,HESI Med-Surg BSN 266 Study Guide |
Complete Q&A Bank with Detailed
Rationales | Guaranteed Pass
1. A patient with chronic heart failure is prescribed carvedilol. Which
assessment finding indicates the medication is having a therapeutic effect?
a) Heart rate of 110 bpm
b) Blood pressure of 150/90 mmHg
c) Decreased shortness of breath and stable weight
d) Increased jugular venous distention
Answer: c) Decreased shortness of breath and stable weight
Rationale: Carvedilol is a beta-blocker that reduces cardiac workload and improves
symptoms; stable weight and decreased dyspnea indicate effective management.
2. A client with suspected pulmonary embolism reports sudden chest pain and
dyspnea. Which diagnostic test is most definitive?
a) Chest x-ray
b) D-dimer
c) CT pulmonary angiography
d) Arterial blood gas
Answer: c) CT pulmonary angiography
Rationale: CT pulmonary angiography is the gold standard for diagnosing pulmonary
embolism.
3. A patient with type 1 diabetes is found unconscious. The nurse should
immediately administer:
a) Orange juice orally
b) Glucagon subcutaneously or IV glucose
c) Insulin IV
d) Normal saline IV
Answer: b) Glucagon subcutaneously or IV glucose
Rationale: If the patient is unconscious, oral glucose is contraindicated; glucagon or IV
glucose is given to treat severe hypoglycemia.
,4. A client with cirrhosis is prescribed lactulose. Which finding indicates the
medication is effective?
a) Decreased serum ammonia
b) Increased serum bilirubin
c) Decreased serum albumin
d) Increased serum AST
Answer: a) Decreased serum ammonia
Rationale: Lactulose acidifies the colon, converting ammonia to ammonium and
promoting its excretion.
5. A patient with a new colostomy has a stoma that is dusky and dry. What is
the nurse's priority action?
a) Apply a moisturizer to the stoma
b) Notify the healthcare provider immediately
c) Change the ostomy appliance
d) Document the finding as normal
Answer: b) Notify the healthcare provider immediately
Rationale: A dusky, dry stoma indicates ischemia or necrosis, requiring immediate
surgical evaluation.
6. A client receiving a blood transfusion develops chills, back pain, and
hypotension. What is the priority action?
a) Slow the transfusion rate
b) Stop the transfusion and infuse normal saline
c) Administer diphenhydramine
d) Increase the transfusion rate to finish quickly
Answer: b) Stop the transfusion and infuse normal saline
Rationale: These are signs of a hemolytic transfusion reaction; the transfusion must be
stopped immediately.
7. A patient with acute pancreatitis is experiencing severe abdominal pain.
Which position best reduces the pain?
a) Supine with legs extended
b) Side-lying with knees flexed
c) Prone
, d) High Fowler's position
Answer: b) Side-lying with knees flexed
Rationale: The fetal position decreases tension on the pancreas and abdominal
muscles, reducing pain.
8. A client with chronic kidney disease has a potassium level of 6.8 mEq/L.
Which intervention does the nurse anticipate?
a) Oral potassium supplements
b) Hemodialysis
c) Fluid restriction
d) High-potassium diet
Answer: b) Hemodialysis
Rationale: A potassium level > 6.5 mEq/L is a medical emergency requiring
hemodialysis to rapidly remove potassium.
9. A patient with COPD is receiving oxygen at 3 L/min via nasal cannula. Which
finding indicates the patient is developing CO2 narcosis?
a) Increased respiratory rate
b) Decreased level of consciousness
c) Productive cough
d) Cyanosis
Answer: b) Decreased level of consciousness
Rationale: High-flow oxygen can suppress the hypoxic drive in chronic CO2 retainers,
leading to CO2 narcosis and decreased LOC.
10. A client with heart failure reports a weight gain of 4 pounds in 2 days. What
is the nurse's best action?
a) Encourage the client to exercise more
b) Restrict fluids to 500 mL/day
c) Notify the healthcare provider
d) Administer a PRN dose of furosemide
Answer: c) Notify the healthcare provider
Rationale: Rapid weight gain indicates fluid retention and worsening heart failure; the
provider should be notified for possible medication adjustment.
