HESI MEDICAL-SURGICAL EXAM QUESTIONS AND ANSWERS 100% CORRECT!!, Exams of Nursing

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HESI MEDICAL-SURGICAL EXAM QUESTIONS

AND ANSWERS 100% CORRECT!!

A client asks the practical nurse what type of food is the best to eat reduce their chances of getting colon cancer. Which type of foods should the PN suggest to the client? (Select all that apply.) - ANSWER b. Fruits and vegetables d. Whole grains Rationale: According to the American Cancer Society, "studies suggest that fiber in the diet, especially from whole grains, may lower colorectal cancer risk."

A client has had a gastrectomy to treat stomach cancer. The nurse has reinforced instructions on ways to prevent "dumping syndrome." Which client statement indicates the need for further instruction? - ANSWER b. "I should walk around after each meal." Rationale: The client should lie down after meals to avoid syncope. The client should eat more protein and less carbohydrates, and smaller more frequent meals.

A client residing in a memory care nursing facility with a diagnosis of diabetes approaches the nurse crying, saying "I just do not feel good." What action should the practical nurse take first? - ANSWER d. Obtain a fingerstick blood glucose test. Rationale: An early sign of hypoglycemia increases confusion and/or irritability, sometimes described as "feeling bad." Based on the history of diabetes, the PN should first obtain objective data of a fingerstick blood glucose level to provide information to guide further nursing actions.

A client has visited the health care provider and has been diagnosed with type 2 diabetes mellitus. Which symptom most likely prompted the client to seek medical attention? - ANSWER d. Frequent vaginal infections Rationale: Symptoms of type 2 diabetes arise more slowly and are less dramatic. The client may learn then have type 2 diabetes when being treated for frequent infections, a change in vision and impotence. Extreme thirst, hunger, and a large urine output are more likely to be noticed with type 1 diabetes. Fruity odor to the breath is associated with diabetic ketoacidosis (DKA). Type 2 diabetes is less likely to cause DKA.

The nurse is caring for a client who has an ileostomy and has reinforced instructions regarding ileostomy care. The nurse realizes the client needs additional instructions if

2. The client who has chronic renal disease is scheduled for hemodialysis today and three times weekly.
3. The client who has had GI bleeding but had a negative guaiac test for the last three stools.
4. The client who is recovering from a left total knee replacement and who ambulates with a walker. Rationale: The client with aphasia should be seen first because this client has safety risks related to limited mobility and communication and requires assessment before the GT is placed. The client with chronic renal disease should be seen next to evaluate the impact of fluid balance and potassium on cardiac function between dialysis treatments. The client with GI bleeding is stable and should be seen third to evaluate resolution of bleeding. The ambulatory client is progressing toward independence and is the least likely to need immediate attention.

A client is diagnosed with fluid volume deficit. Which findings would the practical nurse document consistent with fluid volume deficit? (Select all that apply.) - ANSWER a. Tachycardia c. Cool skin e. Decreased urine output f. Increased thirst Rationale: Fluid volume deficit causes tachycardia because the body tries to compensate and pump blood efficiently. Cool skin is consistent with fluid volume deficit. Decreased urine output results from reduced fluid volume perfusing the kidneys. Thirst will be stimulated by the hypothalamus because of decreased fluid volume.

A client who has undergone closed-appendectomy is prescribed to begin ambulation the next day. The next day when the practical nurse (PN) goes to assist the client with ambulation, the client yells they are watching the television and they do not feel like getting out of bed. Which response should the PN provide? - ANSWER d. "I'll be back in 30 minutes to help you get out of bed and walk around the room." Rationale: Returning within 30 minutes provides a "cooling off" period, is firm, direct, and nonthreatening, and avoids arguing with the client.

A client diagnosed with viral influenza is prescribed vitamin C 1000 mg PO daily and acetaminophen 650 mg PO every 4 hours prn. The client complains to the practical nurse of abdominal cramping and increasing episodes of diarrhea. Which prescription change should the nurse anticipate? - ANSWER c. Decrease the dose of vitamin C.

Rationale: Diarrhea is an adverse effect of high doses of vitamin C, so the nurse should anticipate a reduction in the dose of vitamin C.

