MED SURG HESI PRACTICE
QUESTIONS SET WITH 123
QUESTIONS AD CORRECT ANSWERS
RATED A+
A stroke affects the whole family and in this case the spouse probably thinks that she is
helping and needs to feel that she is contributing to the client's care. Her help is noted
as being incongruent with attempts of self-care by the client thereby disabling family
coping (B). The scenario does not discuss the client's self-esteem (A), interrupted family
processes (C) or the risk for ineffective therapeutic regimen (D).
When teaching diaphragmatic breathing to a client with chronic obstructive pulmonary
disease (COPD), which information should the nurse provide?
A) Place a small book or magazine on the abdomen and make it rise while inhaling
deeply.
B) Purse the lips while inhaling as deeply as possible and then exhale through the nose.
C) Wrap a towel around the abdomen and push against the towel while forcefully
exhaling.
D) Place one hand on the chest, one hand the abdomen and make both hands move
outward.
A) Place a small book or magazine on the abdomen and make it rise while inhaling
deeply.
Diaphragmatic or abdominal breathing uses the diaphragm instead of accessory
muscles to achieve maximum inhalation and to slow the respiratory rate. The client
should protrude the abdomen on inhalation and contract it with exhalation, so (A) helps
the client visualize the rise and fall of the abdomen. The client should purse the lips
while exhaling, not (B). (C and D) are ineffective.
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.
A) He visits his diabetic brother who just had surgery to amputate an infected foot.
The loss of a limb by a family member (A) will be the strongest event or "cue to action"
,and is most likely to increase the perceived seriousness of the disease. (B, C, and D)
may influence his behavior but do not have the personal impact of (A).
After the fourth dose of gentamicin sulfate (Garamycin) IV, the nurse plans to draw
blood samples to determine peak and trough levels. When are the best times to draw
these samples?
A) 15 minutes before and 15 minutes after the next dose.
B) One hour before and one hour after the next dose.
C) 5 minutes before and 30 minutes after the next dose.
D) 30 minutes before and 30 minutes after the next dose.
C) 5 minutes before and 30 minutes after the next dose.
Peak drug serum levels are achieved 30 minutes after IV administration of
aminoglycosides. The best time to draw a trough is the closest time to the next
administration (C). (A, B, and D) are not as good a time to draw the trough as (C). (B
and D) are not the best times to draw the peak of an aminoglycoside that has been
administered IV.
During a health fair, a 72-year-old male client tells the nurse that he is experiencing
shortness of breath. Auscultation reveals crackles and wheezing in both lungs.
Suspecting that the client might have chronic bronchitis, which classic symptom should
the nurse expect this client to have?
A) Racing pulse with exertion.
B) Clubbing of the fingers.
C) An increased chest diameter.
D) Productive cough with grayish-white sputum.
D) Productive cough with grayish-white sputum.
Chronic bronchitis, one of the diseases comprising the diagnosis of COPD, is
characterized by a productive cough with grayish-white sputum (D), which usually
occurs in the morning and is often ignored by smokers. (A) is not related to chronic
bronchitis; however, it is indicative of other problems such as ventricular tachycardia
and should be explored. (B and C) are symptoms of emphysema and are not consistent
with the other symptoms. (C) is usually referred to as a "barrel chest."
What discharge instruction is most important for a client after a kidney transplant?
A) Weigh weekly.
B) Report symptoms of secondary Candidiasis.
C) Use daily reminders to take immunosuppressants.
D) Stop cigarette smoking.
C) Use daily reminders to take immunosuppressants.
After renal transplantation, acute rejection is a risk for several months, so
immunosuppressive therapy, such as corticosteroids and azathioprine (Imuran), is
essential in preventing rejection, so the priority instruction includes measures, such as
daily reminders (C), to ensure the client takes these medications regularly. Daily
weights, not weekly (A), provides a better indicator of weight gain related to rejection.
Although fungal infections related to the immunosuppression should be reported (B), it
is more important to ensure medication compliance to prevent rejection. Although
,smoking (D) increases the risk of atherosclerotic vascular disease which is common in
clients with an organ transplant, (C) remains the priority.
A client experiencing uncontrolled atrial fibrillation is admitted to the telemetry unit. What
initial medication should the nurse anticipate administering to the client?
A) Xylocaine (Lidocaine).
B) Procainamide (Pronestyl).
C) Phenytoin (Dilantin).
D) Digoxin (Lanoxin).
D) Digoxin (Lanoxin).
