HESI MEDSURG EXAM PACK 4 VERSIONS ALL INCLUSIVE TEST BANK ACCURATELY UPDATED 2025 | VERIFIED QUESTIONS AND ANSWERS | GUARANTEED PASS | HIGHEST LEVEL

HESI MEDSURG EXAM PACK 4 VERSIONS ALL INCLUSIVE
TEST BANK ACCURATELY UPDATED 2025 | VERIFIED
QUESTIONS AND ANSWERS | GUARANTEED PASS | HIGHEST
LEVEL



A client diagnosed with chronic kidney disease (CKD) 2 years ago is regularly treated at a community
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hemodialysisfacility.Beforehisscheduleddialysistreatment,whichelectrolyte imbalance should the
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nurse anticipate?
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A) Hypophosphatemia.
B) Hypocalcemia.
C) Hyponatremia.
D) Hypokalemia
B.
Hypocalcemia develops in CKD because of chronic hyperphosphatemia. Increased phosphate levels q q q q q q q q q q




cause the peripheraldeposition of calcium and resistance to vitamin Dabsorption needed forcalcium
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absorption.Priortodialysis,thenurse wouldexpecttofindtheclienthypernatremic and hyperkalemic,
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not with C or D.
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The home health nurse is assessing a male client being treated for Parkinson's disease with Sinemet.
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Thenurseobserves thathedoesnotdemonstrateanyapparent emotion whenspeaking and rarely blinks.
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Which intervention should the nurse implement?
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A) Perform a complete cranial nerveassessment. q q q q q




B) Instructtheclient that he maybe experiencingmedication toxicity.
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C) Documentthe presenceof these assessment findings. q q q q q q




D) Advise theclient to seek immediate medical evaluation. q q q q q q q




C.
Amasklikeexpressionandinfrequentblinkingarecommonclinicalfeaturesofparkinsonism. The
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nurse should document these expected findings. Signs of toxicity of Sinemet include dyskinesia,
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hallucinations, and psychosis.
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AclientwithCHFandAfib developsventricularectopywith apatternof8 ectopicbeats/min. Which
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action should the nurse take based on this observation?
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A) Assess for bilateral jugular vein distention. q q q q q




B) Increaseoxygenflowvia nasal cannula. q q q q q




C) AdministerPRN Lasix. q q




D) Auscultate for a pleural friction rub. q q q q q

,B.
Theclient should havethe oxygen flow immediatelyincreased to promote oxygenation of the
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,myocardium.Ventricularectopy,characterizedbymultiplePVCs,isoftencausedbymyocardial q q q q q q q q q q q




ischemia exacerbated by hypokalemia.
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Duringthechangeofshift report,thechargenurse reviews theinfusions beingreceivedby clients on the
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oncologyunit. The client receiving which infusion should be assessed first?
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A) Continuous IVinfusion of magnesium. q q q q




B) One-timeinfusion ofalbumin. q q q




C) Continuous epidural infusion of morphine. q q q q




D) Intermittent infusion of IV vancomycin. q q q q




C.
All four of these clients have a potential to have significant complications. The client with the
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morphineepiduralinfusion isat highest risk for respiratorydepression and shouldbeassessed first.
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A 25-year-old client was admitted yesterday after a motor vehicle collision. Neurodiagnostic studies
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haveshownabasalskullfractureinthemiddlefossa.Assessment onadmissionrevealed both halo and
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battle signs. Which new symtom indicates that the client is likely to be experiencing a common life-
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threatening complication associated with a basal skull fracture? q q q q q q q




A) Bilateraljugularvein distension. q q q




B) Oral temp of 102. q q q




C) Intermittent focal motorseizures. q q q




D) Intractablepain inthe cervical region. q q q q q




B.
Clients with basilar skull fractures are at high risk for infection of the brain, as indicated by an
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increased oral temp because the fracture leaves the meninges open to bacterial invasion.
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An older client is admitted with a diagnosis of bacterial pneumonia. Which symptom should the nurse
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report to the HCP after assessing the client?
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A) Leukocytosisand febrile. q q




B) Polycythemia andcrackles. q q




C) Pharyngitisand sputum production. q q q




D) Confusion and tachycardia. q q




D.
The onset of Pneumonia in the older client may be signaled by general deterioration, confusion,
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increased HR, and/or increased respirations. A, B, and C are often absent in the older client with
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bacterial pneumonia.
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Thenurseisreviewingroutinemedicationstaken bya clientwithchronicangle closure glaucoma.
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Which medication prescription should the nurse question?
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, A) Antianginal with atherapeutic effect of vasodilation. q q q q q q




B) Anticholinergic with aside effect of pupillarydilation. q q q q q q q




C) Antihistamine with a side effect ofsedation. q q q q q q




D) Corticosteroid with a side effect of hyperglycemia. q q q q q q




B.
Clients with angle-closure glaucoma should not take medications that dilate the pupil because theycan
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precipitateacuteandseverelyincreased IOP.A,C,andDdonotcauseincreased IOP, which is the
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primary concern with angle-closure glaucoma.
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Thenurseis caringfora criticallyillclient with cirrhosis oftheliverwho hasaNGtubedraining bright red
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blood. The nurse notes that the client's serum hemoglobin and hematocrit levels are decreased. Which
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additional change in laboratory data should the nurse expect?
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A) Increasedserumalbumin level. q q q




B) Decreasedserum creatinine. q q




C) Decreasedserum ammonia level. q q q




D) Increasedliverfunction test results. q q q q




C.
Thebreakdownof glutamineintheintestineand theincreased activityofcolonicbacteriafrom the
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digestion of proteins increase ammonia levels in clients with advanced liver disease, so removalof
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blood,aproteinsource,fromtheintestineresults inareducedlevelofammonia.A, B, and D will not be
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significantly affected by the removal of blood.
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Aresidentinalong-term carefacilityisdiagnosed withHepB.Whichinterventionshouldthe nurse
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implement with the staff caring for this client?
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A) Determineif all employees have had theHep B vaccine series. q q q q q q q q q q




B) Explainthatthis typeof hepatitis can betransmitted when feedingthe client. q q q q q q q q q q q q




C) Assurethe employees that theycannot contract Hep B when providingdirect care.
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D) Tellthe employees that wearing gloves anda gown arerequired when providingcare.
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A.
HepBvaccineshouldbe administeredtoallhealthcareproviders.HepA(not HepB)canbe transmitted
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by fecal-oral contamination. There is a chance that staff could contract Hep B if exposed to the client's
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blood and/or bodyfluids, therefore C is incorrect. There is no need to wear gloves and gowns except
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with blood or body fluid contact.
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A client with HTN has been receiving ramipril (altace), 5mg, PO, daily for 2 weeks and is scheduledto
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receiveadoseat0900.At 0830,theclient's blood pressureis120/70.Whichaction should the nurse take?
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A) Administerthe prescribed dose at the scheduled time. q q q q q q q




B) Hold the dose and contact the HCP. q q q q q q