MED-SURG HESI PN QUESTION WITH
COMPLETE SOLUTIONS
During a clinic visit, a client reports to the practical nurse (PN) that they felt a solid
w w w w w w w w w w w w w w w w
mass in their breast during self-examination, but it was not painful. What instruction
w w w w w w w w w w w w w
should the PN reinforce with the client?
w w w w w w w
A. Continue to monitor the mass until the next scheduled annual exam.
w w w w w w w w w w w
B. Notify the PCP if the mass becomes soft or painful or starts to drain.
w w w w w w w w w w w w w w
C. Schedule an appointment with the PCP for evaluation
w w w w w w w w
D. Breast masses are usually insignificant if they feel soft or are easily moveable. -
w w w w w w w w w w w w w w
Answer c. Schedule an appointment with the health care provider for evaluation.
w w w w w w w w w w w w
A painless breast mass is an abnormal finding, and the PN should instruct the client to
w w w w w w w w w w w w w w w
obtain prompt medical evaluation.
w w w w
The health care provider informed a client diagnosed with stage 4 liver cancer that the
w w w w w w w w w w w w w w
cancer has spread to their spine. The client states to the practical nurse, "I have a
w w w w w w w w w w w w w w w w
cancer, but it is not malignant." What is the best initial nursing action?
w w w w w w w w w w w w w
A. Encourage the client to attend a cancer education program
w w w w w w w w w
B. Perform a complete history and physical assessment
w w w w w w w
C. Ask the client to explain his understanding of the term malignancy.
w w w w w w w w w w w
D. Offer the client emotional support to deal with the diagnosis
w w w w w w w w w w
Submit - Answer c. Ask the client to explain his understanding of the term malignancy.
w w w w w w w w w w w w w w
The best initial action is to assess the client's knowledge of the term malignancy when
w w w w w w w w w w w w w w
used to describe cancer. The client appears to have inaccurate knowledge. Stage 4
w w w w w w w w w w w w w
cancer means the cancer has spread (metastasized) from where it has started to
w w w w w w w w w w w w w
another body part.
w w w
A client diagnosed with osteoarthritis. Which intervention should the practical nurse
w w w w w w w w w w
implement to help relieve joint pain and stiffness?
w w w w w w w w
a. Encourage the client to perform weight-bearing exercises.
w w w w w w w
b. Teach the client how to perform range-of-motion exercises.
w w w w w w w w
c. Explain the use of ice and massage for pain relief.
w w w w w w w w w w
d. Instruct the client to take an analgesic before walking daily - Answer d. Instruct the
w w w w w w w w w w w w w w w
client to take an analgesic before walking daily.
w w w w w w w w
,Adequate pain management is important for the success of an exercise program.
w w w w w w w w w w w
Keeping the joints active decreases pain, so taking an analgesic and walking daily is
w w w w w w w w w w w w w w
likely to help decrease joint pain and stiffness.
w w w w w w w w
A client diagnosed with prostate cancer is prescribed radioactive seed implantation
w w w w w w w w w w
(brachytherapy). What is the most important nursing action for the practical nurse
w w w w w w w w w w w w
(PN) to do?
w w w
a. Follow radiation exposure precautions
w w w w
b. Encourage regular meals
w w w
c. Collect all urine in sealed containers
w w w w w w
d. Avoid touching the client. - Answer a. Follow radiation exposure precautions.
w w w w w w w w w w w
Clients being treated for prostate cancer with brachytherapy (radioactive seeds
w w w w w w w w w
implant) should be placed on radiation exposure precautions. The PN needs to follow
w w w w w w w w w w w w w
the institution's protocols put in place regarding the amount of time and distance
w w w w w w w w w w w w w
needed to prevent excessive exposure that would pose a hazard to others.
w w w w w w w w w w w w
A client diagnosed with emphysema that is oxygen-dependent lives alone at home and
w w w w w w w w w w w w
manages self-care with no difficulty. Which finding should prompt the home health
w w w w w w w w w w w w
practical nurse to consult the registered nurse case manager?
