MED SURG HESI V1 QUESTIONS
WITH VERIFIED ANSWERS
1. Following long-term administration of warfarin sodium to a client with a medical
diagnosis of deep vein thrombosis, the nurse should expect which treatment?
a. The hemoglobin will be greater than 10 g/dl
b. The hematocrit will be less than 35%
c. The PT will be 1.5 times the normal
d. The PTT will be 1.5 times the normal - ANSWERSc. The PT will be 1.5 times the
normal
A client who has been taking finasteride, an enzyme (5 alpha reductase) inhibitor used
to shrink the prostate gland, is admitted because of continuing benign prostate prostatic
hypertrophy (BPH) symptoms when planning care. Which nursing problem should the
nurse address first? - ANSWERSUrinary retention
An older client has been diagnosed with chronic venous insufficiency. To prevent
venous return, which action should the nurse encourage the client to? -
ANSWERSWear cotton socks and enclosed toe shoes whenever outside
When caring for a client with a full thickness burn covering 40% of the body, the nurse
observes pertinent drainage at the wound. Before reporting this finding to the healthcare
provider, the nurse should review which of the client's laboratory values? -
ANSWERSWhite blood cell (WBC) count
An older client arrives at the outpatient eye surgery clinic for a right cataract extraction
and implant. During the immediate postoperative period, which intervention should the
nurse implement? - ANSWERSProvide an eye shield to be worn while sleeping
After several days of coughing and taking acetaminophen to treat temperatures of 101 F
(38.3 C), a client with DI is admitted to the hospital with an upper respiratory infection.
Several hours after admission, the client reports having a severe headache and feeling
dizzy. Which intervention should the nurse implement first? - ANSWERSReassess vital
signs
A client takes daily supplemental iron tablets for iron deficiency anemia reports feeling
increasingly fatigued. Which laboratory values should the nurse review? -
ANSWERSComplete blood count
The nurse is caring for a client post anesthesia care unit (PACU) who underwent a
thoracotomy two hours ago. The nurse observes the following vital signs: heart rate 140
beats/ minute, respirations 26 breaths/minute, and blood pressure 140/90 mmHg.
, Which intervention is most important for the nurse to implement? - ANSWERSMedicate
for pain and monitor vital signs according to protocol
A client who was involved in a motor vehicle collision is admitted with a fractured left
femur which is immobilized using a fracture traction splint in preparation for an open
reduction internal fraction (ORIF). The nurse determines that the client's distal pulses
are diminished in the left foot. Which interventions should the nurse implement? (SATA)
- ANSWERS- Verify pedal pulses using a doppler pulse device
- Monitor left leg for pain, pallor, paresthesia, paralysis, pressured. - Evaluate the
application of the splint to the left leg
A nurse is caring for a client with Diabetes Insipidus (DI). which data warrants the most
immediate intervention by the nurse? - ANSWERSSerum sodium of 185 mEq/L
The nurse assesses a client with petechiae and ecchymosis scattered across the arms
and legs. Which laboratory result should the nurse review? - ANSWERSPlatelet count
A male client is admitted to the emergency department with vomiting of dark brown,
foul- smelling emesis. He reports he had a surgical repair of a recurrent inguinal hernia
one week ago and complains of intense abdominal pain. After assessing that his bowel
sounds are hyperactive, which prescription should the nurse implement first? -
ANSWERSInsert a NGT and attach to low suction
A client is admitted to the hospital for shortness of breath and chest pain after an
episode of syncope. Which laboratory finding is most important for the nurse to report to
the healthcare provider? - ANSWERSTroponin I
A client is hospitalized after experiencing a myocardial infarction (MI) to reduce cardiac
workload, which intervention should the nurse include in the client's plan of care? -
ANSWERSProvide a bedside commode for toileting
The healthcare provider prescribes radiation therapy (RT) for a client with terminal
metastatic cancer who is experiencing increased pain due to spinal compression. The
client asks the nurse why radiation therapy is prescribed. Which mechanism supports
the use of RT in the client's metastatic cancer? - ANSWERSPain relief can be provided
by shrinking tumors that press against spinal nerves
The nurse is caring for a client diagnosed with psoriasis vulgaris who is receiving a
PUVA treatment. Which assessment finding indicates that the client has been
overexposed to the treatment? - ANSWERSTenderness upon palpation and
generalized erythema
An older client with long-term type 2 diabetes mellitus (DM) is seen in the clinic for a
routine health assessment. Which assessments would the nurse to determine if the
patient with type 2 DM is experiencing long-term complications? (SATA) - ANSWERS-
Visual acuity
WITH VERIFIED ANSWERS
1. Following long-term administration of warfarin sodium to a client with a medical
diagnosis of deep vein thrombosis, the nurse should expect which treatment?
