HESI RN MEDICAL SURGICAL EXAM PACK 20
QUESTIONS AND ANSWERS
An cER cnurse cis ccompleting can cassessment con ca cpatient cthat cis calert cbut cstruggles cto canswe
cattempts cto ctalk, cshe cslurs cher cspeech cand cappears cvery cfrightened. cWhat cadditional cclinical
cexpect cto cfind cif cnacy's csysmptoms chave cbeen ccaused cby ca cbrain cattack c(stroke)?
A. cA ccarotid cbruit
B. cA chypotensive cblood cpressure
C. chyperreflexic cdeep ctendon crelexes.
D. cDecreased cbowel csounds c- cCORRECT cANS✔✔A) cA ccarotid cbruit.
Rationale: cthe ccarotid cartery c(artery cto cthe cbrain) cis cnarrowed cin cclients cwith ca cbrain cattack. cA
cheard con causcultation cresulting cfrom cinterference cwith cnormal cblood cflow. cUsually cthe cblood c
cInitially cflaccid cparalysis coccurs, cresulting cin chyporefkexic cdeep ctendon creflexes. cBowel csound
cattack.
Which cclinical cmanifestation cfurther csupports can cassessment cof ca cleft-sided cbrain cattack?
A) cVisual cfield cdeficit con cthe cleft cside.
B) cSpatial-perceptual cdeficits.
C) cParesthesia cof cthe cleft cside.
D) cGlobal caphasia.
D) cGlobal caphasia. c- cCORRECT cANS✔✔D) cGlobal caphasia.
Rationale: cGlobal caphasia crefers cto cdifficulty cspeaking, clistening, cand cunderstanding, cas cwell ca
cwriting. cSymptoms cvary cfrom cperson cto cperson. cAphasia cmay coccur csecondary cto cany cbrain c
chemisphere. cVisual cfield cdeficits, cspatial-perceptual cdeficits, cand cparesthsia cof cthe cleft cside cus
cbrain cattack.
When cpreparing ca cpatient cfor ca cnoncontrast ccomputed ctomography c(CT) cscan cSTAT, cwhat cnu
cnurse cimplement?
A) cDetermine cif cthe cclient chas cany callergies cto ciodine
,The cmagnetic cfield cgenerated cby cthe cMRI cis cso cstrong cthat cmetal-containing citems care cstrong
cBecause cthe chip cjoint cis cmade cof cmetal, ca clead cshield cmust cbe cused cduring cthe cprocedure. c
callergy cto cshell cfish, cand ca chistory cof catrial cfibrillation cwould cnot caffect cthe cMRI.
A cclient's cdaughter cis csitting cby cher cmother's cbedside cwho cwas crecently ctransferred cto cthe cIn
cstates c"I cdon't cunderstand cwhat ca cbrain cattack cis. cThe chealthcare cprovider ctold cme cmy cmoth
cthey care cgoing cto crun cseveral ctests. cI cjust cdon't cknow cwhat cis cgoing con. cWhat chappened cto
cbest cresponse cby cthe cnurse?
A) c"I cam csorry, cbut caccording cto cthe cHealth cInsurance cPortability cand cAccounting cAct c(HIPAA
cinformation."
B) c"Your cmother chas chad ca cstroke, cand cthe cblood csupply cto cthe cbrain chas cbeen cblocked."
C) c"How cdo cyou cfeel cabout cwhat cthe chealthcare cprovider csaid?"
D) c"I cwill ccall cthe chealthcare cprovider cso che/she ccan ctalk cto cyou cabout cyour cmother's cserious
cANS✔✔B) c"Your cmother chas chad ca cstroke, cand cthe cblood csupply cto cthe cbrain chas cbeen cblo
Rationale: cThe cnurse ccan cdiscuss cwhat ca cdiagnosis cmeans. cNancy cis cunable cto cmake cdecisio
cdaughter, cGail, cneeds csufficient cinformation cto cmake cinformed cdecisions. cThe cnurse chas cthe c
cresponsibility, cto cexplain cNancy's ccondition cto cGail. cThe cnurse cshould cgive cfacts cfirst, cand cth
cthe cinformation cis cprovided.
What cis cthe cnormal crange cfor ccardiac coutput? c- cCORRECT cANS✔✔The cnormal crange cfor cca
ccerebral cblood cflow cand coxygen cdelivery cis c4 cto c8 cL/min.
