Med Surg HESI Practice Questions
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?
A) The vaccine is given annually before the flu season to those over 50 years of age.
B) The immunization is administered once to older adults or persons with a history of chronic
illness.
C) The vaccine is for all ages and is given primarily to those persons traveling overseas to
areas of infection.
D) The vaccine will prevent the occurrence of pneumococcal pneumonia for up to five years.
- ANS-B) The immunization is administered once to older adults or persons with a history of
chronic illness.
It is usually recommended that persons over 65 years of age and those with a history of
chronic illness receive the vaccine once in a lifetime (B). (Some resources recommend
obtaining the vaccine at 50 years of age.) The influenza vaccine is given once a year, not the
Pneumovax (A). Although the vaccine might be given to a person traveling overseas, that is
not the main rationale for administering the vaccine (C). It is usually given once in a lifetime
(D), but with immunosuppressed clients or clients with a history of pneumonia re-vaccination
is sometimes required.
\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
A) have her own teeth or dentures?"
B) take aspirin and if so, how much?"
C) take nitroglycerin?"
D) take digitalis?" - ANS-D) take digitalis?"
Elderly persons are particularly susceptible to digitalis intoxication (D) which manifests itself
in such symptoms as anorexia, nausea, vomiting, diarrhea, headache, and fatigue. Although
it is important to obtain a complete medication history (B and C), the symptoms described
are classic for digitalis toxicity, and assessment of this problem should be made promptly. (A)
is irrelevant.
\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
A) pulse rate, both apically and radially.
B) blood pressure, both standing and sitting.
C) temperature.
D) skin color and turgor. - ANS-C) temperature.
It is very important to check the client's temperature (C). Infection is the most common factor
precipitating respiratory distress. Clients with COPD who are on maintenance doses of
corticosteroids are particularly predisposed to infection. (A and B) are important data for
, baseline and ongoing assessment, but they are not as important as temperature
measurement for this client who is taking steroids. Assessment of skin color and turgor is
less important (D).
\A client taking furosemide (Lasix), reports difficulty sleeping. What question is important for
the nurse to ask the client?
A) What dose of medication are you taking?
B) Are you eating foods rich in potassium?
C) Have you lost weight recently?
D) At what time do you take your medication? - ANS-D) At what time do you take your
medication?
The nurse needs to first determine at what time of day the client takes the Lasix (D).
Because of the diuretic effect of Lasix, clients should take the medication in the morning to
prevent nocturia. The actual dose of medication (A) is of less importance than the time
taken. (B) is not related to the insomnia. (C) is valuable information about the effect of the
diuretic, but is not likely to be related to insomnia.
\A client with heart disease is on a continuous telemetry monitor and has developed sinus
bradycardia. In determining the possible cause of the bradycardia, the nurse assesses the
client's medication record. Which medication is most likely the cause of the bradycardia?
A) Propanolol (Inderal).
B) Captopril (Capoten).
C) Furosemide (Lasix).
D) Dobutamine (Dobutrex). - ANS-A) Propanolol (Inderal).
Inderal (A) is a beta adrenergic blocking agent, which causes decreased heart rate and
decreased contractility. Neither (B), an ACE inhibitor, nor (C), a loop diuretic, causes
bradycardia. (D) is a sympathomimetic, direct acting cardiac stimulant, which would increase
the heart rate.
\A client with multiple sclerosis has experienced an exacerbation of symptoms, including
paresthesias, diplopia, and nystagmus. Which instruction should the nurse provide?
A) Stay out of direct sunlight.
B) Restrict intake of high protein foods.
C) Schedule extra rest periods.
D) Go to the emergency room immediately. - ANS-C) Schedule extra rest periods.
Exacerbations of the symptoms of MS occur most commonly as the result of fatigue and
stress. Extra rest periods should be scheduled (C) to reduce the symptoms. (A, B, and D)
are not necessary.
\An 81-year-old male client has emphysema. He lives at home with his cat and manages
self-care with no difficulty. When making a home visit, the nurse notices that his tongue is
somewhat cracked and his eyeballs are sunken into his head. What nursing intervention is
indicated?
A) Help the client to determine ways to increase his fluid intake.
B) Obtain an appointment for the client to see an ear, nose, and throat specialist.
C) Schedule an appointment with an allergist to determine if the client is allergic to the cat.
D) Encourage the client to slightly increase his use of oxygen at night and to always use
humidified oxygen. - ANS-A) Help the client to determine ways to increase his fluid intake.
