity. - ✔️✔️A) Teach the client
techniques of intermittent self-catheterization.
Feedback:
Bladder control is a common problem for clients with multiple sclerosis. A client with urinary
retention should receive instructions about self-catheterization (A) to prevent bladder distention.
Adequate hydration, not (B), is important to reduce the risk of urinary tract infections by
promoting elimination which reduces the time microorganisms spend in the bladder and by
diluting the number of microorganisms in the bladder. Self-catheterization helps prevent
dribbling, so (C) is unnecessary. Cholinergic drugs improve bladder muscle tone and help with
bladder emptying, not (D).
Which reaction should the nurse identify in a client who is responding to stimulation of the
sympathetic nervous system?
A) Pupil constriction.
B) Increased heart rate.
C) Bronchial constriction.
D) Decreased blood pressure. - ✔️✔️B) Increased heart rate.
Feedback:
Any stressor that is perceived as threatening to homeostasis acts to stimulate the sympathetic
nervous system and manifests as a flight-or-fight response, which includes an increase in heart
rate (B). (A, C, and D) are responses of the parasympathetic nervous system.
