Evolve: HESI Med Surg Practice Exam
475 with out rationals
A 20-year-old female client calls the nurse to report a lump she found in her breast. Which
response is the best for the nurse to provide? - ANS-B) Most lumps are benign, but it is
always best to come in for an examination.
\A 32-year-old female client complains of severe abdominal pain each month before her
menstrual period, painful intercourse, and painful defecation. Which additional history should
the nurse obtain that is consistent with the client's complaints? - ANS-B) Inability to get
pregnant.
\A 46-year-old female client is admitted for acute renal failure secondary to diabetes and
hypertension. Which test is the best indicator of adequate glomerular filtration? - ANS-A)
Serum creatinine.
\A 49-year-old female client arrives at the clinic for an annual exam and asks the nurse why
she becomes excessively diaphoretic and feels warm during nighttime. What is the nurse's
best response? - ANS-B) Discuss perimenopause and related comfort measures.
\A 51-year-old truck driver who smokes two packs of cigarettes a day and is 30 pounds
overweight is diagnosed with having a gastric ulcer. What content is most important for the
nurse to include in the discharge teaching for this client? - ANS-A) Information about
smoking cessation.
\A 57-year-old male client is scheduled to have a stress-thallium test the following morning
and is NPO after midnight. At 0130, he is agitated because he cannot eat and is demanding
food. Which response is best for the nurse to provide to this client? - ANS-D) The test you
are having tomorrow requires that you have nothing by mouth tonight.
\A 58-year-old client who has been post-menopausal for five years is concerned about the
risk for osteoporosis because her mother has the condition. Which information should the
nurse offer? - ANS-B) Calcium loss from bones can be slowed by increasing calcium intake
and exercise.
\A 58-year-old client, who has no health problems, asks the nurse about the Pneumovax
vaccine. The nurse's response to the client should be based on which information? - ANS-B)
The immunization is administered once to older adults or persons with a history of chronic
illness.
\A 67-year-old woman who lives alone is admitted after tripping on a rug in her home and
fractures her hip. Which predisposing factor probably led to the fracture in the proximal end
of her femur? - ANS-C) Osteoporosis resulting from hormonal changes.
\A 77-year-old female client is admitted to the hospital. She is confused, has no appetite, is
nauseated and vomiting, and is complaining of a headache. Her pulse rate is 43 beats per
minute. Which question is a priority for the nurse to ask this client or her family on
admission? "Does the client - ANS-D) take digitalis?"
\A client experiencing uncontrolled atrial fibrillation is admitted to the telemetry unit. What
initial medication should the nurse anticipate administering to the client? - ANS-D) Digoxin
(Lanoxin).
, \A client has a staging procedure for cancer of the breast and ask the nurse which type of
breast cancer has the poorest prognosis. Which information should the nurse offer the
client? - ANS-D) Inflammatory with peau d'orange.
\A client has been taking oral corticosteroids for the past five days because of seasonal
allergies. Which assessment finding is of most concern to the nurse? - ANS-C) Purulent
sputum.
\A client has taken steroids for 12 years to help manage chronic obstructive pulmonary
disease (COPD). When making a home visit, which nursing function is of greatest
importance to this client? Assess the client's - ANS-C) temperature.
\A client has undergone insertion of a permanent pacemaker. When developing a discharge
teaching plan, the nurse writes a goal of, "The client will verbalize symptoms of pacemaker
failure." Which symptoms are most important to teach the client? - ANS-D) Feelings of
dizziness.
\A client is admitted for further testing to confirm sarcoidosis. Which diagnostic test provides
definitive information that the nurse should report to the healthcare provider? - ANS-A) Lung
tissue biopsy.
\A client is admitted to the hospital with a diagnosis of severe acute diverticulitis. Which
assessment finding should the nurse expect this client to exhibit? - ANS-A) Lower left
quadrant pain and a low-grade fever.
\A client is admitted to the hospital with a medical diagnosis of pneumococcal pneumonia.
