MED SURG HESI V1
Study online at https://quizlet.com/_dhi72i
1. c. The PT will be 1.5 times the normal: 1. Following long-term administration of
warfarin sodium to a client with a medical diagnosis of deep vein thrombosis, the
nurse should expect which treatment?
a. The hemoglobin will be greater than 10 g/dl
b. The hematocrit will be less than 35%
c. The PT will be 1.5 times the normal
d. The PTT will be 1.5 times the normal
2. Urinary retention: A client who has been taking finasteride, an enzyme (5 alpha
reductase) inhibitor used to shrink the prostate gland, is admitted because of
continuing benign prostate prostatic hypertrophy (BPH) symptoms when planning
care. Which nursing problem should the nurse address first?
3. Wear cotton socks and enclosed toe shoes whenever outside: An older client
has been diagnosed with chronic venous insufficiency. To prevent venous return,
which action should the nurse encourage the client to?
4. White blood cell (WBC) count: When caring for a client with a full thickness
burn covering 40% of the body, the nurse observes pertinent drainage at the wound.
Before reporting this finding to the healthcare provider, the nurse should review
which of the client's laboratory values?
5. Provide an eye shield to be worn while sleeping: An older client arrives at the
outpatient eye surgery clinic for a right cataract extraction and implant. During the
immediate postoperative period, which intervention should the nurse implement?
6. Reassess vital signs: After several days of coughing and taking acetaminophen
to treat temperatures of 101 F (38.3 C), a client with DI is admitted to the hospital
with an upper respiratory infection. Several hours after admission, the client reports
having a severe headache and feeling dizzy. Which intervention should the nurse
implement first?
7. Complete blood count: A client takes daily supplemental iron tablets for iron
deficiency anemia reports feeling increasingly fatigued. Which laboratory values
should the nurse review?
8. Medicate for pain and monitor vital signs according to protocol: The nurse is
caring for a client post anesthesia care unit (PACU) who underwent a thoracotomy
two hours ago. The nurse observes the following vital signs: heart rate 140 beats/
minute, respirations 26 breaths/minute, and blood pressure 140/90 mmHg. Which
intervention is most important for the nurse to implement?
9. - Verify pedal pulses using a doppler pulse device
- Monitor left leg for pain, pallor, paresthesia, paralysis, pressured. - Evaluate
the application of the splint to the left leg: A client who was involved in a motor
vehicle collision is admitted with a fractured left femur which is immobilized using a
fracture traction splint in preparation for an open reduction internal fraction (ORIF).
1/6
, MED SURG HESI V1
Study online at https://quizlet.com/_dhi72i
The nurse determines that the client's distal pulses are diminished in the left foot.
Which interventions should the nurse implement? (SATA)
10. Serum sodium of 185 mEq/L: A nurse is caring for a client with Diabetes
Insipidus (DI). which data warrants the most immediate intervention by the nurse?
11. Platelet count: The nurse assesses a client with petechiae and ecchymosis
scattered across the arms and legs. Which laboratory result should the nurse
review?
12. Insert a NGT and attach to low suction: A male client is admitted to the
emergency department with vomiting of dark brown, foul- smelling emesis. He
reports he had a surgical repair of a recurrent inguinal hernia one week ago and
complains of intense abdominal pain. After assessing that his bowel sounds are
hyperactive, which prescription should the nurse implement first?
13. Troponin I: A client is admitted to the hospital for shortness of breath and chest
pain after an episode of syncope. Which laboratory finding is most important for the
nurse to report to the healthcare provider?
14. Provide a bedside commode for toileting: A client is hospitalized after expe-
riencing a myocardial infarction (MI) to reduce cardiac workload, which intervention
should the nurse include in the client's plan of care?
15. Pain relief can be provided by shrinking tumors that press against spinal
nerves: The healthcare provider prescribes radiation therapy (RT) for a client with
terminal metastatic cancer who is experiencing increased pain due to spinal com-
pression. The client asks the nurse why radiation therapy is prescribed. Which
mechanism supports the use of RT in the client's metastatic cancer?
16. Tenderness upon palpation and generalized erythema: The nurse is caring
for a client diagnosed with psoriasis vulgaris who is receiving a PUVA treatment.
Which assessment finding indicates that the client has been overexposed to the
treatment?
17. - Visual acuity
- Skin condition of lower extremities
-Sensation in feet and legs
-Serum creatinine and blood urea nitrogen (BUN): 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 to determine if the patient with type 2 DM is
experiencing long-term complications? (SATA)
18. Coarse breath sounds: A client with a history of chronic obstructive disease
(COPD) is admitted with pneumonia. Vital signs include oxygen saturation 89% tem-
perature 100.5 F (38 C) heart rate 120 beats/minute, respirations 28 breaths/minute
and blood pressure 170/90mmHg. Which finding warrants immediate intervention
by the nurse?
