NGN NURSING Med surg HESI exit exam latest 2024 test
!| !| !| !| !| !| !| !| !| !|
bank with rationales complete Rated A+ !| !| !| !| !| !|
The mother of an adolescent tells the clinic nurse, "My son has athlete's foot, I
!| !| !| !| !| !| !| !| !| !| !| !| !| !|
have been applying triple antibiotic ointment for two days, but there has been no
!| !| !| !| !| !| !| !| !| !| !| !| !| !|
improvement." What instruction should the nurse provide?
!| !| !| !| !| !| !|
(ANS- Stop using the ointment and encourage complete drying of the feet and
!| !| !| !| !| !| !| !| !| !| !| !|
wearing clean socks.
!| !| !|
A 26-year-old female client is admitted to the hospital for treatment of a simple
!| !| !| !| !| !| !| !| !| !| !| !| !|
goiter, and levothyroxine sodium (Synthroid) is prescribed. Which symptoms
!| !| !| !| !| !| !| !| !|
indicate to the nurse that the prescribed dosage is too high for this client? The
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
client experiences
!| !|
Bradycardia and constipation !| !|
Lethargy and lack of appetite
!| !| !| !| !|
Muscle cramping and dry, flushed skin
!| !| !| !| !|
Palpitations and shortness of breath
!| !| !| !| !|
(ANS- Palpitations and shortness of breath
!| !| !| !| !|
A client with a history of heart failure presents to the clinic with nausea, vomiting,
!| !| !| !| !| !| !| !| !| !| !| !| !| !|
yellow vision and palpitations. Which finding is most important for the nurse to
!| !| !| !| !| !| !| !| !| !| !| !| !|
assess to the client?
!| !| !| !|
(ANS- Obtain a list of medications taken for cardiac history
!| !| !| !| !| !| !| !| !|
The healthcare provider prescribes an IV solution of isoproterenol (Isuprel) 1 mg
!| !| !| !| !| !| !| !| !| !| !|
in 250 ml of D5W at 300 mcg/hour. The nurse should program the infusion pump
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
to deliver how many ml/hour? (Enter numeric value only.)
!| !| !| !| !| !| !| !| !|
(ANS- 75 !|
Rationale: Convert mg to mcg and use the formula D/H x Q. 300 mcg/hour / 1,000
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
NGN NURSING Med surg HESI exit exam latest 2024 test
!| !| !| !| !| !| !| !| !| !|
bank with rationales complete Rated A+ !| !| !| !| !| !|
,mcg x 250 ml = 3/1 x 25 = 75 ml/hour
!| !| !| !| !| !| !| !| !| !|
The pathophysiological mechanisms that are responsible for ascites related to liver
!| !| !| !| !| !| !| !| !| !|
failure? (Select all that apply)
!| !| !| !| !|
(ANS- Fluid shifts from intravascular to interstitial area due to decreased serum
!| !| !| !| !| !| !| !| !| !| !|
protein
!|
Increased hydrostatic pressure in portal circulation increases fluid shifts into
!| !| !| !| !| !| !| !| !|
abdomen
!|
Increased circulating aldosterone levels that increase sodium and water retention
!| !| !| !| !| !| !| !| !|
The nurse is auscultating a client's heart sounds. Which description should the
!| !| !| !| !| !| !| !| !| !| !|
nurse use to document this sound? (Please listen to the audio first to select the
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
option that applies)
!| !| !|
(ANS- Murmur !|
Rationale: A murmur is auscultated as a swishing sound that is associated with the
!| !| !| !| !| !| !| !| !| !| !| !| !|
blood turbulence created by the heart or valvular defect.
!| !| !| !| !| !| !| !| !|
The healthcare provider prescribes celtazidime (Fortax) 35 mg every 8 hours IM
!| !| !| !| !| !| !| !| !| !| !|
for an infant. The 500 mg vial is labeled with the instruction to add 5.3 ml diluent
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
to provide a concentration of 100 mg/ml. How many ml should the nurse
!| !| !| !| !| !| !| !| !| !| !| !| !|
administered for each dose? (Enter numeric value only. If rounding is required,
!| !| !| !| !| !| !| !| !| !| !| !|
round to the nearest tenth)
!| !| !| !| !|
(ANS- 0.4 !|
ationale: 35mg/100mg x 1 = 0.35 = 0.4 ml !| !| !| !| !| !| !| !|
The nurse notes that a client has been receiving hydromorphone (Dilaudid) every
!| !| !| !| !| !| !| !| !| !| !|
six hours for four days. What assessment is most important for the nurse to
!| !| !| !| !| !| !| !| !| !| !| !| !| !|
complete?