Digoxin (Lanoxin) (D) is administered for uncontrolled, symptomatic atrial fibrillation
resulting in a decreased cardiac output. Digoxin slows the rate of conduction by
prolonging the refractory period of the AV node, thus slowing the ventricular response,
decreasing the heart rate, and effecting cardiac output. (A, B, and C) are not indicated
in the initial treatment of uncontrolled atrial fibrillation.
What instruction should the nurse give a client who is diagnosed with fibrocystic
changes of the breast?
A) Observe cyst size fluctuations as a sign of malignancy.
B) Use estrogen supplements to reduce breast discomfort.
C) Notify the healthcare provider if whitish nipple discharge occurs.
D) Perform a breast self-exam (BSE) procedure monthly.
D) Perform a breast self-exam (BSE) procedure monthly.
Fibrocystic changes in the breast are related to excess fibrous tissue, proliferation of
mammary ducts and cyst formation that cause edema and nerve irritation. These
changes obscure typical diagnostic tests, such as mammography, due to an increased
breast density. Women with fibrocystic breasts should be instructed to carefully perform
monthly BSE (D) and consider changes in any previous "lumpiness." Fibrocystic
disease does not increase the risk of breast cancer (A). Cyst size fluctuates with the
menstrual cycle, and typically lessens after menopause, and responds with a
heightened sensitivity to circulating estrogen (B), which is not indicated. Nipple
discharge associated with fibrocystic breasts is often milky or watery-milky and is an
expected finding (C).
After checking the urinary drainage system for kinks in the tubing, the nurse determines
that a client who has returned from the post-anesthesia care has a dark, concentrated
urinary output of 54 ml for the last 2 hours. What priority nursing action should be
implemented?
A) Report the findings to the surgeon.
B) Irrigate the indwelling urinary catheter.
C) Apply manual pressure to the bladder.
D) Increase the IV flow rate for 15 minutes.
A) Report the findings to the surgeon.
B) Which description of symptoms is characteristic of a client diagnosed with
trigeminal neuralgia (tic douloureux)?
A) Tinnitus, vertigo, and hearing difficulties.
, B) Sudden, stabbing, severe pain over the lip and chin.
C) Facial weakness and paralysis.
D) Difficulty in chewing, talking, and swallowing.
C) B) Sudden, stabbing, severe pain over the lip and chin.
Trigeminal neuralgia is characterized by paroxysms of pain, similar to an electric
shock, in the area innervated by one or more branches of the trigeminal nerve
(5th cranial) (B). (A) would be characteristic of Méniére's disease (8th cranial
nerve). (C) would be characteristic of Bell's palsy (7th cranial nerve). (D) would
be characteristic of disorders of the hypoglossal cranial nerve (12th).
D) A 67-year-old woman who lives alone is admitted after tripping on a rug in her
home and fractures her hip. Which predisposing factor probably led to the
fracture in the proximal end of her femur?
A) Failing eyesight resulting in an unsafe environment.
B) Renal osteodystrophy resulting from chronic renal failure.
C) Osteoporosis resulting from hormonal changes.
D) Cardiovascular changes resulting in small strokes which impair mental acuity.
E) C) Osteoporosis resulting from hormonal changes.
The most common cause of a fractured hip in elderly women is osteoporosis,
resulting from reduced calcium in the bones as a result of hormonal changes in
later life (C). (A) may or may not have contributed to the accident, but it had
nothing to do with the hip being involved. (B) is not a common condition of the
elderly; it is common in chronic renal failure. (D) may occur in some people, but
does not affect the fragility of the bones as osteoporosis does.
F) The nurse is assisting a client out of bed for the first time after surgery. What
action should the nurse do first?
A) Place a chair at a right angle to the bedside.
B) Encourage deep breathing prior to standing.
C) Help the client to sit and dangle legs on the side of the bed.
D) Allow the client to sit with the bed in a high Fowler's position.
G) D) Allow the client to sit with the bed in a high Fowler's position.
The first step is to raise the head of the bed to a high Fowler's position (D), which
allow venous return to compensate from lying flat and vasodilating effects of
perioperative drugs. (A, B, and C) are implemented after (D).
H) A 20-year-old female client calls the nurse to report a lump she found in her
breast. Which response is the best for the nurse to provide?
A) Check it again in one month, and if it is still there schedule an appointment.
B) Most lumps are benign, but it is always best to come in for an examination.
C) Try not to worry too much about it, because usually, most lumps are benign.
D) If you are in your menstrual period it is not a good time to check for lumps.
I) B) Most lumps are benign, but it is always best to come in for an examination.
(B) provides the best response because it addresses the client's anxiety most
effectively and encourages prompt and immediate action for a potential problem.
