HESI Med Surg Exam Review #1 BSN 266, Questions &
Answers, Explained With Rationales
A client with acute osteomyelitis has undergone surgical debridement of the diseased
bone and asks the nurse how long will antibiotics have to be administered. Which
information should the nurse communicate?
A. Oral antibiotics for 2 to 4 months, then for dental procedure prophylaxis.
B. Parenteral antibiotics for 4 to 6 weeks, then oral antibiotics for up to 1 year.
C. Parenteral antibiotics for 4 to 8 weeks, then oral antibiotics for 4 to 8 weeks.
Parenteral antibiotics for 2 to 3 weeks, then oral antibiotics for 4 weeks-C
Treatment of acute osteomyelitis requires the administration of high doses of parenteral
antibiotics for 4 to 8 weeks, followed by oral antibiotics for another 4 to 8 weeks
In planning care for a client with an acute stroke resulting in right-sided hemiplegia,
which positioning should the nurse should use to maintain optimal functioning?
A. Mid-Fowlers with knees supported.
B. Supine with trochanter rolls to the hips.
C. Sim's position alternated with right lateral position q2 hours.
D. Left lateral, supine, brief periods on the right side, and prone -D
Rationale
After an acute stroke, a positioning and turning schedule that minimizes lying on the
affected side, which can impair circulation and cause pain, and includes the prone
position to help prevent flexion contractures of the hips, prepares the client for optimal
functioning and ambulation.
Which preexisting diagnosis places a client at the greatest risk of developing superior
vena cava syndrome?
A. Carotid stenosis.
,B. Steatosis hepatitis.
C. Metastatic cancer.
D. Clavicular fracture.-C
Rationale
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 from a
primary tumor in the upper lobe of the right lung that compresses the superior vena cava.
The nurse is giving discharge instructions to a client with chronic prostatitis. What
instruction should the nurse provide the client to reduce the risk of spreading the infection
to other areas of the client's urinary tract?
A. Wear a condom when having sexual intercourse.
B. Avoid consuming alcohol and caffeinated beverages.
C. Empty the bladder completely with each voiding.
D. Have intercourse or masturbate at least twice a week.-D
Rationale
The prostate is not easily penetrated by antibiotics and can serve as a reservoir for
microorganisms, which can infect other areas of the genitourinary tract. Draining the
prostate regularly through intercourse or masturbation decreases the number of
microorganisms present and reduces the risk for further infection from stored
contaminated seminal fluids
During the initial outbreak of genital herpes simplex for a female client, what should be
the nurse's primary focus in planning care?
A. Promotion of comfort.
B. Prevention of pregnancy.
C. Instruction in condom use.
,Information about transmission-A
Rationale
The initial outbreak of genital herpes simplex in a woman causes severe discomfort.
Promotion of comfort is the first priority
A client who has a chronic cough with blood-tinged sputum returns to the unit after a
bronchoscopy. What nursing interventions should be implemented in the immediate post-
procedural period?
A. Keep the client on bed rest for eight hours.
B. Check vital signs every 15 minutes for two hours.
C. Allow the client nothing by mouth until the gag reflex returns.
D. Encourage fluid intake to promote elimination of the contrast media.-C
Rationale
The nasal pharynx and oral pharynx are anesthetized with local anesthetic spray prior to
bronchoscopy, and the bronchoscope is coated with lidocaine (Xylocaine) gel to inhibit
the gag reflex and prevent laryngeal spasm during insertion. The client should be NPO
until the client's gag reflex returns to prevent aspiration from any oral intake or
secretions.
The nurse is assessing a client admitted from the emergency room with gastrointestinal
bleeding related to peptic ulcer disease (PUD). Which physiological factors can produce
ulceration? (Select all that apply.)
Select all that apply
A. Vagal stimulation.
B. An increased level of stress.
C. Decreased duodenal inhibition.
D. Hypersecretion of hydrochloric acid.
E. An increased number of parietal cells-D,E
, Rationale
Hypersecretion of gastric juices and an increased number of parietal cells that stimulate
secretion are most often the causes of ulceration. Vagal stimulation and decreased
duodenal inhibition also increase the secretion of caustic fluids.
The nurse is caring for a client with non-Hodgkin’s lymphoma who is receiving
chemotherapy. Laboratory results reveal a platelet count of 10,000/ml. What action
should the nurse implement?
A. Encourage fluids to 3000 ml/day.
B. Check stools for occult blood.
C. Provide oral hygiene every 2 hours.
Check for fever every 4 hours-B
Rationale
Platelet counts less than 100,000/mm3 are indicative of thrombocytopenia, a common
side effect of chemotherapy. A client with thrombocytopenia should be assessed
frequently for occult bleeding in the emesis, sputum, feces, urine, nasogastric secretions,
or wounds.
Which action should the nurse implement on the scheduled day of surgery for a client
with type 1 diabetes mellitus (DM)?
A. Obtain a prescription for an adjusted dose of insulin.
B. Administer an oral anti-diabetic agent.
C. Give an insulin dose using parameters of a sliding scale.
Withhold insulin while the client is NPO-A
Rationale
Stressors, such as surgery, increase serum glucose levels. A client with type 1 DM who is
NPO for scheduled surgery should receive a prescribed adjusted dose of insulin.