w w w w w w w w w
a. A pulse oximetry reading of 91% on oxygen at 2 L/m
w w w w w w w w w w w
b. A weight loss of 5 pounds since the last monthly home visit
w w w w w w w w w w w w
c. The client reports feeling as tired as at the last visit by the nurse
w w w w w w w w w w w w w w
d. Upon entering the home, the PN noticed dirty dishes and clothing scattered around
w w w w w w w w w w w w w
the home. - Answer b. A weight loss of 5 pounds since the last monthly home visit
w w w w w w w w w w w w w w w w w
A weight loss of 5 pounds in 1 month is a concern. Clients with COPD need additional
w w w w w w w w w w w w w w w w
calorie intake because they are using up a lot from the energy they are using to
w w w w w w w w w w w w w w w w
breath. The practical nurse needs to consult with the registered nurse case manager
w w w w w w w w w w w w w
for a nutrition consult
w w w w
The nurse has reinforced instructions to a client with diabetes mellitus on how to self-
w w w w w w w w w w w w w w
monitor for symptoms of diabetic ketoacidosis (DKA). The nurse realizes the
w w w w w w w w w w
instructions have been effective if the client can list which symptoms? (Select all that
w w w w w w w w w w w w w w
apply.)
w
a. Fruity breath odor
w w w
b. Rapid, weak pulse
w w w
c. Cold, clammy skin
w w w
d. Extreme thirst
w w
e. Urinary frequency
w w
f. Protruding eyeballs - Answer a. Fruity breath odor
w w w w w w w w
b. Rapid, weak pulse
w w w
d. Extreme thirst
w w
, e. Urinary frequency
w w
Diabetic ketoacidosis is caused by a profound deficiency of insulin. Some common
w w w w w w w w w w w
characteristics include a sweet, fruity breath odor, a rapid weak pulse, extreme thirst,
w w w w w w w w w w w w w
urinary frequency, and sunken-appearing eyeballs.
w w w w w
A client mentions using garlic daily as an herb to lower cholesterol and triglyceride
w w w w w w w w w w w w w
levels. Which nursing action is a priority?
w w w w w w w
a. Monitor the client for signs of bleeding.
w w w w w w w
b. Instruct the client that garlic tends to cause hypertension.
w w w w w w w w w
c. This may relieve fever in the same way that acetaminophen does.
w w w w w w w w w w w
d. Remind the patient to use tooth brushing and mouthwash to prevent garlic odor. -
w w w w w w w w w w w w w w
Answer a. Monitor the client for signs of bleeding.
w w w w w w w w w
Garlic inhibits platelet aggregation in the same way that aspirin works, and the client
w w w w w w w w w w w w w
should be monitored for bleeding. Garlic can lower the blood pressure, not raise it. It
w w w w w w w w w w w w w w w
does not relieve fever. While the client will likely want to avoid garlic odor, it is not a
w w w w w w w w w w w w w w w w w w
priority.
w
The practical nurse (PN) is reviewing the health histories of assigned clients. Which
w w w w w w w w w w w w
wfactors have a potential for development of throat cancer? (Select all that apply.)
w w w w w w w w w w w w
a. Tobacco use
w w
b. Excessive intake of alcohol
w w w w
c. Intake of hot and spicy foods
w w w w w w
d. Human papillomavirus (HPV)
w w w
e. Lack of exercise
w w w
f. Lack of dietary fiber - Answer a. Tobacco use
w w w w w w w w w
b. Excessive intake of alcohol
w w w w
d. Human papillomavirus (HPV)
w w w
Rationale:
The most common risk factors for throat cancer are tobacco use, alcohol abuse,
w w w w w w w w w w w w
whuman papillomavirus (HPV), a diet lacking in fruits and vegetable, and
w w w w w w w w w w
wgastroesophageal reflux disease (GERD). Foods seasoned with herbs and spices w w w w w w w w w
whave shown to have some health benefits in decreasing the risk of developing cancer.
w w w w w w w w w w w w w
A client has undergone craniotomy to remove a brain tumor. The client spent several
w w w w w w w w w w w w w
days in the intensive care unit, and is now on the post-surgical unit. The nurse has
w w w w w w w w w w w w w w w w
urgently contact the surgeon to report signs of increasing intracranial pressure (ICP).
w w w w w w w w w w w w
Which was the most likely EARLY sign that the client was experiencing increased
w w w w w w w w w w w w w
ICP?
w
a. The client's blood pressure dropped from 128/70 to 124/68, preoperative BP 122/72
w w w w w w w w w w w w
b. The client became more confused than he was upon transfer to the post-surgical
w w w w w w w w w w w w w
unit.
w
c. The client had a large amount of sanguineous drainage noted on the gauze
w w w w w w w w w w w w w
dressings.