The nurse knows that the prognosis for gram-negative pneumonias (such as E. coli,
Klebsiella, Pseudomonas, and Proteus) is very poor because - ANS-B) gram-negative
organisms are more resistant to antibiotic therapy.
\A client is admitted to the medical intensive care unit with a diagnosis of myocardial
infarction. The client's history indicates the infarction occurred ten hours ago. Which
laboratory test result should the nurse expect this client to exhibit? - ANS-C) Elevated
CK-MB.
\A client is brought to the Emergency Center after a snow-skiing accident. Which intervention
is most important for the nurse to implement? - ANS-A) Review the electrocardiogram
tracing.
\A client is placed on a respirator following a cerebral hemorrhage, and vecuronium bromide
(Norcuron) 0.04 mg/kg q12h IV is prescribed. Which nursing diagnosis is the priority for this
client? - ANS-A) Impaired communication related to paralysis of skeletal muscles.
\A client receiving cholestyramine (Questran) for hyperlipidemia should be evaluated for
what vitamin deficiency? - ANS-A) K.
\A client reports unprotected sexual intercourse one week ago and is worried about HIV
exposure. An initial HIV antibody screen (ELISA) is obtained. The nurse teaches the client
that seroconversion to HIV positive relies on antibody production by B lymphocytes after
exposure to the virus. When should the nurse recommend the client return for repeat blood
testing? - ANS-D) 6 to 12 weeks.
\A client taking a thiazide diuretic for the past six months has a serum potassium level of 3.
The nurse anticipates which change in prescription for the client? - ANS-C) A potassium
supplement will be prescribed.
\A client taking furosemide (Lasix), reports difficulty sleeping. What question is important for
the nurse to ask the client? - ANS-D) At what time do you take your medication?
\A client who has heart failure is admitted with a serum potassium level of 2.9 mEq/L. Which
action is most important for the nurse to implement? - ANS-B) Initiate continuous cardiac
monitoring.
475 with out rationals
A 20-year-old female client calls the nurse to report a lump she found in her breast. Which
response is the best for the nurse to provide? - ANS-B) Most lumps are benign, but it is
always best to come in for an examination.
\A 32-year-old female client complains of severe abdominal pain each month before her
menstrual period, painful intercourse, and painful defecation. Which additional history should
the nurse obtain that is consistent with the client's complaints? - ANS-B) Inability to get
pregnant.
\A 46-year-old female client is admitted for acute renal failure secondary to diabetes and
hypertension. Which test is the best indicator of adequate glomerular filtration? - ANS-A)
Serum creatinine.
\A 49-year-old female client arrives at the clinic for an annual exam and asks the nurse why
she becomes excessively diaphoretic and feels warm during nighttime. What is the nurse's
best response? - ANS-B) Discuss perimenopause and related comfort measures.
\A 51-year-old truck driver who smokes two packs of cigarettes a day and is 30 pounds
overweight is diagnosed with having a gastric ulcer. What content is most important for the
nurse to include in the discharge teaching for this client? - ANS-A) Information about
smoking cessation.
\A 57-year-old male client is scheduled to have a stress-thallium test the following morning
and is NPO after midnight. At 0130, he is agitated because he cannot eat and is demanding
food. Which response is best for the nurse to provide to this client? - ANS-D) The test you
are having tomorrow requires that you have nothing by mouth tonight.
\A 58-year-old client who has been post-menopausal for five years is concerned about the
risk for osteoporosis because her mother has the condition. Which information should the
nurse offer? - ANS-B) Calcium loss from bones can be slowed by increasing calcium intake
and exercise.
\A 58-year-old client, who has no health problems, asks the nurse about the Pneumovax
vaccine. The nurse's response to the client should be based on which information? - ANS-B)
The immunization is administered once to older adults or persons with a history of chronic
illness.