!|
Auscultate the client's bowel sounds !| !| !| !|
Observe for edema around the ankles
!| !| !| !| !| !|
Measure the client's capillary glucose level
!| !| !| !| !| !|
Count the apical and radial pulses simultaneously
!| !| !| !| !| !|
(ANS- Auscultate the client's bowel sounds
!| !| !| !| !| !|
NGN NURSING Med surg HESI exit exam latest 2024 test !| !| !| !| !| !| !| !| !| !|
bank with rationales complete Rated A+ !| !| !| !| !| !|
,Rationale: hydromorphone is a potent opioid analgesic that slows peristalsis and
!| !| !| !| !| !| !| !| !| !|
frequently causes constipation, so it is most important to Auscultate the client's
!| !| !| !| !| !| !| !| !| !| !| !|
bowel sounds
!| !|
A female client is admitted with end stage pulmonary disease is alert, oriented, and
!| !| !| !| !| !| !| !| !| !| !| !| !|
complaining of shortness of breath. The client tells the nurse that she wants "no
!| !| !| !| !| !| !| !| !| !| !| !| !| !|
heroic measures" taken if she stops breathing, and she asks the nurse to
!| !| !| !| !| !| !| !| !| !| !| !| !|
document this in her medical record. What action should the nurse implement?
!| !| !| !| !| !| !| !| !| !| !| !|
(ANS- Ask the client to discuss "do not resuscitate" with her healthcare provider
!| !| !| !| !| !| !| !| !| !| !| !|
A client is receiving a full strength continuous enteral tube feeding at 50 ml/hour
!| !| !| !| !| !| !| !| !| !| !| !| !|
and has developed diarrhea. The client has a new prescription to change the
!| !| !| !| !| !| !| !| !| !| !| !| !|
feeding to half strength. What intervention should the nurse implement?
!| !| !| !| !| !| !| !| !| !|
(ANS- Add equal amounts of water and feeding to a feeding bag and infuse at
!| !| !| !| !| !| !| !| !| !| !| !| !| !|
50ml/hour
!|
A female client reports that her hair is becoming coarse and breaking off, that the
!| !| !| !| !| !| !| !| !| !| !| !| !| !|
outer part of her eyebrows have disappeared, and that her eyes are all puffy. Which
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
follow-up question is best for the nurse to ask?
!| !| !| !| !| !| !| !| !|
(ANS- Have you noticed any changes in your fingernails?
!| !| !| !| !| !| !| !|
Rationale: The pattern of reported manifestations is suggestive of hypothyroidism
!| !| !| !| !| !| !| !| !|
Following discharge teaching, a male client with duodenal ulcer tells the nurse the
!| !| !| !| !| !| !| !| !| !| !| !|
he will drink plenty of dairy products, such as milk, to help coat and protect his
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
ulcer. What is the best follow-up action by the nurse?
!| !| !| !| !| !| !| !| !| !|
(ANS- Review with the client the need to avoid foods that are rich in milk and
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
cream
!|
A male client with hypertension, who received new antihypertensive prescriptions
!| !| !| !| !| !| !| !| !|
at his last visit returns to the clinic two weeks later to evaluate his blood
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
pressure (BP). His BP is 158/106 and he admits that he has not been taking the
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
prescribed medication because the drugs make him "feel bad". In explaining the
!| !| !| !| !| !| !| !| !| !| !| !|
need for hypertension control, the nurse should stress that an elevated BP places
!| !| !| !| !| !| !| !| !| !| !| !| !|
the client at risk for which pathophysiological condition?
!| !| !| !| !| !| !| !|
(ANS- Stroke secondary to hemorrhage !| !| !| !|
NGN NURSING Med surg HESI exit exam latest 2024 test !| !| !| !| !| !| !| !| !| !|
bank with rationales complete Rated A+ !| !| !| !| !| !|
, The nurse observes unlicensed assistive personnel (UAP) positioning a newly
!| !| !| !| !| !| !| !| !|
admitted client who has a seizure disorder. The client is supine and the UAP is
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
placing soft pillows along the side rails. What action should the nurse
!| !| !| !| !| !| !| !| !| !| !| !|
implement? (ANS- Instruct the UAP to obtain soft blankets to secure to the side
!| !| !| !| !| !| !| !| !| !| !| !| !| !|
rails instead of pillows.
