Med/Surg HESI Practice Questions with complete solutions 2023.

Med/Surg HESI Practice Questions with complete solutions 2023. The nurse is planning to initiate a socialization group for older residents of a long-term facility. Which information would be most useful to the nurse when planning activities for the group? A. The length of time each group member has resided at the nursing home. B. A brief description of each resident's family life. C. The age of each group member. D. The usual activity patterns of each member of the group. - correct answers.D An older person's level of activity is a determining factor in adjustment to aging as described by the Activity Theory of Aging. The most useful information initially would be an assessment of each individual's adjustment to the aging process. A client has taken steroids for 12 years to help manage chronic obstructive pulmonary disease (COPD). When making a home visit, which nursing assessment is of greatest importance to this client? A. pulse rate, both apically and radially. B. blood pressure, both standing and sitting. C. temperature. D. skin color and turgor. - correct answers.C Long term use of steroids by COPD clients is effective in suppressing inflammation in their airways making it easier for them to breath, but at the same time suppresses the immune system, placing the client at risk for infection, so it is very important to obtain the client's temperature. A client who is sexually active with several partners requests an intrauterine device (IUD) as a contraceptive method. Which information should the nurse provide? A. Using an IUD offers no protection against sexually transmitted diseases (STD), which increase the risk for pelvic inflammatory disease (PID). B. Getting pregnant while using an IUD is common and is not the best contraceptive choice. C. Relying on an IUD may be a safer choice for monogamous partners, but a barrier method provides a better option in preventing STD transmission. D. Selecting a contraceptive device should consider choosing a successful method used in the past. - correct answers.A The use of an intrauterine device (IUD) provides the client with no protection from sexually transmitted diseases (STD). Which symptoms should the nurse expect a client to exhibit who is diagnosed with a pheochromocytoma? A. Numbness, tingling, and cramps in the extremities. B. Headache, diaphoresis, and palpitations. C. Cyanosis, fever, and classic signs of shock. D. Nausea, vomiting, and muscular weakness. - correct answers.B Pheochromocytoma is a catecholamine secreting non-cancerous tumor of the adrenal medulla, and a headache, profuse sweating and palpitations is the typical triad of symptoms depending upon the relative proportions of epinephrine and norepinephrine secretion. Surgical removal of the tumor is the only treatment. 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 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. When preparing a client who has had a total laryngectomy for discharge, which instruction is most important for the nurse to include in the discharge teaching? A. Recommend that the client carry suction equipment at all times. B. Instruct the client to have writing materials with him at all times. C. Tell the client to carry a medic alert card stating that he is a total neck breather. D. Tell the client not to travel alone. - correct answers.C It is imperative that total neck breathers carry a medic alert notice so, that if they have a cardiac arrest, mouth-to-neck breathing can be done. During an interview with a client planning elective surgery, the client asks the nurse, "What is the advantage of having a preferred provider organization insurance plan?" Which response is best for the nurse to provide? A. Neither plan allows selections of healthcare providers or hospitals. B. There are fewer healthcare providers to choose from than in an HMO plan. C. An individual may select healthcare providers from outside of the PPO network. D. An individual can become a member of a PPO without belonging to a group. - correct answers.C The financial implication of selecting a provider from outside of the network is the feature most relevant to the average consumer. The nurse must have knowledge about preferred provider organizations (PPOs), which provides the option for the consumer to select a Healthcare Provider (HCP) from within the PPO network (in-network) at a reduced cost versus a higher cost for selecting an out-of-network HCP. A client is admitted to the hospital with a medical diagnosis of pneumococcal pneumonia. The nurse knows that the prognosis for gram-negative pneumonias (such as E. coli, Klebsiella, Pseudomonas, and Proteus) is very poor. Which information relates most directly to the prognosis for gram-negative pneumonias? A. The gram-negative infections occur in the lower lobe alveoli which are more sensitive to infection. B. Gram-negative organisms are more resistant to antibiotic therapy. C. Usually