\A 67-year-old woman who lives alone is admitted after tripping on a rug in her home and
fractures her hip. Which predisposing factor probably led to the fracture in the proximal end
of her femur? - ANS-C) Osteoporosis resulting from hormonal changes.
\A 77-year-old female client is admitted to the hospital. She is confused, has no appetite, is
nauseated and vomiting, and is complaining of a headache. Her pulse rate is 43 beats per
minute. Which question is a priority for the nurse to ask this client or her family on
admission? "Does the client - ANS-D) take digitalis?"
\A client experiencing uncontrolled atrial fibrillation is admitted to the telemetry unit. What
initial medication should the nurse anticipate administering to the client? - ANS-D) Digoxin
(Lanoxin).
, \A client has a staging procedure for cancer of the breast and ask the nurse which type of
breast cancer has the poorest prognosis. Which information should the nurse offer the
client? - ANS-D) Inflammatory with peau d'orange.
\A client has been taking oral corticosteroids for the past five days because of seasonal
allergies. Which assessment finding is of most concern to the nurse? - ANS-C) Purulent
sputum.
\A client has taken steroids for 12 years to help manage chronic obstructive pulmonary
disease (COPD). When making a home visit, which nursing function is of greatest
importance to this client? Assess the client's - ANS-C) temperature.
\A client has undergone insertion of a permanent pacemaker. When developing a discharge
teaching plan, the nurse writes a goal of, "The client will verbalize symptoms of pacemaker
failure." Which symptoms are most important to teach the client? - ANS-D) Feelings of
dizziness.
\A client is admitted for further testing to confirm sarcoidosis. Which diagnostic test provides
definitive information that the nurse should report to the healthcare provider? - ANS-A) Lung
tissue biopsy.
\A client is admitted to the hospital with a diagnosis of severe acute diverticulitis. Which
assessment finding should the nurse expect this client to exhibit? - ANS-A) Lower left
quadrant pain and a low-grade fever.
\A client is admitted to the hospital with a medical diagnosis of pneumococcal pneumonia.
The nurse knows that the prognosis for gram-negative pneumonias (such as E. coli,
Klebsiella, Pseudomonas, and Proteus) is very poor because - ANS-B) gram-negative
organisms are more resistant to antibiotic therapy.
\A client is admitted to the medical intensive care unit with a diagnosis of myocardial
infarction. The client's history indicates the infarction occurred ten hours ago. Which
laboratory test result should the nurse expect this client to exhibit? - ANS-C) Elevated
CK-MB.
\A client is brought to the Emergency Center after a snow-skiing accident. Which intervention
is most important for the nurse to implement? - ANS-A) Review the electrocardiogram
tracing.
\A client is placed on a respirator following a cerebral hemorrhage, and vecuronium bromide
(Norcuron) 0.04 mg/kg q12h IV is prescribed. Which nursing diagnosis is the priority for this
client? - ANS-A) Impaired communication related to paralysis of skeletal muscles.
\A client receiving cholestyramine (Questran) for hyperlipidemia should be evaluated for
what vitamin deficiency? - ANS-A) K.
\A client reports unprotected sexual intercourse one week ago and is worried about HIV
exposure. An initial HIV antibody screen (ELISA) is obtained. The nurse teaches the client
that seroconversion to HIV positive relies on antibody production by B lymphocytes after
exposure to the virus. When should the nurse recommend the client return for repeat blood
testing? - ANS-D) 6 to 12 weeks.
\A client taking a thiazide diuretic for the past six months has a serum potassium level of 3.
The nurse anticipates which change in prescription for the client? - ANS-C) A potassium
supplement will be prescribed.
\A client taking furosemide (Lasix), reports difficulty sleeping. What question is important for
the nurse to ask the client? - ANS-D) At what time do you take your medication?
\A client who has heart failure is admitted with a serum potassium level of 2.9 mEq/L. Which
action is most important for the nurse to implement? - ANS-B) Initiate continuous cardiac
monitoring.