!| !| !| !|
An adolescent with major depressive disorder has been taking duloxetine
!| !| !| !| !| !| !| !| !|
(Cymbalta) for the past 12 days. Which assessment finding requires
!| !| !| !| !| !| !| !| !| !|
immediate follow-up?
!| !|
(ANS- Describes life without purpose!| !| !| !|
A 60-year-old female client with a positive family history of ovarian cancer has
!| !| !| !| !| !| !| !| !| !| !| !|
developed an abdominal mass and is being evaluated for possible ovarian cancer.
!| !| !| !| !| !| !| !| !| !| !| !|
Her Papanicolau (Pap) smear results are negative. What information should the
!| !| !| !| !| !| !| !| !| !| !|
nurse include in the client's teaching plan?
!| !| !| !| !| !| !|
(ANS- Further evaluation involving surgery may be needed
!| !| !| !| !| !| !|
A client who recently underwear a tracheostomy is being prepared for discharge to
!| !| !| !| !| !| !| !| !| !| !| !|
home. Which instructions is most important for the nurse to include in the
!| !| !| !| !| !| !| !| !| !| !| !| !|
discharge plan?
!| !|
(ANS- Teach tracheal suctioning techniques
!| !| !| !|
In assessing an adult client with a partial rebreather mask, the nurse notes that the
!| !| !| !| !| !| !| !| !| !| !| !| !| !|
oxygen reservoir bag does not deflate completely during inspiration and the
!| !| !| !| !| !| !| !| !| !| !|
client's respiratory rate is 14 breaths / minute. What action should the nurse
!| !| !| !| !| !| !| !| !| !| !| !| !|
implement? (ANS- Document the assessment data
!| !| !| !| !| !|
Rationale: reservoir bag should not deflate completely during inspiration and the
!| !| !| !| !| !| !| !| !| !|
client's respiratory rate is within normal limits.
!| !| !| !| !| !| !|
During shift report, the central electrocardiogram (EKG) monitoring systemalarms.
!| !| !| !| !| !| !| !|
Which client alarm should the nurse investigate firs?
!| !| !| !| !| !| !| !|
(ANS- Respiratory apnea of 30 seconds
!| !| !| !| !|
NGN NURSING Med surg HESI exit exam latest 2024 test
!| !| !| !| !| !| !| !| !| !|
bank with rationales complete Rated A+ !| !| !| !| !| !|
!| !| !| !| !| !| !| !| !| !|
bank with rationales complete Rated A+ !| !| !| !| !| !|
The mother of an adolescent tells the clinic nurse, "My son has athlete's foot, I
!| !| !| !| !| !| !| !| !| !| !| !| !| !|
have been applying triple antibiotic ointment for two days, but there has been no
!| !| !| !| !| !| !| !| !| !| !| !| !| !|
improvement." What instruction should the nurse provide?
!| !| !| !| !| !| !|
(ANS- Stop using the ointment and encourage complete drying of the feet and
!| !| !| !| !| !| !| !| !| !| !| !|
wearing clean socks.
!| !| !|
A 26-year-old female client is admitted to the hospital for treatment of a simple
!| !| !| !| !| !| !| !| !| !| !| !| !|
goiter, and levothyroxine sodium (Synthroid) is prescribed. Which symptoms
!| !| !| !| !| !| !| !| !|
indicate to the nurse that the prescribed dosage is too high for this client? The
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
client experiences
!| !|
Bradycardia and constipation !| !|
Lethargy and lack of appetite
!| !| !| !| !|
Muscle cramping and dry, flushed skin
!| !| !| !| !|
Palpitations and shortness of breath
!| !| !| !| !|
(ANS- Palpitations and shortness of breath
!| !| !| !| !|
A client with a history of heart failure presents to the clinic with nausea, vomiting,
!| !| !| !| !| !| !| !| !| !| !| !| !| !|
yellow vision and palpitations. Which finding is most important for the nurse to
!| !| !| !| !| !| !| !| !| !| !| !| !|
assess to the client?
!| !| !| !|
(ANS- Obtain a list of medications taken for cardiac history
!| !| !| !| !| !| !| !| !|
The healthcare provider prescribes an IV solution of isoproterenol (Isuprel) 1 mg
!| !| !| !| !| !| !| !| !| !| !|
in 250 ml of D5W at 300 mcg/hour. The nurse should program the infusion pump
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
to deliver how many ml/hour? (Enter numeric value only.)