A client diagnosed with chronic obstructive pulmonary disease complains to the practical nurse of extreme fatigue after coughing. Which self-care measures can help minimize the client's dyspnea? (Select all that apply.) - ANSWER a. Assume a sitting position with shoulders relaxed and knees flexed. b. Support forearms with a pillow and place both feet flat on the floor. c. Slightly drop the head, bend forward, and slowly exhale with pursed lips. d. Resume sitting up straight, using diaphragmatic breathing to inhale slowly and deeply. Rationale: Effective coughing can help the client to cough secretions, therefore improving gas exchange and minimize fatigue. The client should assume the sitting position with shoulders relaxed and knees flexed. Their forearms should be supported with a pillow and both feet place flat on the floor. The client should slightly drop their head, bent forward, and slowly exhale through pursed lips using slow and deep diaphragmatic breathing to help facilitate effective coughing. The client should repeat the previous steps two or three times. The client should initiate the cough reflex, not wait for it. The client should also take a deep abdominal breath before initiating a cough.

A client has undergone craniotomy to remove a brain tumor. The client spent several days in the intensive care unit, and is now on the post-surgical unit. The nurse has urgently contact the surgeon to report signs of increasing intracranial pressure (ICP). Which was the most likely EARLY sign that the client was experiencing increased ICP? - ANSWER b. The client became more confused than he was upon transfer to the post-surgical unit. Rationale: A change in the level of consciousness is most likely the earliest symptom of increased ICP. Vital sign changes can also occur, with a widening pulse pressure and bradycardia. Neither of these are indicated by data in the options. Sanguineous drainage does not indicate increased ICP.

Which foods should the practical nurse encourage a client to eat to increase their potassium intake? (Select all that apply.) - ANSWER a. Green beans d. Milk e. Flounder f. Sweet potatoes g. Cantaloupe

Which educational materials should the practical nurse select for reinforcement of teaching for secondary prevention? (Select all that apply.) - ANSWER a. Video that teaches client to do breast self-examinations. b. Pamphlets describing how to do testicular self-examinations. e. Postcard reminders for clients to get papanicolaou (Pap) smears and mammograms. Rationale: Secondary prevention deals with early diagnosis to treat disease in the beginning of its development. Breast self-examinations, testicular self-examinations, mammograms, and Pap smears are considered secondary prevention methods.

A client diagnosed with status asthmaticus is admitted to the unit. Which breath sounds would the practical nurse anticipate to hear when auscultating the client's lungs? - ANSWER b. Wheezes Rationale: Wheezes are continuous, high-pitched musical or squeaking-type sounds. They are reflective of the narrowing of the airways as a result of the inflammation from the asthma. Wheezes are generally heard with expiration, but can be heard with inspiration in severe cases of asthma.

The nurse is assisting with data collection for an older adult who is visiting the health care provider today. Which signs and symptoms should the nurse report to the health care provider as possible signs associated with colon cancer? (Select all that apply.) - ANSWER a. Rectal bleeding c. Abdominal distention d. Sensation that bowels are not evacuating completely Rationale: Some signs and symptoms associated with colon cancer include rectal bleeding, abdominal distention, and a sensation the bowels are not evacuating completely. A diet high in cauliflower, cabbage, and kale is associated with a reduced, not increased, risk of colon cancer. A client who has colon cancer is more likely to have a weight loss rather than weight gain.

The nurse is teaching concerned family members of a client who experienced a cardiac arrest prior to admission in the technique of cardiopulmonary resuscitation. The nurse recognizes the family members are performing the technique correctly if they use which depth of manual chest compression on the manikin? - ANSWER c. 2 inches (5 cm) to 2.4 inches (6 cm) Rationale:

According to the American Heart Association 2015 guidelines, the depth of compressions on an adult during CPR should be at least 2 inches (5 cm) to 2.4 inches (6 cm).

The nurse is caring for a 70-year-old female client who experienced a myocardial infarction. During review of the client's medical records, which signs and symptoms did the client most likely experience? (Select all that apply.) - ANSWER b. Shortness of breath c. Fatigue e. Sleep disturbances Rationale: A female client is more likely to experience dyspnea, fatigue, and sleep disturbances. Hot dry skin and extreme hunger are more likely associated with an elevated blood sugar. Melena is blood in the stools.

A client underwent a colon resection 48 hours ago. Which finding requires the most immediate intervention by the practical nurse (PN)? - ANSWER a. Fever of 102° F (38.9° C) and chills Rationale: A sudden increase in temperature is an indicator of peritonitis and chills, along with abdominal pain and tenderness. The PN should immediately notify the charge nurse, who should notify the health care provider.