w
COMPLETE SOLUTIONS
During a clinic visit, a client reports to the practical nurse (PN) that they felt a solid
w w w w w w w w w w w w w w w w
mass in their breast during self-examination, but it was not painful. What instruction
w w w w w w w w w w w w w
should the PN reinforce with the client?
w w w w w w w
A. Continue to monitor the mass until the next scheduled annual exam.
w w w w w w w w w w w
B. Notify the PCP if the mass becomes soft or painful or starts to drain.
w w w w w w w w w w w w w w
C. Schedule an appointment with the PCP for evaluation
w w w w w w w w
D. Breast masses are usually insignificant if they feel soft or are easily moveable. -
w w w w w w w w w w w w w w
Answer c. Schedule an appointment with the health care provider for evaluation.
w w w w w w w w w w w w
A painless breast mass is an abnormal finding, and the PN should instruct the client to
w w w w w w w w w w w w w w w
obtain prompt medical evaluation.
w w w w
The health care provider informed a client diagnosed with stage 4 liver cancer that the
w w w w w w w w w w w w w w
cancer has spread to their spine. The client states to the practical nurse, "I have a
w w w w w w w w w w w w w w w w
cancer, but it is not malignant." What is the best initial nursing action?
w w w w w w w w w w w w w
A. Encourage the client to attend a cancer education program
w w w w w w w w w
B. Perform a complete history and physical assessment
w w w w w w w
C. Ask the client to explain his understanding of the term malignancy.
w w w w w w w w w w w
D. Offer the client emotional support to deal with the diagnosis
w w w w w w w w w w
Submit - Answer c. Ask the client to explain his understanding of the term malignancy.
w w w w w w w w w w w w w w
The best initial action is to assess the client's knowledge of the term malignancy when
w w w w w w w w w w w w w w
used to describe cancer. The client appears to have inaccurate knowledge. Stage 4
w w w w w w w w w w w w w
cancer means the cancer has spread (metastasized) from where it has started to
w w w w w w w w w w w w w
another body part.
w w w
A client diagnosed with osteoarthritis. Which intervention should the practical nurse
w w w w w w w w w w
implement to help relieve joint pain and stiffness?
w w w w w w w w
a. Encourage the client to perform weight-bearing exercises.
w w w w w w w
b. Teach the client how to perform range-of-motion exercises.
w w w w w w w w
c. Explain the use of ice and massage for pain relief.
w w w w w w w w w w
d. Instruct the client to take an analgesic before walking daily - Answer d. Instruct the
w w w w w w w w w w w w w w w
client to take an analgesic before walking daily.
w w w w w w w w
,Adequate pain management is important for the success of an exercise program.
w w w w w w w w w w w
Keeping the joints active decreases pain, so taking an analgesic and walking daily is
w w w w w w w w w w w w w w
likely to help decrease joint pain and stiffness.
w w w w w w w w
A client diagnosed with prostate cancer is prescribed radioactive seed implantation
w w w w w w w w w w
(brachytherapy). What is the most important nursing action for the practical nurse
w w w w w w w w w w w w
(PN) to do?
w w w
a. Follow radiation exposure precautions
w w w w
b. Encourage regular meals
w w w
c. Collect all urine in sealed containers
w w w w w w
d. Avoid touching the client. - Answer a. Follow radiation exposure precautions.
w w w w w w w w w w w
Clients being treated for prostate cancer with brachytherapy (radioactive seeds
w w w w w w w w w
implant) should be placed on radiation exposure precautions. The PN needs to follow
w w w w w w w w w w w w w
the institution's protocols put in place regarding the amount of time and distance
w w w w w w w w w w w w w
needed to prevent excessive exposure that would pose a hazard to others.
w w w w w w w w w w w w
A client diagnosed with emphysema that is oxygen-dependent lives alone at home and
w w w w w w w w w w w w
manages self-care with no difficulty. Which finding should prompt the home health
w w w w w w w w w w w w
practical nurse to consult the registered nurse case manager?