!| !| !| !| !| !| !| !| !|
(ANS- 75 !|
Rationale: Convert mg to mcg and use the formula D/H x Q. 300 mcg/hour / 1,000
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
NGN NURSING Med surg HESI exit exam latest 2024 test
!| !| !| !| !| !| !| !| !| !|
bank with rationales complete Rated A+ !| !| !| !| !| !|
,mcg x 250 ml = 3/1 x 25 = 75 ml/hour
!| !| !| !| !| !| !| !| !| !|
The pathophysiological mechanisms that are responsible for ascites related to liver
!| !| !| !| !| !| !| !| !| !|
failure? (Select all that apply)
!| !| !| !| !|
(ANS- Fluid shifts from intravascular to interstitial area due to decreased serum
!| !| !| !| !| !| !| !| !| !| !|
protein
!|
Increased hydrostatic pressure in portal circulation increases fluid shifts into
!| !| !| !| !| !| !| !| !|
abdomen
!|
Increased circulating aldosterone levels that increase sodium and water retention
!| !| !| !| !| !| !| !| !|
The nurse is auscultating a client's heart sounds. Which description should the
!| !| !| !| !| !| !| !| !| !| !|
nurse use to document this sound? (Please listen to the audio first to select the
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
option that applies)
!| !| !|
(ANS- Murmur !|
Rationale: A murmur is auscultated as a swishing sound that is associated with the
!| !| !| !| !| !| !| !| !| !| !| !| !|
blood turbulence created by the heart or valvular defect.
!| !| !| !| !| !| !| !| !|
The healthcare provider prescribes celtazidime (Fortax) 35 mg every 8 hours IM
!| !| !| !| !| !| !| !| !| !| !|
for an infant. The 500 mg vial is labeled with the instruction to add 5.3 ml diluent
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
to provide a concentration of 100 mg/ml. How many ml should the nurse
!| !| !| !| !| !| !| !| !| !| !| !| !|
administered for each dose? (Enter numeric value only. If rounding is required,
!| !| !| !| !| !| !| !| !| !| !| !|
round to the nearest tenth)
!| !| !| !| !|
(ANS- 0.4 !|
ationale: 35mg/100mg x 1 = 0.35 = 0.4 ml !| !| !| !| !| !| !| !|
The nurse notes that a client has been receiving hydromorphone (Dilaudid) every
!| !| !| !| !| !| !| !| !| !| !|
six hours for four days. What assessment is most important for the nurse to
!| !| !| !| !| !| !| !| !| !| !| !| !| !|
complete?
!|
Auscultate the client's bowel sounds !| !| !| !|
Observe for edema around the ankles
!| !| !| !| !| !|
Measure the client's capillary glucose level
!| !| !| !| !| !|
Count the apical and radial pulses simultaneously
!| !| !| !| !| !|
(ANS- Auscultate the client's bowel sounds
!| !| !| !| !| !|
NGN NURSING Med surg HESI exit exam latest 2024 test !| !| !| !| !| !| !| !| !| !|
bank with rationales complete Rated A+ !| !| !| !| !| !|
,Rationale: hydromorphone is a potent opioid analgesic that slows peristalsis and
!| !| !| !| !| !| !| !| !| !|
frequently causes constipation, so it is most important to Auscultate the client's
!| !| !| !| !| !| !| !| !| !| !| !|
bowel sounds
!| !|
A female client is admitted with end stage pulmonary disease is alert, oriented, and
!| !| !| !| !| !| !| !| !| !| !| !| !|
complaining of shortness of breath. The client tells the nurse that she wants "no
!| !| !| !| !| !| !| !| !| !| !| !| !| !|
heroic measures" taken if she stops breathing, and she asks the nurse to
!| !| !| !| !| !| !| !| !| !| !| !| !|
document this in her medical record. What action should the nurse implement?
!| !| !| !| !| !| !| !| !| !| !| !|
(ANS- Ask the client to discuss "do not resuscitate" with her healthcare provider
!| !| !| !| !| !| !| !| !| !| !| !|
A client is receiving a full strength continuous enteral tube feeding at 50 ml/hour
!| !| !| !| !| !| !| !| !| !| !| !| !|
and has developed diarrhea. The client has a new prescription to change the
!| !| !| !| !| !| !| !| !| !| !| !| !|
feeding to half strength. What intervention should the nurse implement?