A client with chronic obstructive pulmonary disease (COPD) tells the nurse "I get so tired when I eat; I'm just about ready to stop eating altogether". Which nursing intervention is most appropriate for this client? - ANSWER b. Advise the client to take smaller, but more frequent meals. Rationale: Having a full stomach can cause difficulty breathing, and the client is advised to take frequent small meals and take most of their fluids between meals. Using an oxygen mask during meals would not be practical, as it would have to be removed with every bite of food.

The nurse is reinforcing instructions regarding risk factor reduction for a client with angina. The nurse should focus instructions to reduce the risk of cardiovascular disease by which risk factors? (Select all that apply.) - ANSWER a. Blood pressure c. Blood sugar e. Stressful lifestyle Rationale:

not inhibit the nurse for taking care of a HIV+ client as long as standard precautions are observed.

A client diagnosed with osteoarthritis. Which intervention should the practical nurse implement to help relieve joint pain and stiffness? - ANSWER d. Instruct the client to take an analgesic before walking daily. Rationale: Adequate pain management is important for the success of an exercise program. Keeping the joints active decreases pain, so taking an analgesic and walking daily is likely to help decrease joint pain and stiffness.

The practical nurse is reinforcing osteoporosis prevention education to a group of senior citizens. The nurse realizes teaching has been effective if the senior citizens select which life style choices will help decrease the risk of developing osteoporosis? (Select all that apply.) - ANSWER a. Alcohol in moderation and smoking cessation c. Regular weight-bearing exercises e. Consumption of a diet rich in calcium and vitamin D Rationale: Alcohol in moderation and smoking cessation, regular weight-bearing exercises at least 30 minutes a day, and consumption of a diet rich in calcium and vitamin D are life style choices that decrease the risk for developing osteoporosis.

A client diagnosed with bacterial meningitis is admitted to the unit and is prescribed neuro checks every 2 hours. Which manifestation would the practical nurse monitor for that would provide the first indication of altered neurological function? - ANSWER a. Change in level of consciousness Rationale: A decrease or change in the level of consciousness is usually the first indication of neurological deterioration.

A client is admitted to the hospital for a Crohn's disease flare up and severe dehydration. Which findings should the practical nurse report to the registered nurse and/or health care provider immediately? - ANSWER a. A rigid hard abdomen and elevated white blood cell count Rationale: A hard, rigid abdomen and elevated white blood cell (WBC) count are indicative of peritonitis, which is a medical emergency and should be reported to the RN and health care provider immediately.

An older adult client diagnosed with dementia was admitted from a long-term facility to the hospital 2 days ago. The client's children express concern that their parent's confusion has gotten worse since being admitted. How should the practical nurse (PN) respond? - ANSWER b. "Confusion in an older person is expected with a relocation to new surroundings." Rationale: Relocation often results in confusion among older adult clients and is stressful for clients of all ages.

A client diagnosed with diabetes has a prescription of 5 units of regular insulin and 15 units of NPH insulin. In which order should the practical nurse prepare to administer the insulin? - ANSWER

The nurse is assisting with planning care for a client who is undergoing chemotherapy to treat breast cancer. Which elements should be included in the client's education on ways to prevent contracting pneumonia? (Select all that apply.) - ANSWER a. Maintain a healthy diet with protein, fruits, and vegetables. b. Ask your health care provider about receiving the flu and pneumonia vaccine. d. Try to do your grocery shopping when your local grocery store is the least crowded. Rationale: Adequate nutrition reduces the risk of contracting pneumonia. The client should receive all recommended flu and pneumonia vaccines. The client should go in public places when those places are the last crowded to avoid contact with large number of microorganisms. The client should stop smoking, not simply cut back. Adequate rest periods during the day can improve the client's ability to resist infection.

A client diagnosed with ulcerative colitis (UC) asks the practical nurse why a low-fiber diet has been prescribed. Which is the most appropriate response? - ANSWER a. To reduce the amount and frequency of stool Rationale: The purpose of a low-fiber diet is to reduce the amount and frequency of stooling to promote healing of the bowels by consuming foods that do not irritate the intestinal lining and prolong intestinal transit time to encourage optimal absorption of nutrients.