Answers, Explained With Rationales
A client with acute osteomyelitis has undergone surgical debridement of the diseased
bone and asks the nurse how long will antibiotics have to be administered. Which
information should the nurse communicate?
A. Oral antibiotics for 2 to 4 months, then for dental procedure prophylaxis.
B. Parenteral antibiotics for 4 to 6 weeks, then oral antibiotics for up to 1 year.
C. Parenteral antibiotics for 4 to 8 weeks, then oral antibiotics for 4 to 8 weeks.
Parenteral antibiotics for 2 to 3 weeks, then oral antibiotics for 4 weeks-C
Treatment of acute osteomyelitis requires the administration of high doses of parenteral
antibiotics for 4 to 8 weeks, followed by oral antibiotics for another 4 to 8 weeks
In planning care for a client with an acute stroke resulting in right-sided hemiplegia,
which positioning should the nurse should use to maintain optimal functioning?
A. Mid-Fowlers with knees supported.
B. Supine with trochanter rolls to the hips.
C. Sim's position alternated with right lateral position q2 hours.
D. Left lateral, supine, brief periods on the right side, and prone -D
Rationale
After an acute stroke, a positioning and turning schedule that minimizes lying on the
affected side, which can impair circulation and cause pain, and includes the prone
position to help prevent flexion contractures of the hips, prepares the client for optimal
functioning and ambulation.
Which preexisting diagnosis places a client at the greatest risk of developing superior
vena cava syndrome?
A. Carotid stenosis.
,B. Steatosis hepatitis.
C. Metastatic cancer.
D. Clavicular fracture.-C
Rationale
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 from a
primary tumor in the upper lobe of the right lung that compresses the superior vena cava.
The nurse is giving discharge instructions to a client with chronic prostatitis. What
instruction should the nurse provide the client to reduce the risk of spreading the infection
to other areas of the client's urinary tract?
A. Wear a condom when having sexual intercourse.
B. Avoid consuming alcohol and caffeinated beverages.
C. Empty the bladder completely with each voiding.
D. Have intercourse or masturbate at least twice a week.-D
Rationale
The prostate is not easily penetrated by antibiotics and can serve as a reservoir for
microorganisms, which can infect other areas of the genitourinary tract. Draining the
prostate regularly through intercourse or masturbation decreases the number of
microorganisms present and reduces the risk for further infection from stored
contaminated seminal fluids
During the initial outbreak of genital herpes simplex for a female client, what should be
the nurse's primary focus in planning care?
A. Promotion of comfort.
B. Prevention of pregnancy.
C. Instruction in condom use.
,Information about transmission-A
Rationale
The initial outbreak of genital herpes simplex in a woman causes severe discomfort.
Promotion of comfort is the first priority
A client who has a chronic cough with blood-tinged sputum returns to the unit after a
bronchoscopy. What nursing interventions should be implemented in the immediate post-
procedural period?
A. Keep the client on bed rest for eight hours.
B. Check vital signs every 15 minutes for two hours.
C. Allow the client nothing by mouth until the gag reflex returns.
D. Encourage fluid intake to promote elimination of the contrast media.-C
Rationale
The nasal pharynx and oral pharynx are anesthetized with local anesthetic spray prior to
bronchoscopy, and the bronchoscope is coated with lidocaine (Xylocaine) gel to inhibit
the gag reflex and prevent laryngeal spasm during insertion. The client should be NPO
until the client's gag reflex returns to prevent aspiration from any oral intake or
secretions.
The nurse is assessing a client admitted from the emergency room with gastrointestinal
bleeding related to peptic ulcer disease (PUD). Which physiological factors can produce
ulceration? (Select all that apply.)
Select all that apply
A. Vagal stimulation.
B. An increased level of stress.
C. Decreased duodenal inhibition.
D. Hypersecretion of hydrochloric acid.
E. An increased number of parietal cells-D,E
, Rationale
Hypersecretion of gastric juices and an increased number of parietal cells that stimulate
secretion are most often the causes of ulceration. Vagal stimulation and decreased
duodenal inhibition also increase the secretion of caustic fluids.
The nurse is caring for a client with non-Hodgkin’s lymphoma who is receiving
chemotherapy. Laboratory results reveal a platelet count of 10,000/ml. What action
should the nurse implement?
A. Encourage fluids to 3000 ml/day.
B. Check stools for occult blood.
C. Provide oral hygiene every 2 hours.
Check for fever every 4 hours-B
Rationale
Platelet counts less than 100,000/mm3 are indicative of thrombocytopenia, a common
side effect of chemotherapy. A client with thrombocytopenia should be assessed
frequently for occult bleeding in the emesis, sputum, feces, urine, nasogastric secretions,
or wounds.
Which action should the nurse implement on the scheduled day of surgery for a client
with type 1 diabetes mellitus (DM)?
A. Obtain a prescription for an adjusted dose of insulin.
B. Administer an oral anti-diabetic agent.
C. Give an insulin dose using parameters of a sliding scale.
Withhold insulin while the client is NPO-A
Rationale
Stressors, such as surgery, increase serum glucose levels. A client with type 1 DM who is
NPO for scheduled surgery should receive a prescribed adjusted dose of insulin.