w w w w w w w w w
a. A pulse oximetry reading of 91% on oxygen at 2 L/m
w w w w w w w w w w w
b. A weight loss of 5 pounds since the last monthly home visit
w w w w w w w w w w w w
c. The client reports feeling as tired as at the last visit by the nurse
w w w w w w w w w w w w w w
d. Upon entering the home, the PN noticed dirty dishes and clothing scattered around
w w w w w w w w w w w w w
the home. - Answer b. A weight loss of 5 pounds since the last monthly home visit
w w w w w w w w w w w w w w w w w
A weight loss of 5 pounds in 1 month is a concern. Clients with COPD need additional
w w w w w w w w w w w w w w w w
calorie intake because they are using up a lot from the energy they are using to
w w w w w w w w w w w w w w w w
breath. The practical nurse needs to consult with the registered nurse case manager
w w w w w w w w w w w w w
for a nutrition consult
w w w w
The nurse has reinforced instructions to a client with diabetes mellitus on how to self-
w w w w w w w w w w w w w w
monitor for symptoms of diabetic ketoacidosis (DKA). The nurse realizes the
w w w w w w w w w w
instructions have been effective if the client can list which symptoms? (Select all that
w w w w w w w w w w w w w w
apply.)
w
a. Fruity breath odor
w w w
b. Rapid, weak pulse
w w w
c. Cold, clammy skin
w w w
d. Extreme thirst
w w
e. Urinary frequency
w w
f. Protruding eyeballs - Answer a. Fruity breath odor
w w w w w w w w
b. Rapid, weak pulse
w w w
d. Extreme thirst
w w
, e. Urinary frequency
w w
Diabetic ketoacidosis is caused by a profound deficiency of insulin. Some common
w w w w w w w w w w w
characteristics include a sweet, fruity breath odor, a rapid weak pulse, extreme thirst,
w w w w w w w w w w w w w
urinary frequency, and sunken-appearing eyeballs.
w w w w w
A client mentions using garlic daily as an herb to lower cholesterol and triglyceride
w w w w w w w w w w w w w
levels. Which nursing action is a priority?
w w w w w w w
a. Monitor the client for signs of bleeding.
w w w w w w w
b. Instruct the client that garlic tends to cause hypertension.
w w w w w w w w w
c. This may relieve fever in the same way that acetaminophen does.
w w w w w w w w w w w
d. Remind the patient to use tooth brushing and mouthwash to prevent garlic odor. -
w w w w w w w w w w w w w w
Answer a. Monitor the client for signs of bleeding.
w w w w w w w w w
Garlic inhibits platelet aggregation in the same way that aspirin works, and the client
w w w w w w w w w w w w w
should be monitored for bleeding. Garlic can lower the blood pressure, not raise it. It
w w w w w w w w w w w w w w w
does not relieve fever. While the client will likely want to avoid garlic odor, it is not a
w w w w w w w w w w w w w w w w w w
priority.
w
The practical nurse (PN) is reviewing the health histories of assigned clients. Which
w w w w w w w w w w w w
wfactors have a potential for development of throat cancer? (Select all that apply.)
w w w w w w w w w w w w
a. Tobacco use
w w
b. Excessive intake of alcohol
w w w w
c. Intake of hot and spicy foods
w w w w w w
d. Human papillomavirus (HPV)
w w w
e. Lack of exercise
w w w
f. Lack of dietary fiber - Answer a. Tobacco use
w w w w w w w w w
b. Excessive intake of alcohol
w w w w
d. Human papillomavirus (HPV)
w w w
Rationale:
The most common risk factors for throat cancer are tobacco use, alcohol abuse,
w w w w w w w w w w w w
whuman papillomavirus (HPV), a diet lacking in fruits and vegetable, and
w w w w w w w w w w
wgastroesophageal reflux disease (GERD). Foods seasoned with herbs and spices w w w w w w w w w
whave shown to have some health benefits in decreasing the risk of developing cancer.
w w w w w w w w w w w w w
A client has undergone craniotomy to remove a brain tumor. The client spent several
w w w w w w w w w w w w w
days in the intensive care unit, and is now on the post-surgical unit. The nurse has
w w w w w w w w w w w w w w w w
urgently contact the surgeon to report signs of increasing intracranial pressure (ICP).
w w w w w w w w w w w w
Which was the most likely EARLY sign that the client was experiencing increased
w w w w w w w w w w w w w
ICP?
w
a. The client's blood pressure dropped from 128/70 to 124/68, preoperative BP 122/72
w w w w w w w w w w w w
b. The client became more confused than he was upon transfer to the post-surgical
w w w w w w w w w w w w w
unit.
w
c. The client had a large amount of sanguineous drainage noted on the gauze
w w w w w w w w w w w w w
dressings.
w