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?
A) The vaccine is given annually before the flu season to those over 50 years of age.
B) The immunization is administered once to older adults or persons with a history of chronic
illness.
C) The vaccine is for all ages and is given primarily to those persons traveling overseas to
areas of infection.
D) The vaccine will prevent the occurrence of pneumococcal pneumonia for up to five years.
- ANS-B) The immunization is administered once to older adults or persons with a history of
chronic illness.
It is usually recommended that persons over 65 years of age and those with a history of
chronic illness receive the vaccine once in a lifetime (B). (Some resources recommend
obtaining the vaccine at 50 years of age.) The influenza vaccine is given once a year, not the
Pneumovax (A). Although the vaccine might be given to a person traveling overseas, that is
not the main rationale for administering the vaccine (C). It is usually given once in a lifetime
(D), but with immunosuppressed clients or clients with a history of pneumonia re-vaccination
is sometimes required.
\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
A) have her own teeth or dentures?"
B) take aspirin and if so, how much?"
C) take nitroglycerin?"
D) take digitalis?" - ANS-D) take digitalis?"
Elderly persons are particularly susceptible to digitalis intoxication (D) which manifests itself
in such symptoms as anorexia, nausea, vomiting, diarrhea, headache, and fatigue. Although
it is important to obtain a complete medication history (B and C), the symptoms described
are classic for digitalis toxicity, and assessment of this problem should be made promptly. (A)
is irrelevant.
\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
A) pulse rate, both apically and radially.
B) blood pressure, both standing and sitting.
C) temperature.
D) skin color and turgor. - ANS-C) temperature.
It is very important to check the client's temperature (C). Infection is the most common factor
precipitating respiratory distress. Clients with COPD who are on maintenance doses of
corticosteroids are particularly predisposed to infection. (A and B) are important data for
, baseline and ongoing assessment, but they are not as important as temperature
measurement for this client who is taking steroids. Assessment of skin color and turgor is
less important (D).
\A client taking furosemide (Lasix), reports difficulty sleeping. What question is important for
the nurse to ask the client?
A) What dose of medication are you taking?
B) Are you eating foods rich in potassium?
C) Have you lost weight recently?
D) At what time do you take your medication? - ANS-D) At what time do you take your
medication?
The nurse needs to first determine at what time of day the client takes the Lasix (D).
Because of the diuretic effect of Lasix, clients should take the medication in the morning to
prevent nocturia. The actual dose of medication (A) is of less importance than the time
taken. (B) is not related to the insomnia. (C) is valuable information about the effect of the
diuretic, but is not likely to be related to insomnia.
\A client with heart disease is on a continuous telemetry monitor and has developed sinus
bradycardia. In determining the possible cause of the bradycardia, the nurse assesses the
client's medication record. Which medication is most likely the cause of the bradycardia?
A) Propanolol (Inderal).
B) Captopril (Capoten).
C) Furosemide (Lasix).
D) Dobutamine (Dobutrex). - ANS-A) Propanolol (Inderal).
Inderal (A) is a beta adrenergic blocking agent, which causes decreased heart rate and
decreased contractility. Neither (B), an ACE inhibitor, nor (C), a loop diuretic, causes
bradycardia. (D) is a sympathomimetic, direct acting cardiac stimulant, which would increase
the heart rate.
\A client with multiple sclerosis has experienced an exacerbation of symptoms, including
paresthesias, diplopia, and nystagmus. Which instruction should the nurse provide?
A) Stay out of direct sunlight.
B) Restrict intake of high protein foods.
C) Schedule extra rest periods.
D) Go to the emergency room immediately. - ANS-C) Schedule extra rest periods.
Exacerbations of the symptoms of MS occur most commonly as the result of fatigue and
stress. Extra rest periods should be scheduled (C) to reduce the symptoms. (A, B, and D)
are not necessary.
\An 81-year-old male client has emphysema. He lives at home with his cat and manages
self-care with no difficulty. When making a home visit, the nurse notices that his tongue is
somewhat cracked and his eyeballs are sunken into his head. What nursing intervention is
indicated?
A) Help the client to determine ways to increase his fluid intake.
B) Obtain an appointment for the client to see an ear, nose, and throat specialist.
C) Schedule an appointment with an allergist to determine if the client is allergic to the cat.
D) Encourage the client to slightly increase his use of oxygen at night and to always use
humidified oxygen. - ANS-A) Help the client to determine ways to increase his fluid intake.