A cclient cwas cadmitted cwith cthe cdiagnosis cof ca cbrain cattack. cTheir csymptoms cbegan c24 chours
cwould cthis cclient cnot cbe ca ccandidate cfor cfor cthrombolytic ctherapy? c- cCORRECT cANS✔✔Thro
ccontraindicated cin cclients cwith csymptom conset clonger cthan c3 chours cprior cto cadmission. cThis c
chours cbefore cbeing cbrought cto cthe cmedical ccenter
What care cplate cguards? c- cCORRECT cANS✔✔Plate cguards cprevent cfood cfrom cbeing cpushed c
cguards cand cother cassistive cdevices cwill cencourage cindependence cin ca cclient cwith ca cself-care
Which ccondition cis cconsidered ca cnon-modifiable crisk cfactor cfor ca cbrain cattack?
A) cHigh ccholesterol clevels.
B) cObesity.
C) cHistory cof catrial cfibrillation.
D) cAdvanced cage. c- cCORRECT cANS✔✔D) cAdvanced cage.
Rationale: cPeople cover cage c55 care ca chigh-risk cgroup cfor ca cbrain cattack cbecause cthe cincidenc
cdoubles cin ceach csuccessive cdecade cof clife. cNon-modifiable cmeans cthe cclient ccannot cdo canyth
cAll cthe cother coptions care cmodifiable crisk cfactors.
A cclient cis cexperiencing chomonymous chemianopsia cas cthe cresult cof ca cbrain cattack. cWhich cnu
cnurse cimplement cto caddress cthis ccondition?
A) cTurn cNancy cevery ctwo chours cand cperform cactive crange cof cmotion cexercises.
B) cPlace cthe cobjects cNancy cneeds cfor cactivities cof cdaily cliving con cthe cleft cside cof cthe ctable.
C) cSpeak cslowly cand cclearly cto cassist cNancy cin cforming csounds cto cwords.
D) cRequest cthat cthe cdietary cdepartment cthicken call cliquids con cNancy's cmeal cand csnack ctrays.
cPlace cthe cobjects cNancy cneeds cfor cactivities cof cdaily cliving con cthe cleft cside cof cthe ctable.
Rationale: cHomonymous chemianopsia cis closs cof cthe cvisual cfield con cthe csame cside cas cthe cpa
cthe cclient cneglecting cthat cside cof cthe cbody, cso cit cis cbeneficial cto cplace cobjects con cthat cside.
cbrain cattack cso cher cright cside cis cthe cweak cside. cSpeaking cslowly cand cclearly cwould caddress
,A cnew cnurse cgraduate cis ccaring cfor ca cpostoperative cclient cwith cthe cfollowing carterial cblood cga
c60 cmm cHg; cPO2, c80 cmm cHg; cbicarbonate, c24 cmEq/L; cand cO2 csaturation, c96%. cWhich cof cth
cgraduate cis cindicated?
A) cEncourage cthe cclient cto cuse cthe cincentive cspirometer cand cto ccough.
B) cAdminister coxygen cby cnasal ccannula.
C) cRequest ca cprescription cfor csodium cbicarbonate cfrom cthe chealth ccare cprovider.
D) cInform cthe ccharge cnurse cthat cno cchanges cin ctherapy care cneeded. c- cCORRECT cANS✔✔A)
cthe cincentive cspirometer cand cto ccough.
Rationale: cRespiratory cacidosis cis ccaused cby cCO2 cretention cand cimpaired cchest cexpansion cse
cnurse ctakes csteps cto cpromote cCO2 celimination, cincluding cmaintaining ca cpatent cairway cand cex
cbreathing ctechniques. cO2 cis cnot cindicated cbecause cPo2 cand coxygen csaturation care cwithin cthe
cbicarbonate cis cnot cindicated cbecause cthe cbicarbonate clevel cis cin cthe cnormal crange; cpromoting
cacids cis cthe cpriority cin crespiratory cacidosis. cPost canesthesia, cthe cclient cwill cneed cinterventions
cmay cprogress cto ca cstate cof csomnolence cand cunresponsiveness.
The cnurse cis cproviding cdietary cinstructions cto ca c68-year-old cclient cwho cis cat chigh crisk cfor cdev
cdisease c(CHD). cWhich cinformation cshould cthe cnurse cinclude?
