Medical-Surgical HESI Practice Test questions and answers well illustrated.

Medical-Surgical HESI Practice Test questions and answers well illustrated. 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 would the nurse expect this client to exhibit? A. Elevated LDH B. Elevated serum amylase C. Elevated CK-MB D. Elevated hematocrit - correct answers.C. Elevated CK-MB Rationale: The cardiac isoenzyme CK-MB (C) is the one of the cardiac markers to indicate myocardial damage in the presence of MI symptoms and after a positive troponin. The troponin levels will elevate within 2-3 hours indicating myocardial ischemia, followed by the CK-MB cardiac markers within 6-9 hours, peaking within 12 to 20 hours after myocardial infarction (MI). 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? A. Stage II B. Invasive infiltrating ductal carcinoma C. T1N0M0 D. Inflammatory with peau d'orange - correct answers.D. Inflammatory with peau d'orange Rationale: Inflammatory breast cancer onset is very rapid and a very rare form of breast cancer and is considered the most aggressive form of breast malignancies. It is often mistaken for a breast infection because it has a thickened appearance like an orange peel (peau d'orange), causing the breast to become swollen and tender. A middle-aged male client with diabetes continues to eat an abundance of foods that are high in sugar and fat. According to the Health Belief Model, which event is most likely to increase the client's willingness to become compliant with the prescribed diet? A. He visits his diabetic brother who just had surgery to amputate an infected foot B. He is provided with the most current information about the dangers of untreated diabetes C. He comments on the community service announcements about preventing complications associated with diabetes D. His wife expresses a sincere willingness to prepare meals that are within his prescribed diet - correct answers.A. He visits his diabetic brother who just had surgery to amputate an infected foot Rationale: The loss of a limb due to diabetes by a family member should be the strongest event or "cue to action" and is most likely to increase the client's perceived seriousness of the disease. 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? A. Lung tissue biopsy B. Positive blood cultures C. Magnetic resonance imaging (MRI) D. Computerized tomography (CT) of the thorax - correct answers.A. Lung tissue biopsy Rationale: Sarcoidosis is an inflammatory condition that is characterized by the formation of widespread granulomatous lesions involving a pulmonary primary site. Although chest radiography identifies sarcoidosis, lung tissue biopsy obtained by bronchoscopy or bronchoalveolar lavage provides definitive confirmation. A client with a completed ischemic stroke has a blood pressure of 180/90 mm Hg. Which action should the nurse implement? A. Position the head of the bed (HOB) flat B. Withhold intravenous fluids C. Administer a bolus of IV fluids D. Give an antihypertensive medication - correct answers.D. Give an antihypertensive medication Rationale: Most ischemic strokes occur during sleep when baseline blood pressure declines or blood viscosity increases due to minimal fluid intake. Completed strokes usually produce neurologic deficits within an hour, and the client's current elevated blood pressure requires antihypertensive medication. An elderly client is admitted with a diagnosis of bacterial pneumonia. The nurse's assessment of the client will most likely reveal which sign/symptom? A. Leukocytosis and febrile B. Polycythemia and crackles C. Pharyngitis and sputum production D. Confusion and tachycardia - correct answers.D. Confusion and tachycardia Rationale: The onset of pneumonia in the elderly may be signaled by general deterioration, confusion, increased heart rate or increased respiratory rate due to the decreased oxygen- carbon dioxide exchange at the alveoli, known as the V-Q mismatch. The nurse is working with a 71-year-old obese client with bilateral osteoarthritis (OA) of the hips. What recommendation should the nurse make that is most beneficial in protecting the client's joints? A. Increase the amount of calcium intake in the diet B. Apply alternating heat and cold therapies C. Initiate a weight-reduction diet to achieve a healthy body weight D. Use a walker for ambulation to lessen weight-bearing on the hips - correct answers.C. Initiate a weight-reduction diet to achieve a healthy body weight Rationale: Achieving a healthy weight is critical to protect the joints of clients with OA. Weight loss for obese clients will take off the excess pressure that weight bearing joints such as the hips and knees are exposed to and reduce the wear and tear of the joints. Which intervention should the nurse implement for a female client diagnosed with pelvic relaxation disorder? A. Describe proper administration of vaginal suppositories and cream B. Encourage the client to perform Kegel exercises 10 times daily C. Explain the importance of using condoms when having sexual intercourse D. Discuss the importance of keeping a diary of daily temperature and menstrual cycle events - correct answers.B. Encourage the client to perform Kegel exercises 10 times daily Rationale: Pelvic relaxation disorders are structural disorders resulting from weakening support tissues of the pelvis. Kegel exercises helps strengthen the surrounding muscles. The nurse is interviewing a male client with hypertension. Which additional medical diagnosis in the client's history presents the greatest risk for developing a cerebral vascular accident (CVA)? A. Diabetes mellitus B. Hypothyroidism C. Parkinson's disease D. Recurring pneumonia - correct answers.A. Diabetes mellitus Rationale: According to the National Stroke Association (2013), history of diabetes mellitus poses the greatest risk for developing a CVA, 2-4Xs more than those who do not have diabetes mellitus. The reason for this occurrence is related to the excess glucose circulating throughout the body not being utilizing by the cells of the body, leading to the increased fatty deposits or clots inside the blood vessels in the brain or neck, eventually causing a stroke. An adult client is admitted to the hospital burn unit with partial-thickness and full-thickness burns over 40% of the body surface area. In assessing the potential for skin regeneration, what should the nurse remember about full-thickness burns? A. Regenerative function of the skin is absent because the dermal layer has been destroyed B. Tissue regeneration will begin several days following return of normal circulation C. Debridement of eschar will delay the body's ability to regenerate normal tissue D. Normal tissue formation will be preceded by scar formation for the first year - correct answers.A. Regenerative function of the skin is absent because the dermal layer has been destroyed Rationale: Full-thickness burns destroy the entire dermal layer. Included in this destruction is the regenerative tissue. For this reason, tissue regeneration does not occur, and skin grafting is necessary. The nurse is assessing a client who smokes cigarettes and has been diagnosed with emphysema. Which finding would the nurse expect this client to exhibit? A. A decreased total lung capacity