a. The hemoglobin will be greater than 10 g/dl
b. The hematocrit will be less than 35%
c. The PT will be 1.5 times the normal
d. The PTT will be 1.5 times the normal - ANSWERSc. The PT will be 1.5 times the
normal
A client who has been taking finasteride, an enzyme (5 alpha reductase) inhibitor used
to shrink the prostate gland, is admitted because of continuing benign prostate prostatic
hypertrophy (BPH) symptoms when planning care. Which nursing problem should the
nurse address first? - ANSWERSUrinary retention
An older client has been diagnosed with chronic venous insufficiency. To prevent
venous return, which action should the nurse encourage the client to? -
ANSWERSWear cotton socks and enclosed toe shoes whenever outside
When caring for a client with a full thickness burn covering 40% of the body, the nurse
observes pertinent drainage at the wound. Before reporting this finding to the healthcare
provider, the nurse should review which of the client's laboratory values? -
ANSWERSWhite blood cell (WBC) count
An older client arrives at the outpatient eye surgery clinic for a right cataract extraction
and implant. During the immediate postoperative period, which intervention should the
nurse implement? - ANSWERSProvide an eye shield to be worn while sleeping
After several days of coughing and taking acetaminophen to treat temperatures of 101 F
(38.3 C), a client with DI is admitted to the hospital with an upper respiratory infection.
Several hours after admission, the client reports having a severe headache and feeling
dizzy. Which intervention should the nurse implement first? - ANSWERSReassess vital
signs
A client takes daily supplemental iron tablets for iron deficiency anemia reports feeling
increasingly fatigued. Which laboratory values should the nurse review? -
ANSWERSComplete blood count
The nurse is caring for a client post anesthesia care unit (PACU) who underwent a
thoracotomy two hours ago. The nurse observes the following vital signs: heart rate 140
beats/ minute, respirations 26 breaths/minute, and blood pressure 140/90 mmHg.
, Which intervention is most important for the nurse to implement? - ANSWERSMedicate
for pain and monitor vital signs according to protocol
A client who was involved in a motor vehicle collision is admitted with a fractured left
femur which is immobilized using a fracture traction splint in preparation for an open
reduction internal fraction (ORIF). The nurse determines that the client's distal pulses
are diminished in the left foot. Which interventions should the nurse implement? (SATA)
- ANSWERS- Verify pedal pulses using a doppler pulse device
- Monitor left leg for pain, pallor, paresthesia, paralysis, pressured. - Evaluate the
application of the splint to the left leg
A nurse is caring for a client with Diabetes Insipidus (DI). which data warrants the most
immediate intervention by the nurse? - ANSWERSSerum sodium of 185 mEq/L
The nurse assesses a client with petechiae and ecchymosis scattered across the arms
and legs. Which laboratory result should the nurse review? - ANSWERSPlatelet count
A male client is admitted to the emergency department with vomiting of dark brown,
foul- smelling emesis. He reports he had a surgical repair of a recurrent inguinal hernia
one week ago and complains of intense abdominal pain. After assessing that his bowel
sounds are hyperactive, which prescription should the nurse implement first? -
ANSWERSInsert a NGT and attach to low suction
A client is admitted to the hospital for shortness of breath and chest pain after an
episode of syncope. Which laboratory finding is most important for the nurse to report to
the healthcare provider? - ANSWERSTroponin I
A client is hospitalized after experiencing a myocardial infarction (MI) to reduce cardiac
workload, which intervention should the nurse include in the client's plan of care? -
ANSWERSProvide a bedside commode for toileting
The healthcare provider prescribes radiation therapy (RT) for a client with terminal
metastatic cancer who is experiencing increased pain due to spinal compression. The
client asks the nurse why radiation therapy is prescribed. Which mechanism supports
the use of RT in the client's metastatic cancer? - ANSWERSPain relief can be provided
by shrinking tumors that press against spinal nerves
The nurse is caring for a client diagnosed with psoriasis vulgaris who is receiving a
PUVA treatment. Which assessment finding indicates that the client has been
overexposed to the treatment? - ANSWERSTenderness upon palpation and
generalized erythema
An older client with long-term type 2 diabetes mellitus (DM) is seen in the clinic for a
routine health assessment. Which assessments would the nurse to determine if the
patient with type 2 DM is experiencing long-term complications? (SATA) - ANSWERS-
Visual acuity