A) cLimit cdietary cselection cof ccholesterol cto c300 cmg cper cday
B) cIncrease cintake cof csoluble cfiber cto c10 cto c25 cgrams cper cday. c
C) cDecrease cplant cstanols cand csterols cto cless cthan c2 cgrams/day. c
D) cEnsure csaturated cfat cis cless cthan c30% cof ctotal ccaloric cintake. c- cCORRECT cANS✔✔B) cInc
cto c10 cto c25 cgrams cper cday. c
Rationale: cTo creduce crisk cfactors cassociated cwith ccoronary cheart cdisease, cthe cdaily cintake cof
cincreased cto cbetween c10 cand c25 cgm. cCholesterol cintake c(A) cshould cbe climited cto c180 cmg/da
cstanols cand csterols cis crecommended cat c2 cg/day c(C). cSaturated cfat c(D) cintake cshould cbe climi
ccalories.
A csplint cis cprescribed cfor cnighttime cuse cby ca cclient cwith crheumatoid carthritis. cWhich cstatemen
cmost caccurate cexplanation cfor cuse cof cthe csplints?
A) cPrevention cof cdeformities. c
B) cAvoidance cof cjoint ctrauma. c
C) cRelief cof cjoint cinflammation. c
D) cImprovement cin cjoint cstrength. c- cCORRECT cANS✔✔A) cPrevention cof cdeformities. c
Rationale: cSplints cmay cbe cused cat cnight cby cclients cwith crheumatoid carthritis cto cprevent cdeform
cspasms cand ccontractures. cSplints care cnot cused cfor c(B). c(C) cis cusually ctreated cwith cmedicatio
cas cnon-steroidal cantiinflammatory cdrugs c(NSAIDs). cFor c(D), ca cprescribed cexercise cprogram cis
A c32-year-old cfemale cclient ccomplains cof csevere cabdominal cpain ceach cmonth cbefore cher cmen
cintercourse, cand cpainful cdefecation. cWhich cadditional chistory cshould cthe cnurse cobtain cthat cis c
ccomplaints?
A) cFrequent curinary ctract cinfections.
B) cInability cto cget cpregnant. c
C) cPremenstrual csyndrome. c
D) cChronic cuse cof claxatives. c- cCORRECT cANS✔✔B) cInability cto cget cpregnant. c
Rationale: cDysmenorrhea, cdyspareunia, cand cdifficulty cor cpainful cdefecation care ccommon csymp
cis cthe cabnormal cdisplacement cof cendometrial ctissue cin cthe cdependent careas cof cthe cpelvic cpe
c(B) cis canother ccommon cfinding cassociated cwith cendometriosis. cAlthough c(A, cC, cand cD) care cc
, A) cPropanolol c(Inderal). c
B) cCaptopril c(Capoten). c
C) cFurosemide c(Lasix). c
D) cDobutamine c(Dobutrex). c- cCORRECT cANS✔✔A) cPropanolol c(Inderal).
Rationale: cInderal c(A) cis ca cbeta cadrenergic cblocking cagent, cwhich ccauses cdecreased cheart cra
cNeither c(B), can cACE cinhibitor, cnor c(C), ca cloop cdiuretic, ccauses cbradycardia. c(D) cis ca csympath
ccardiac cstimulant, cwhich cwould cincrease cthe cheart crate.
A cclient chas cbeen ctaking coral ccorticosteroids cfor cthe cpast cfive cdays cbecause cof cseasonal calle
cfinding cis cof cmost cconcern cto cthe cnurse?
A) cWhite cblood ccount cof c10,000 cmm3. c
B) cSerum cglucose cof c115 cmg/dl. c
C) cPurulent csputum. c
D) cExcessive chunger. c- cCORRECT cANS✔✔C) cPurulent csputum. c
Rationale: cSteroids ccause cimmunosuppression, cand ca cpurulent csputum c(C) cis can cindication cof
cof cgreatest cconcern. cOral csteroids cmay cincrease c(A) cand coften ccause c(D). c(B) cmay cremain cn
cwhile ctaking coral csteroids.
A cfemale cclient creceiving cIV cvasopressin c(Pitressin) cfor cesophageal cvarice crupture creports cto c
csubsternal ctightness cand cpressure cacross cher cchest. cWhich cPRN cprotocol cshould cthe cnurse c
A) cStart can cIV cnitroglycerin cinfusion.