QUESTIONS SET WITH 123
QUESTIONS AD CORRECT ANSWERS
RATED A+
A stroke affects the whole family and in this case the spouse probably thinks that she is
helping and needs to feel that she is contributing to the client's care. Her help is noted
as being incongruent with attempts of self-care by the client thereby disabling family
coping (B). The scenario does not discuss the client's self-esteem (A), interrupted family
processes (C) or the risk for ineffective therapeutic regimen (D).
When teaching diaphragmatic breathing to a client with chronic obstructive pulmonary
disease (COPD), which information should the nurse provide?
A) Place a small book or magazine on the abdomen and make it rise while inhaling
deeply.
B) Purse the lips while inhaling as deeply as possible and then exhale through the nose.
C) Wrap a towel around the abdomen and push against the towel while forcefully
exhaling.
D) Place one hand on the chest, one hand the abdomen and make both hands move
outward.
A) Place a small book or magazine on the abdomen and make it rise while inhaling
deeply.
Diaphragmatic or abdominal breathing uses the diaphragm instead of accessory
muscles to achieve maximum inhalation and to slow the respiratory rate. The client
should protrude the abdomen on inhalation and contract it with exhalation, so (A) helps
the client visualize the rise and fall of the abdomen. The client should purse the lips
while exhaling, not (B). (C and D) are ineffective.
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.
A) He visits his diabetic brother who just had surgery to amputate an infected foot.
The loss of a limb by a family member (A) will be the strongest event or "cue to action"
,and is most likely to increase the perceived seriousness of the disease. (B, C, and D)
may influence his behavior but do not have the personal impact of (A).
After the fourth dose of gentamicin sulfate (Garamycin) IV, the nurse plans to draw
blood samples to determine peak and trough levels. When are the best times to draw
these samples?
A) 15 minutes before and 15 minutes after the next dose.
B) One hour before and one hour after the next dose.
C) 5 minutes before and 30 minutes after the next dose.
D) 30 minutes before and 30 minutes after the next dose.
C) 5 minutes before and 30 minutes after the next dose.
Peak drug serum levels are achieved 30 minutes after IV administration of
aminoglycosides. The best time to draw a trough is the closest time to the next
administration (C). (A, B, and D) are not as good a time to draw the trough as (C). (B
and D) are not the best times to draw the peak of an aminoglycoside that has been
administered IV.
During a health fair, a 72-year-old male client tells the nurse that he is experiencing
shortness of breath. Auscultation reveals crackles and wheezing in both lungs.
Suspecting that the client might have chronic bronchitis, which classic symptom should
the nurse expect this client to have?
A) Racing pulse with exertion.
B) Clubbing of the fingers.
C) An increased chest diameter.
D) Productive cough with grayish-white sputum.
D) Productive cough with grayish-white sputum.
Chronic bronchitis, one of the diseases comprising the diagnosis of COPD, is
characterized by a productive cough with grayish-white sputum (D), which usually
occurs in the morning and is often ignored by smokers. (A) is not related to chronic
bronchitis; however, it is indicative of other problems such as ventricular tachycardia
and should be explored. (B and C) are symptoms of emphysema and are not consistent
with the other symptoms. (C) is usually referred to as a "barrel chest."
What discharge instruction is most important for a client after a kidney transplant?
A) Weigh weekly.
B) Report symptoms of secondary Candidiasis.
C) Use daily reminders to take immunosuppressants.
D) Stop cigarette smoking.
C) Use daily reminders to take immunosuppressants.
After renal transplantation, acute rejection is a risk for several months, so
immunosuppressive therapy, such as corticosteroids and azathioprine (Imuran), is
essential in preventing rejection, so the priority instruction includes measures, such as
daily reminders (C), to ensure the client takes these medications regularly. Daily
weights, not weekly (A), provides a better indicator of weight gain related to rejection.
Although fungal infections related to the immunosuppression should be reported (B), it
is more important to ensure medication compliance to prevent rejection. Although
,smoking (D) increases the risk of atherosclerotic vascular disease which is common in
clients with an organ transplant, (C) remains the priority.
A client experiencing uncontrolled atrial fibrillation is admitted to the telemetry unit. What
initial medication should the nurse anticipate administering to the client?
A) Xylocaine (Lidocaine).
B) Procainamide (Pronestyl).
C) Phenytoin (Dilantin).
D) Digoxin (Lanoxin).
D) Digoxin (Lanoxin).