!| !| !| !| !| !| !| !| !| !|
(ANS- Add equal amounts of water and feeding to a feeding bag and infuse at
!| !| !| !| !| !| !| !| !| !| !| !| !| !|
50ml/hour
!|
A female client reports that her hair is becoming coarse and breaking off, that the
!| !| !| !| !| !| !| !| !| !| !| !| !| !|
outer part of her eyebrows have disappeared, and that her eyes are all puffy. Which
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
follow-up question is best for the nurse to ask?
!| !| !| !| !| !| !| !| !|
(ANS- Have you noticed any changes in your fingernails?
!| !| !| !| !| !| !| !|
Rationale: The pattern of reported manifestations is suggestive of hypothyroidism
!| !| !| !| !| !| !| !| !|
Following discharge teaching, a male client with duodenal ulcer tells the nurse the
!| !| !| !| !| !| !| !| !| !| !| !|
he will drink plenty of dairy products, such as milk, to help coat and protect his
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
ulcer. What is the best follow-up action by the nurse?
!| !| !| !| !| !| !| !| !| !|
(ANS- Review with the client the need to avoid foods that are rich in milk and
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
cream
!|
A male client with hypertension, who received new antihypertensive prescriptions
!| !| !| !| !| !| !| !| !|
at his last visit returns to the clinic two weeks later to evaluate his blood
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
pressure (BP). His BP is 158/106 and he admits that he has not been taking the
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
prescribed medication because the drugs make him "feel bad". In explaining the
!| !| !| !| !| !| !| !| !| !| !| !|
need for hypertension control, the nurse should stress that an elevated BP places
!| !| !| !| !| !| !| !| !| !| !| !| !|
the client at risk for which pathophysiological condition?
!| !| !| !| !| !| !| !|
(ANS- Stroke secondary to hemorrhage !| !| !| !|
NGN NURSING Med surg HESI exit exam latest 2024 test !| !| !| !| !| !| !| !| !| !|
bank with rationales complete Rated A+ !| !| !| !| !| !|
, The nurse observes unlicensed assistive personnel (UAP) positioning a newly
!| !| !| !| !| !| !| !| !|
admitted client who has a seizure disorder. The client is supine and the UAP is
!| !| !| !| !| !| !| !| !| !| !| !| !| !| !|
placing soft pillows along the side rails. What action should the nurse
!| !| !| !| !| !| !| !| !| !| !| !|
implement? (ANS- Instruct the UAP to obtain soft blankets to secure to the side
!| !| !| !| !| !| !| !| !| !| !| !| !| !|
rails instead of pillows.
!| !| !| !|
An adolescent with major depressive disorder has been taking duloxetine
!| !| !| !| !| !| !| !| !|
(Cymbalta) for the past 12 days. Which assessment finding requires
!| !| !| !| !| !| !| !| !| !|
immediate follow-up?
!| !|
(ANS- Describes life without purpose!| !| !| !|
A 60-year-old female client with a positive family history of ovarian cancer has
!| !| !| !| !| !| !| !| !| !| !| !|
developed an abdominal mass and is being evaluated for possible ovarian cancer.
!| !| !| !| !| !| !| !| !| !| !| !|
Her Papanicolau (Pap) smear results are negative. What information should the
!| !| !| !| !| !| !| !| !| !| !|
nurse include in the client's teaching plan?
!| !| !| !| !| !| !|
(ANS- Further evaluation involving surgery may be needed
!| !| !| !| !| !| !|
A client who recently underwear a tracheostomy is being prepared for discharge to
!| !| !| !| !| !| !| !| !| !| !| !|
home. Which instructions is most important for the nurse to include in the
!| !| !| !| !| !| !| !| !| !| !| !| !|
discharge plan?
!| !|
(ANS- Teach tracheal suctioning techniques
!| !| !| !|
In assessing an adult client with a partial rebreather mask, the nurse notes that the
!| !| !| !| !| !| !| !| !| !| !| !| !| !|
oxygen reservoir bag does not deflate completely during inspiration and the
!| !| !| !| !| !| !| !| !| !| !|
client's respiratory rate is 14 breaths / minute. What action should the nurse
!| !| !| !| !| !| !| !| !| !| !| !| !|
implement? (ANS- Document the assessment data
!| !| !| !| !| !|
Rationale: reservoir bag should not deflate completely during inspiration and the
!| !| !| !| !| !| !| !| !| !|
client's respiratory rate is within normal limits.
!| !| !| !| !| !| !|
During shift report, the central electrocardiogram (EKG) monitoring systemalarms.
!| !| !| !| !| !| !| !|
Which client alarm should the nurse investigate firs?
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