occur in healthy young adults who have recently been debilitated by an upper respiratory infection. D. Gram-negative pneumonias usually affect infants and small children. - correct answers.B Gram-negative organisms are very resistant to drug therapy which makes recovery difficult. Antibiotic resistance has become a world-wide concern and the World Health Organization is keeping a very close surveillance on these occurrences. The nurse is planning care to prevent complications for a client with multiple myeloma. Which intervention is most important for the nurse to include? A. Safety precautions during activity. B. Assess for changes in size of lymph nodes. C. Maintain a fluid intake of 3 to 4 L per day. D. Administer narcotic analgesic around the clock. - correct answers.C Multiple myeloma is a malignancy of plasma cells that infiltrate bone causing demineralization and hypercalcemia, so maintaining a urinary output of 1.5 to 2 L per day requires an intake of 3 to 4 L to promote excretion of serum calcium. A 58-year-old client, who has no health problems, asks the nurse about the Pneumovax vaccine. The nurse's response to the client should be based on which information? A. The vaccine is given annually before the flu season to those over 50 years of age. B. The immunization is administered once to older adults or persons with a history of chronic illness. C. The vaccine is for all ages and is given primarily to those persons traveling overseas to areas of infection. D. The vaccine will prevent the occurrence of pneumococcal pneumonia for up to five years. - correct answers.B It is recommended by the CDC (Dec 2016) that persons over 65 years of age and those with a history of chronic illness receive the vaccine once in a lifetime. The nurse is caring for a client who has been diagnosed with primary hyperaldosteronism. Which laboratory test result should the nurse expect an increase in the serum level? A. Sodium. B. Antidiuretic hormone. C. Potassium. D. Glucose. - correct answers.A Clients with primary aldosteronism exhibit an increase in serum sodium levels (hypernatremia) and have profound decline in the serum levels of potassium (hypokalemia)--hypertension is the most prominent and universal sign. Antidiuretic hormone is decreased with diabetes insipidus. Glucose is not affected by primary aldosteronism. Which information about mammograms is most important to provide a post-menopausal female client? A. Breast self-examinations are not needed if annual mammograms are obtained. B. Radiation exposure is minimized by shielding the abdomen with a lead-lined apron. C. Yearly mammograms should be done regardless of previous normal x-rays. D. Women at high risk should have annual routine and ultrasound mammograms. - correct answers.C There are different recommendations from different agnecies. For a client with no risk factors, the earliest breast screening recommendation is a yearly mammogram at the age 40 and till the age of 54. After that every two years. The American College of OB/GYN still recommend starting mammograms starting at the age of 40 and yearly screeenings. The American Cancer Society new guidelines recommend starting at the age of 45 and thereafter till the age of 54 years old, then every two years. The US Preventive Services Task Force Services (USPSTS) recommends starting at the age of 50 years old and screenings every two years thereafter. A client receiving cholestyramine for hyperlipidemia should be evaluated for which vitamin deficiency? A. K. B. B12. C. B6. D. C. - correct answers.A Cholestyramine is administered to help lower the triglycerides levels. Side effects clients should be monitored for include increased prothrombin time and prolonged bleeding times which would alert the nurse to a vitamin K deficiency. These drugs reduce absorption of the fat soluble (lipid) vitamins A, D, E, and K. 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, which 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 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 working on a telemetry unit finds a client unconscious and in pulseless ventricular tachycardia (VT). The client has an implanted automatic defibrillator. Which action should the nurse implement? A. Prepare the client for transcutaneous pacemaker. B. Shock the client with 200 joules per hospital policy. C. Use a magnet to deactivate the implanted pacemaker. D. Observe the monitor until the onset of ventricular fibrillation. - correct answers.B A client with an automatic defibrillator who is experiencing pulseless ventricular tachycardia (VT) must be externally shocked with 200 joules per hospital policy to restore an effective cardiac rhythm. The automatic defibrillator is obviously malfunctioning. A female client taking oral contraceptives reports to the nurse that she is experiencing calf pain. Which action should the nurse implement? A. Determine if the client has also experienced breast tenderness and weight gain.