Med-Surg HESI Evolve
Comprehensive Questions
(Frequently Tested) with
Verified Answers Graded A+
A client with impaired peripheral pulses and signs of chronic hypoxia in a lower extremity is
scheduled for a femoral angiogram. What would be appropriate for the nurse to include in the
postprocedure plan of care?
Elevate the foot of the bed.
Perform urinary catheter care every 12 hours.
Place in the high-Fowler position.
Perform a neurovascular assessment every 2 hours. - Answer: Perform a neurovascular
assessment every 2 hours.
Because of the trauma associated with the insertion of the catheter during the procedure, the
involved extremity should be assessed for sensation, motor ability, and arterial perfusion;
hemorrhage or an arterial embolus can occur. The client has an arterial problem, and perfusion
is promoted by keeping the legs at the level of or lower than the heart. A general anesthetic is
not used; therefore voiding is not a concern. Keeping the client in the high-Fowler position is
unsafe; this position increases pressure in the groin area, which can dislodge the clot at the
,catheter insertion site, resulting in bleeding. It also impedes arterial perfusion and venous
return.
A client with a history of heart disease has been receiving a calcium channel blocker and
morphine sulfate for pain from abdominal surgery. When getting the client out of bed, the nurse
first should have the client sit on the edge of the bed with feet on the floor. What untoward
client response can be prevented by this nursing action?
Abdominal pain
Respiratory distress
Sudden hemorrhage
Postural hypotension - Answer: Postural hypotension
After administration of certain antihypertensives or opioids, a client's neurocirculatory reflexes
may have some difficulty adjusting to the force of gravity when an upright position is assumed.
Postural or orthostatic hypotension occurs, and blood supply to the brain is temporarily
decreased. Abdominal pain, respiratory distress, and sudden hemorrhage will not be prevented
by the intervention described.
A client is admitted to the hospital for an emergency cardiac catheterization. What adaptation is
the client most likely to complain of after this procedure?
Fear of dying
Skipped heartbeats
,Pain at the insertion site
Anxiety in response to intensive monitoring - Answer: Pain at the insertion site
Pain at the arterial puncture site is attributable to entry and cannulation of the artery and is a
common complaint after a cardiac catheterization. Fear of dying might occur during the
precatheterization period. Although skipped heartbeats may occur during the procedure
because of trauma to the conduction system, usually it does not continue after the procedure.
Although some clients may be anxious, many feel safe when receiving ongoing monitoring.
Which client is at greatest risk for the development of a venous thrombosis?
A 76-year-old female with a 100-pack-per-year smoking history and hypertension
A 68-year-old male on bed rest following a left hip fracture
A 59-year-old male who is an intravenous drug user with hyperlipidemia
A 42-year-old female with Factor V Leiden mutation on warfarin - Answer: A 68-year-old male
on bed rest following a left hip fracture
Venous thrombosis is the result of inflammation to a vein, hypercoagulability, venous stasis, or a
combination of the three, known as Virchow triad. Bed rest and hip fracture are two major risk
factors for the development of a thrombosis. While the other options present risk factors
(cigarette smoking, drug abuse, and clotting disorders), the combination of the two (venous
stasis and vessel injury) results in greatest risk for thrombus development.
After multiple bee stings, a client experiences an anaphylactic reaction. The nurse determines
that the symptoms the client is experiencing are caused by what processes?
, Respiratory depression and cardiac arrest
Bronchial constriction and decreased peripheral resistance
Decreased cardiac output and dilation of major blood vessels
Constriction of capillaries and decreased peripheral circulation - Answer: Bronchial constriction
and decreased peripheral resistance
Hypersensitivity to a foreign substance can cause an anaphylactic reaction; histamine is
released, causing bronchial constriction, increased capillary permeability, and dilation of
arterioles. This decreased peripheral resistance is associated with hypotension and inadequate
circulation to major organs. Respiratory depression and cardiac arrest are the problems that
result from bronchial constriction and vascular collapse. Dilation of arterioles occurs. Arterioles
dilate, capillary permeability increases, and eventually vascular collapse occurs.
Which respiratory measurement is useful in differentiating between obstructive and restrictive
pulmonary dysfunction?