Digoxin (Lanoxin) (D) is administered for uncontrolled, symptomatic atrial fibrillation
resulting in a decreased cardiac output. Digoxin slows the rate of conduction by
prolonging the refractory period of the AV node, thus slowing the ventricular response,
decreasing the heart rate, and effecting cardiac output. (A, B, and C) are not indicated
in the initial treatment of uncontrolled atrial fibrillation.
What instruction should the nurse give a client who is diagnosed with fibrocystic
changes of the breast?
A) Observe cyst size fluctuations as a sign of malignancy.
B) Use estrogen supplements to reduce breast discomfort.
C) Notify the healthcare provider if whitish nipple discharge occurs.
D) Perform a breast self-exam (BSE) procedure monthly.
D) Perform a breast self-exam (BSE) procedure monthly.
Fibrocystic changes in the breast are related to excess fibrous tissue, proliferation of
mammary ducts and cyst formation that cause edema and nerve irritation. These
changes obscure typical diagnostic tests, such as mammography, due to an increased
breast density. Women with fibrocystic breasts should be instructed to carefully perform
monthly BSE (D) and consider changes in any previous "lumpiness." Fibrocystic
disease does not increase the risk of breast cancer (A). Cyst size fluctuates with the
menstrual cycle, and typically lessens after menopause, and responds with a
heightened sensitivity to circulating estrogen (B), which is not indicated. Nipple
discharge associated with fibrocystic breasts is often milky or watery-milky and is an
expected finding (C).
After checking the urinary drainage system for kinks in the tubing, the nurse determines
that a client who has returned from the post-anesthesia care has a dark, concentrated
urinary output of 54 ml for the last 2 hours. What priority nursing action should be
implemented?
A) Report the findings to the surgeon.
B) Irrigate the indwelling urinary catheter.
C) Apply manual pressure to the bladder.
D) Increase the IV flow rate for 15 minutes.
A) Report the findings to the surgeon.
B) Which description of symptoms is characteristic of a client diagnosed with
trigeminal neuralgia (tic douloureux)?
A) Tinnitus, vertigo, and hearing difficulties.
, B) Sudden, stabbing, severe pain over the lip and chin.
C) Facial weakness and paralysis.
D) Difficulty in chewing, talking, and swallowing.
C) B) Sudden, stabbing, severe pain over the lip and chin.
Trigeminal neuralgia is characterized by paroxysms of pain, similar to an electric
shock, in the area innervated by one or more branches of the trigeminal nerve
(5th cranial) (B). (A) would be characteristic of Méniére's disease (8th cranial
nerve). (C) would be characteristic of Bell's palsy (7th cranial nerve). (D) would
be characteristic of disorders of the hypoglossal cranial nerve (12th).
D) A 67-year-old woman who lives alone is admitted after tripping on a rug in her
home and fractures her hip. Which predisposing factor probably led to the
fracture in the proximal end of her femur?
A) Failing eyesight resulting in an unsafe environment.
B) Renal osteodystrophy resulting from chronic renal failure.
C) Osteoporosis resulting from hormonal changes.
D) Cardiovascular changes resulting in small strokes which impair mental acuity.
E) C) Osteoporosis resulting from hormonal changes.
The most common cause of a fractured hip in elderly women is osteoporosis,
resulting from reduced calcium in the bones as a result of hormonal changes in
later life (C). (A) may or may not have contributed to the accident, but it had
nothing to do with the hip being involved. (B) is not a common condition of the
elderly; it is common in chronic renal failure. (D) may occur in some people, but
does not affect the fragility of the bones as osteoporosis does.
F) The nurse is assisting a client out of bed for the first time after surgery. What
action should the nurse do first?
A) Place a chair at a right angle to the bedside.
B) Encourage deep breathing prior to standing.
C) Help the client to sit and dangle legs on the side of the bed.
D) Allow the client to sit with the bed in a high Fowler's position.
G) D) Allow the client to sit with the bed in a high Fowler's position.
The first step is to raise the head of the bed to a high Fowler's position (D), which
allow venous return to compensate from lying flat and vasodilating effects of
perioperative drugs. (A, B, and C) are implemented after (D).
H) A 20-year-old female client calls the nurse to report a lump she found in her
breast. Which response is the best for the nurse to provide?
A) Check it again in one month, and if it is still there schedule an appointment.
B) Most lumps are benign, but it is always best to come in for an examination.
C) Try not to worry too much about it, because usually, most lumps are benign.
D) If you are in your menstrual period it is not a good time to check for lumps.
I) B) Most lumps are benign, but it is always best to come in for an examination.
(B) provides the best response because it addresses the client's anxiety most
effectively and encourages prompt and immediate action for a potential problem.