B) cNasogastric clavage cwith ccool csaline. c
C) cIncrease cthe cvasopressin cinfusion. c
D) cPrepare cfor cendotracheal cintubation. c- cCORRECT cANS✔✔A) cStart can cIV cnitroglycerin cinfu
Rationale: cVasopressin cis cused cto cpromote cvasoconstriction, cthereby creducing cbleeding. cVasoc
carteries ccan clead cto cangina cand cmyocardial cinfarction, cand cshould cbe ccounteracted cby cIV cnit
cprotocol c(A). c(B) cwill cnot cresolve cthe ccardiac cproblem. c(C) cwill cworsen cthe cproblem. cEndotrac
cneeded cif crespiratory cdistress coccurs c(D).
A cclient cwith cgastroesophageal creflux cdisease c(GERD) chas cbeen cexperiencing csevere creflux cd
crecommendation cby cthe cnurse cis cmost ceffective cto cassist cthe cclient?
A) cLosing cweight. c
B) cDecreasing ccaffeine cintake. c
C) cAvoiding clarge cmeals. c
D) cRaising cthe chead cof cthe cbed con cblocks. c- cCORRECT cANS✔✔D) cRaising cthe chead cof cthe
Rationale: cRaising cthe chead cof cthe cbed con cblocks c(D) c(reverse cTrendelenburg cposition) cto cre
caspiration cis cthe cmost ceffective crecommendation cfor ca cclient cexperiencing csevere cgastroesoph
cB cand cC) cmay cbe ceffective crecommendations cbut craising cthe chead cof cthe cbed cis cmore ceffec
The cnurse cis ccaring cfor ca cclient cwith csyndrome cof cinappropriate cantidiuretic chormone c(SIADH)
cwhich csymptoms?
A) cLoss cof cthirst, cweight cgain. c
B) cDependent cedema, cfever. c
C) cPolydipsia, cpolyuria. c
D) cHypernatremia, ctachypnea. c- cCORRECT cANS✔✔A) cLoss cof cthirst, cweight cgain.
c
Rationale: cSIADH coccurs cwhen cthe cposterior cpituitary cgland creleases ctoo cmuch cADH, ccausing
coutput cof cless cthan c20 cml/hour, cand cdilutional chyponatremia. cOther cindications cof cSIADH care
QUESTIONS AND ANSWERS
An cER cnurse cis ccompleting can cassessment con ca cpatient cthat cis calert cbut cstruggles cto canswe
cattempts cto ctalk, cshe cslurs cher cspeech cand cappears cvery cfrightened. cWhat cadditional cclinical
cexpect cto cfind cif cnacy's csysmptoms chave cbeen ccaused cby ca cbrain cattack c(stroke)?
A. cA ccarotid cbruit
B. cA chypotensive cblood cpressure
C. chyperreflexic cdeep ctendon crelexes.
D. cDecreased cbowel csounds c- cCORRECT cANS✔✔A) cA ccarotid cbruit.
Rationale: cthe ccarotid cartery c(artery cto cthe cbrain) cis cnarrowed cin cclients cwith ca cbrain cattack. cA
cheard con causcultation cresulting cfrom cinterference cwith cnormal cblood cflow. cUsually cthe cblood c
cInitially cflaccid cparalysis coccurs, cresulting cin chyporefkexic cdeep ctendon creflexes. cBowel csound
cattack.
Which cclinical cmanifestation cfurther csupports can cassessment cof ca cleft-sided cbrain cattack?
A) cVisual cfield cdeficit con cthe cleft cside.
B) cSpatial-perceptual cdeficits.
C) cParesthesia cof cthe cleft cside.
D) cGlobal caphasia.
D) cGlobal caphasia. c- cCORRECT cANS✔✔D) cGlobal caphasia.
Rationale: cGlobal caphasia crefers cto cdifficulty cspeaking, clistening, cand cunderstanding, cas cwell ca
cwriting. cSymptoms cvary cfrom cperson cto cperson. cAphasia cmay coccur csecondary cto cany cbrain c
chemisphere. cVisual cfield cdeficits, cspatial-perceptual cdeficits, cand cparesthsia cof cthe cleft cside cus
cbrain cattack.
When cpreparing ca cpatient cfor ca cnoncontrast ccomputed ctomography c(CT) cscan cSTAT, cwhat cnu
cnurse cimplement?