Complete Q&A Bank with Detailed
Rationales | Guaranteed Pass
1. A patient with chronic heart failure is prescribed carvedilol. Which
assessment finding indicates the medication is having a therapeutic effect?
a) Heart rate of 110 bpm
b) Blood pressure of 150/90 mmHg
c) Decreased shortness of breath and stable weight
d) Increased jugular venous distention
Answer: c) Decreased shortness of breath and stable weight
Rationale: Carvedilol is a beta-blocker that reduces cardiac workload and improves
symptoms; stable weight and decreased dyspnea indicate effective management.
2. A client with suspected pulmonary embolism reports sudden chest pain and
dyspnea. Which diagnostic test is most definitive?
a) Chest x-ray
b) D-dimer
c) CT pulmonary angiography
d) Arterial blood gas
Answer: c) CT pulmonary angiography
Rationale: CT pulmonary angiography is the gold standard for diagnosing pulmonary
embolism.
3. A patient with type 1 diabetes is found unconscious. The nurse should
immediately administer:
a) Orange juice orally
b) Glucagon subcutaneously or IV glucose
c) Insulin IV
d) Normal saline IV
Answer: b) Glucagon subcutaneously or IV glucose
Rationale: If the patient is unconscious, oral glucose is contraindicated; glucagon or IV
glucose is given to treat severe hypoglycemia.
,4. A client with cirrhosis is prescribed lactulose. Which finding indicates the
medication is effective?
a) Decreased serum ammonia
b) Increased serum bilirubin
c) Decreased serum albumin
d) Increased serum AST
Answer: a) Decreased serum ammonia
Rationale: Lactulose acidifies the colon, converting ammonia to ammonium and
promoting its excretion.
5. A patient with a new colostomy has a stoma that is dusky and dry. What is
the nurse's priority action?
a) Apply a moisturizer to the stoma
b) Notify the healthcare provider immediately
c) Change the ostomy appliance
d) Document the finding as normal
Answer: b) Notify the healthcare provider immediately
Rationale: A dusky, dry stoma indicates ischemia or necrosis, requiring immediate
surgical evaluation.
6. A client receiving a blood transfusion develops chills, back pain, and
hypotension. What is the priority action?
a) Slow the transfusion rate
b) Stop the transfusion and infuse normal saline
c) Administer diphenhydramine
d) Increase the transfusion rate to finish quickly
Answer: b) Stop the transfusion and infuse normal saline
Rationale: These are signs of a hemolytic transfusion reaction; the transfusion must be
stopped immediately.
7. A patient with acute pancreatitis is experiencing severe abdominal pain.
Which position best reduces the pain?
a) Supine with legs extended
b) Side-lying with knees flexed
c) Prone
, d) High Fowler's position
Answer: b) Side-lying with knees flexed
Rationale: The fetal position decreases tension on the pancreas and abdominal
muscles, reducing pain.
8. A client with chronic kidney disease has a potassium level of 6.8 mEq/L.
Which intervention does the nurse anticipate?
a) Oral potassium supplements
b) Hemodialysis
c) Fluid restriction
d) High-potassium diet
Answer: b) Hemodialysis
Rationale: A potassium level > 6.5 mEq/L is a medical emergency requiring
hemodialysis to rapidly remove potassium.
9. A patient with COPD is receiving oxygen at 3 L/min via nasal cannula. Which
finding indicates the patient is developing CO2 narcosis?
a) Increased respiratory rate
b) Decreased level of consciousness
c) Productive cough
d) Cyanosis
Answer: b) Decreased level of consciousness
Rationale: High-flow oxygen can suppress the hypoxic drive in chronic CO2 retainers,
leading to CO2 narcosis and decreased LOC.
10. A client with heart failure reports a weight gain of 4 pounds in 2 days. What
is the nurse's best action?
a) Encourage the client to exercise more
b) Restrict fluids to 500 mL/day
c) Notify the healthcare provider
d) Administer a PRN dose of furosemide
Answer: c) Notify the healthcare provider
Rationale: Rapid weight gain indicates fluid retention and worsening heart failure; the
provider should be notified for possible medication adjustment.