2/6
Study online at https://quizlet.com/_dhi72i
1. c. The PT will be 1.5 times the normal: 1. Following long-term administration of
warfarin sodium to a client with a medical diagnosis of deep vein thrombosis, the
nurse should expect which treatment?
a. The hemoglobin will be greater than 10 g/dl
b. The hematocrit will be less than 35%
c. The PT will be 1.5 times the normal
d. The PTT will be 1.5 times the normal
2. Urinary retention: A client who has been taking finasteride, an enzyme (5 alpha
reductase) inhibitor used to shrink the prostate gland, is admitted because of
continuing benign prostate prostatic hypertrophy (BPH) symptoms when planning
care. Which nursing problem should the nurse address first?
3. Wear cotton socks and enclosed toe shoes whenever outside: An older client
has been diagnosed with chronic venous insufficiency. To prevent venous return,
which action should the nurse encourage the client to?
4. White blood cell (WBC) count: When caring for a client with a full thickness
burn covering 40% of the body, the nurse observes pertinent drainage at the wound.
Before reporting this finding to the healthcare provider, the nurse should review
which of the client's laboratory values?
5. Provide an eye shield to be worn while sleeping: An older client arrives at the
outpatient eye surgery clinic for a right cataract extraction and implant. During the
immediate postoperative period, which intervention should the nurse implement?
6. Reassess vital signs: After several days of coughing and taking acetaminophen
to treat temperatures of 101 F (38.3 C), a client with DI is admitted to the hospital
with an upper respiratory infection. Several hours after admission, the client reports
having a severe headache and feeling dizzy. Which intervention should the nurse
implement first?
7. Complete blood count: A client takes daily supplemental iron tablets for iron
deficiency anemia reports feeling increasingly fatigued. Which laboratory values
should the nurse review?
8. Medicate for pain and monitor vital signs according to protocol: The nurse is
caring for a client post anesthesia care unit (PACU) who underwent a thoracotomy
two hours ago. The nurse observes the following vital signs: heart rate 140 beats/
minute, respirations 26 breaths/minute, and blood pressure 140/90 mmHg. Which
intervention is most important for the nurse to implement?
9. - Verify pedal pulses using a doppler pulse device
- Monitor left leg for pain, pallor, paresthesia, paralysis, pressured. - Evaluate
the application of the splint to the left leg: A client who was involved in a motor
vehicle collision is admitted with a fractured left femur which is immobilized using a
fracture traction splint in preparation for an open reduction internal fraction (ORIF).
1/6
, MED SURG HESI V1
Study online at https://quizlet.com/_dhi72i
The nurse determines that the client's distal pulses are diminished in the left foot.
Which interventions should the nurse implement? (SATA)
10. Serum sodium of 185 mEq/L: A nurse is caring for a client with Diabetes
Insipidus (DI). which data warrants the most immediate intervention by the nurse?
11. Platelet count: The nurse assesses a client with petechiae and ecchymosis
scattered across the arms and legs. Which laboratory result should the nurse
review?
12. Insert a NGT and attach to low suction: A male client is admitted to the
emergency department with vomiting of dark brown, foul- smelling emesis. He
reports he had a surgical repair of a recurrent inguinal hernia one week ago and
complains of intense abdominal pain. After assessing that his bowel sounds are
hyperactive, which prescription should the nurse implement first?
13. Troponin I: A client is admitted to the hospital for shortness of breath and chest
pain after an episode of syncope. Which laboratory finding is most important for the
nurse to report to the healthcare provider?
14. Provide a bedside commode for toileting: A client is hospitalized after expe-
riencing a myocardial infarction (MI) to reduce cardiac workload, which intervention
should the nurse include in the client's plan of care?
15. Pain relief can be provided by shrinking tumors that press against spinal
nerves: The healthcare provider prescribes radiation therapy (RT) for a client with
terminal metastatic cancer who is experiencing increased pain due to spinal com-
pression. The client asks the nurse why radiation therapy is prescribed. Which
mechanism supports the use of RT in the client's metastatic cancer?
16. Tenderness upon palpation and generalized erythema: The nurse is caring
for a client diagnosed with psoriasis vulgaris who is receiving a PUVA treatment.
Which assessment finding indicates that the client has been overexposed to the
treatment?
17. - Visual acuity
- Skin condition of lower extremities
-Sensation in feet and legs
-Serum creatinine and blood urea nitrogen (BUN): 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 to determine if the patient with type 2 DM is
experiencing long-term complications? (SATA)
18. Coarse breath sounds: A client with a history of chronic obstructive disease
(COPD) is admitted with pneumonia. Vital signs include oxygen saturation 89% tem-
perature 100.5 F (38 C) heart rate 120 beats/minute, respirations 28 breaths/minute
and blood pressure 170/90mmHg. Which finding warrants immediate intervention
by the nurse?
2/6