A) cDetermine cif cthe cclient chas cany callergies cto ciodine
,The cmagnetic cfield cgenerated cby cthe cMRI cis cso cstrong cthat cmetal-containing citems care cstrong
cBecause cthe chip cjoint cis cmade cof cmetal, ca clead cshield cmust cbe cused cduring cthe cprocedure. c
callergy cto cshell cfish, cand ca chistory cof catrial cfibrillation cwould cnot caffect cthe cMRI.
A cclient's cdaughter cis csitting cby cher cmother's cbedside cwho cwas crecently ctransferred cto cthe cIn
cstates c"I cdon't cunderstand cwhat ca cbrain cattack cis. cThe chealthcare cprovider ctold cme cmy cmoth
cthey care cgoing cto crun cseveral ctests. cI cjust cdon't cknow cwhat cis cgoing con. cWhat chappened cto
cbest cresponse cby cthe cnurse?
A) c"I cam csorry, cbut caccording cto cthe cHealth cInsurance cPortability cand cAccounting cAct c(HIPAA
cinformation."
B) c"Your cmother chas chad ca cstroke, cand cthe cblood csupply cto cthe cbrain chas cbeen cblocked."
C) c"How cdo cyou cfeel cabout cwhat cthe chealthcare cprovider csaid?"
D) c"I cwill ccall cthe chealthcare cprovider cso che/she ccan ctalk cto cyou cabout cyour cmother's cserious
cANS✔✔B) c"Your cmother chas chad ca cstroke, cand cthe cblood csupply cto cthe cbrain chas cbeen cblo
Rationale: cThe cnurse ccan cdiscuss cwhat ca cdiagnosis cmeans. cNancy cis cunable cto cmake cdecisio
cdaughter, cGail, cneeds csufficient cinformation cto cmake cinformed cdecisions. cThe cnurse chas cthe c
cresponsibility, cto cexplain cNancy's ccondition cto cGail. cThe cnurse cshould cgive cfacts cfirst, cand cth
cthe cinformation cis cprovided.
What cis cthe cnormal crange cfor ccardiac coutput? c- cCORRECT cANS✔✔The cnormal crange cfor cca
ccerebral cblood cflow cand coxygen cdelivery cis c4 cto c8 cL/min.
A cclient cwas cadmitted cwith cthe cdiagnosis cof ca cbrain cattack. cTheir csymptoms cbegan c24 chours
cwould cthis cclient cnot cbe ca ccandidate cfor cfor cthrombolytic ctherapy? c- cCORRECT cANS✔✔Thro
ccontraindicated cin cclients cwith csymptom conset clonger cthan c3 chours cprior cto cadmission. cThis c
chours cbefore cbeing cbrought cto cthe cmedical ccenter
What care cplate cguards? c- cCORRECT cANS✔✔Plate cguards cprevent cfood cfrom cbeing cpushed c
cguards cand cother cassistive cdevices cwill cencourage cindependence cin ca cclient cwith ca cself-care
Which ccondition cis cconsidered ca cnon-modifiable crisk cfactor cfor ca cbrain cattack?
A) cHigh ccholesterol clevels.
B) cObesity.
C) cHistory cof catrial cfibrillation.
D) cAdvanced cage. c- cCORRECT cANS✔✔D) cAdvanced cage.
Rationale: cPeople cover cage c55 care ca chigh-risk cgroup cfor ca cbrain cattack cbecause cthe cincidenc
cdoubles cin ceach csuccessive cdecade cof clife. cNon-modifiable cmeans cthe cclient ccannot cdo canyth
cAll cthe cother coptions care cmodifiable crisk cfactors.
A cclient cis cexperiencing chomonymous chemianopsia cas cthe cresult cof ca cbrain cattack. cWhich cnu
cnurse cimplement cto caddress cthis ccondition?
A) cTurn cNancy cevery ctwo chours cand cperform cactive crange cof cmotion cexercises.
B) cPlace cthe cobjects cNancy cneeds cfor cactivities cof cdaily cliving con cthe cleft cside cof cthe ctable.
C) cSpeak cslowly cand cclearly cto cassist cNancy cin cforming csounds cto cwords.
D) cRequest cthat cthe cdietary cdepartment cthicken call cliquids con cNancy's cmeal cand csnack ctrays.
cPlace cthe cobjects cNancy cneeds cfor cactivities cof cdaily cliving con cthe cleft cside cof cthe ctable.