Peak expiratory flow rate
Forced vital capacity
Forced mid-expiratory flow rate
Forced expiratory volume/forced vital capacity ratio - Answer: Forced expiratory volume/forced
vital capacity ratio
Comprehensive Questions
(Frequently Tested) with
Verified Answers Graded A+
A client with impaired peripheral pulses and signs of chronic hypoxia in a lower extremity is
scheduled for a femoral angiogram. What would be appropriate for the nurse to include in the
postprocedure plan of care?
Elevate the foot of the bed.
Perform urinary catheter care every 12 hours.
Place in the high-Fowler position.
Perform a neurovascular assessment every 2 hours. - Answer: Perform a neurovascular
assessment every 2 hours.
Because of the trauma associated with the insertion of the catheter during the procedure, the
involved extremity should be assessed for sensation, motor ability, and arterial perfusion;
hemorrhage or an arterial embolus can occur. The client has an arterial problem, and perfusion
is promoted by keeping the legs at the level of or lower than the heart. A general anesthetic is
not used; therefore voiding is not a concern. Keeping the client in the high-Fowler position is
unsafe; this position increases pressure in the groin area, which can dislodge the clot at the
,catheter insertion site, resulting in bleeding. It also impedes arterial perfusion and venous
return.
A client with a history of heart disease has been receiving a calcium channel blocker and
morphine sulfate for pain from abdominal surgery. When getting the client out of bed, the nurse
first should have the client sit on the edge of the bed with feet on the floor. What untoward
client response can be prevented by this nursing action?
Abdominal pain
Respiratory distress
Sudden hemorrhage
Postural hypotension - Answer: Postural hypotension
After administration of certain antihypertensives or opioids, a client's neurocirculatory reflexes
may have some difficulty adjusting to the force of gravity when an upright position is assumed.
Postural or orthostatic hypotension occurs, and blood supply to the brain is temporarily
decreased. Abdominal pain, respiratory distress, and sudden hemorrhage will not be prevented
by the intervention described.
A client is admitted to the hospital for an emergency cardiac catheterization. What adaptation is
the client most likely to complain of after this procedure?
Fear of dying
Skipped heartbeats
,Pain at the insertion site
Anxiety in response to intensive monitoring - Answer: Pain at the insertion site
Pain at the arterial puncture site is attributable to entry and cannulation of the artery and is a
common complaint after a cardiac catheterization. Fear of dying might occur during the
precatheterization period. Although skipped heartbeats may occur during the procedure
because of trauma to the conduction system, usually it does not continue after the procedure.
Although some clients may be anxious, many feel safe when receiving ongoing monitoring.
Which client is at greatest risk for the development of a venous thrombosis?
A 76-year-old female with a 100-pack-per-year smoking history and hypertension
A 68-year-old male on bed rest following a left hip fracture
A 59-year-old male who is an intravenous drug user with hyperlipidemia
A 42-year-old female with Factor V Leiden mutation on warfarin - Answer: A 68-year-old male
on bed rest following a left hip fracture
Venous thrombosis is the result of inflammation to a vein, hypercoagulability, venous stasis, or a
combination of the three, known as Virchow triad. Bed rest and hip fracture are two major risk
factors for the development of a thrombosis. While the other options present risk factors
(cigarette smoking, drug abuse, and clotting disorders), the combination of the two (venous
stasis and vessel injury) results in greatest risk for thrombus development.
After multiple bee stings, a client experiences an anaphylactic reaction. The nurse determines
that the symptoms the client is experiencing are caused by what processes?
, Respiratory depression and cardiac arrest
Bronchial constriction and decreased peripheral resistance
Decreased cardiac output and dilation of major blood vessels
Constriction of capillaries and decreased peripheral circulation - Answer: Bronchial constriction
and decreased peripheral resistance
Hypersensitivity to a foreign substance can cause an anaphylactic reaction; histamine is
released, causing bronchial constriction, increased capillary permeability, and dilation of
arterioles. This decreased peripheral resistance is associated with hypotension and inadequate
circulation to major organs. Respiratory depression and cardiac arrest are the problems that
result from bronchial constriction and vascular collapse. Dilation of arterioles occurs. Arterioles
dilate, capillary permeability increases, and eventually vascular collapse occurs.
Which respiratory measurement is useful in differentiating between obstructive and restrictive
pulmonary dysfunction?
Peak expiratory flow rate
Forced vital capacity
Forced mid-expiratory flow rate
Forced expiratory volume/forced vital capacity ratio - Answer: Forced expiratory volume/forced
vital capacity ratio