Rationale: cHomonymous chemianopsia cis closs cof cthe cvisual cfield con cthe csame cside cas cthe cpa
cthe cclient cneglecting cthat cside cof cthe cbody, cso cit cis cbeneficial cto cplace cobjects con cthat cside.
cbrain cattack cso cher cright cside cis cthe cweak cside. cSpeaking cslowly cand cclearly cwould caddress
,A cnew cnurse cgraduate cis ccaring cfor ca cpostoperative cclient cwith cthe cfollowing carterial cblood cga
c60 cmm cHg; cPO2, c80 cmm cHg; cbicarbonate, c24 cmEq/L; cand cO2 csaturation, c96%. cWhich cof cth
cgraduate cis cindicated?
A) cEncourage cthe cclient cto cuse cthe cincentive cspirometer cand cto ccough.
B) cAdminister coxygen cby cnasal ccannula.
C) cRequest ca cprescription cfor csodium cbicarbonate cfrom cthe chealth ccare cprovider.
D) cInform cthe ccharge cnurse cthat cno cchanges cin ctherapy care cneeded. c- cCORRECT cANS✔✔A)
cthe cincentive cspirometer cand cto ccough.
Rationale: cRespiratory cacidosis cis ccaused cby cCO2 cretention cand cimpaired cchest cexpansion cse
cnurse ctakes csteps cto cpromote cCO2 celimination, cincluding cmaintaining ca cpatent cairway cand cex
cbreathing ctechniques. cO2 cis cnot cindicated cbecause cPo2 cand coxygen csaturation care cwithin cthe
cbicarbonate cis cnot cindicated cbecause cthe cbicarbonate clevel cis cin cthe cnormal crange; cpromoting
cacids cis cthe cpriority cin crespiratory cacidosis. cPost canesthesia, cthe cclient cwill cneed cinterventions
cmay cprogress cto ca cstate cof csomnolence cand cunresponsiveness.
The cnurse cis cproviding cdietary cinstructions cto ca c68-year-old cclient cwho cis cat chigh crisk cfor cdev
cdisease c(CHD). cWhich cinformation cshould cthe cnurse cinclude?
A) cLimit cdietary cselection cof ccholesterol cto c300 cmg cper cday
B) cIncrease cintake cof csoluble cfiber cto c10 cto c25 cgrams cper cday. c
C) cDecrease cplant cstanols cand csterols cto cless cthan c2 cgrams/day. c
D) cEnsure csaturated cfat cis cless cthan c30% cof ctotal ccaloric cintake. c- cCORRECT cANS✔✔B) cInc
cto c10 cto c25 cgrams cper cday. c
Rationale: cTo creduce crisk cfactors cassociated cwith ccoronary cheart cdisease, cthe cdaily cintake cof
cincreased cto cbetween c10 cand c25 cgm. cCholesterol cintake c(A) cshould cbe climited cto c180 cmg/da
cstanols cand csterols cis crecommended cat c2 cg/day c(C). cSaturated cfat c(D) cintake cshould cbe climi
ccalories.
A csplint cis cprescribed cfor cnighttime cuse cby ca cclient cwith crheumatoid carthritis. cWhich cstatemen
cmost caccurate cexplanation cfor cuse cof cthe csplints?
A) cPrevention cof cdeformities. c
B) cAvoidance cof cjoint ctrauma. c
C) cRelief cof cjoint cinflammation. c
D) cImprovement cin cjoint cstrength. c- cCORRECT cANS✔✔A) cPrevention cof cdeformities. c
Rationale: cSplints cmay cbe cused cat cnight cby cclients cwith crheumatoid carthritis cto cprevent cdeform
cspasms cand ccontractures. cSplints care cnot cused cfor c(B). c(C) cis cusually ctreated cwith cmedicatio
cas cnon-steroidal cantiinflammatory cdrugs c(NSAIDs). cFor c(D), ca cprescribed cexercise cprogram cis
A c32-year-old cfemale cclient ccomplains cof csevere cabdominal cpain ceach cmonth cbefore cher cmen
cintercourse, cand cpainful cdefecation. cWhich cadditional chistory cshould cthe cnurse cobtain cthat cis c
ccomplaints?
A) cFrequent curinary ctract cinfections.
B) cInability cto cget cpregnant. c
C) cPremenstrual csyndrome. c
D) cChronic cuse cof claxatives. c- cCORRECT cANS✔✔B) cInability cto cget cpregnant. c
Rationale: cDysmenorrhea, cdyspareunia, cand cdifficulty cor cpainful cdefecation care ccommon csymp
cis cthe cabnormal cdisplacement cof cendometrial ctissue cin cthe cdependent careas cof cthe cpelvic cpe
c(B) cis canother ccommon cfinding cassociated cwith cendometriosis. cAlthough c(A, cC, cand cD) care cc
, A) cPropanolol c(Inderal). c
B) cCaptopril c(Capoten). c
C) cFurosemide c(Lasix). c
D) cDobutamine c(Dobutrex). c- cCORRECT cANS✔✔A) cPropanolol c(Inderal).
Rationale: cInderal c(A) cis ca cbeta cadrenergic cblocking cagent, cwhich ccauses cdecreased cheart cra
cNeither c(B), can cACE cinhibitor, cnor c(C), ca cloop cdiuretic, ccauses cbradycardia. c(D) cis ca csympath
ccardiac cstimulant, cwhich cwould cincrease cthe cheart crate.
A cclient chas cbeen ctaking coral ccorticosteroids cfor cthe cpast cfive cdays cbecause cof cseasonal calle
cfinding cis cof cmost cconcern cto cthe cnurse?
A) cWhite cblood ccount cof c10,000 cmm3. c
B) cSerum cglucose cof c115 cmg/dl. c
C) cPurulent csputum. c
D) cExcessive chunger. c- cCORRECT cANS✔✔C) cPurulent csputum. c
Rationale: cSteroids ccause cimmunosuppression, cand ca cpurulent csputum c(C) cis can cindication cof
cof cgreatest cconcern. cOral csteroids cmay cincrease c(A) cand coften ccause c(D). c(B) cmay cremain cn
cwhile ctaking coral csteroids.
A cfemale cclient creceiving cIV cvasopressin c(Pitressin) cfor cesophageal cvarice crupture creports cto c
csubsternal ctightness cand cpressure cacross cher cchest. cWhich cPRN cprotocol cshould cthe cnurse c
A) cStart can cIV cnitroglycerin cinfusion.
B) cNasogastric clavage cwith ccool csaline. c
C) cIncrease cthe cvasopressin cinfusion. c
D) cPrepare cfor cendotracheal cintubation. c- cCORRECT cANS✔✔A) cStart can cIV cnitroglycerin cinfu
Rationale: cVasopressin cis cused cto cpromote cvasoconstriction, cthereby creducing cbleeding. cVasoc
carteries ccan clead cto cangina cand cmyocardial cinfarction, cand cshould cbe ccounteracted cby cIV cnit
cprotocol c(A). c(B) cwill cnot cresolve cthe ccardiac cproblem. c(C) cwill cworsen cthe cproblem. cEndotrac
cneeded cif crespiratory cdistress coccurs c(D).
A cclient cwith cgastroesophageal creflux cdisease c(GERD) chas cbeen cexperiencing csevere creflux cd
crecommendation cby cthe cnurse cis cmost ceffective cto cassist cthe cclient?
A) cLosing cweight. c
B) cDecreasing ccaffeine cintake. c
C) cAvoiding clarge cmeals. c
D) cRaising cthe chead cof cthe cbed con cblocks. c- cCORRECT cANS✔✔D) cRaising cthe chead cof cthe
Rationale: cRaising cthe chead cof cthe cbed con cblocks c(D) c(reverse cTrendelenburg cposition) cto cre
caspiration cis cthe cmost ceffective crecommendation cfor ca cclient cexperiencing csevere cgastroesoph
cB cand cC) cmay cbe ceffective crecommendations cbut craising cthe chead cof cthe cbed cis cmore ceffec
The cnurse cis ccaring cfor ca cclient cwith csyndrome cof cinappropriate cantidiuretic chormone c(SIADH)
cwhich csymptoms?
A) cLoss cof cthirst, cweight cgain. c
B) cDependent cedema, cfever. c
C) cPolydipsia, cpolyuria. c
D) cHypernatremia, ctachypnea. c- cCORRECT cANS✔✔A) cLoss cof cthirst, cweight cgain.
c
Rationale: cSIADH coccurs cwhen cthe cposterior cpituitary cgland creleases ctoo cmuch cADH, ccausing
coutput cof cless cthan c20 cml/hour, cand cdilutional chyponatremia. cOther cindications cof cSIADH care
