Hesi Medsurg Practice Exam
A. Right calf is 24 cm and left calf is 21 cm.
Which finding is most important for the practical nurse (PN) to explore further for a client who had a total abdominal hysterectomy and bilateral oophorectomy yesterday?
Notify the health care provider.
A male client with peptic ulcer disease complains of feeling weak and dizzy. The practical nurse (PN) observes that the client is diaphoretic, has a firm abdomen, thready pulse at 104 beats/minute, and blood pressure of 90/50. Which action should the PN implement?
Raise the head of the bed 30 degrees and lower the feet
A male client with increased intracranial pressure (ICP) due to a skull fracture is in the supine position with his legs elevated. What should the practical nurse (PN) do first?
No vomiting with oral fluid intake
A client who has vomiting, dysuria, and urinary tract infection (UTI) arrives in the clinic and receives an IV antiemetic and a liter of IV fluids. The healthcare provider prescribes oral antibiotics for the client's discharge. Which finding is essential for the practical nurse to determine before the client is discharged?
metabolic alkalosis
A client who is 2-days postoperative for abdominal surgery has a nasogastric tube (NGT) to low continuous suction. The client tells the practical nurse (PN) his mouth is so dry that he has been drinking water to quench his thirst. Which potential imbalance should the PN monitor for development in the client?
Sleeps with two additional pillows
A client with heart failure (HF) takes a daily tablet of furosemide (Lasix) and lisinopril (Zestril). Which finding during the clinic visit should indicate to the practical nurse that the client's condition is worsening?
Absence of blood in the stool
A client with major burns is receiving cimetidine (Tagamet). Which finding should the practical nurse (PN) obtain to best evaluate the effectiveness of the medication?
The four-drug protocol should be taken concurrently
A male client who has been taking a four-drug regimen for tuberculosis (TB) tells the practical nurse (PN) that he has finished the first drug, isoniazid, and will start taking rifampin next. How should the PN respond?
Notify the healthcare provider of the changes
A male client who is 6 hours post radical nephrectomy has a urine output of 20 ml/hour and his blood pressure has changed from 134/90 to 100/56 in the past hour. Which action should the PN implement?
500/mm3
A practical nurse (PN) is coordinating the care of four clients on an oncology unit. Which neutrophil count should the PN identify as a risk for a life-threatening infection in one of the clients?
Apply oxygen per nasal cannula at 2L/minute
An older male with a history of emphysema arrives to the emergent care center with complaints of increasing dyspnea on exertion. The client's chest has an increased anteroposterior diameter, a dry, hacking cough, and pulse oximetry of 89%. What action should the practical nurse take?
unilateral neglect
After a stroke, a male client with left hemiplegia ignores his left leg and arm. He is unable to use his right arm to assist with moving his left arm or leg. Which descriptor should the practical nurse (PN) document to describe this behavior?
Palpation of both pedal pulses
Which assessment is most important for the practical nurse (PN) to implement for a client who returns from surgery for an arthroscopic repair of the right knee?
PInpoint rash on upper chest that does not blanch
The practical nurse (PN) is performing a shift assessment of a client with a fractured left hip that occurred in a motor vehicle collision 36 hours ago. Which finding should the PN report to the charge nurse?
Pain medication should be taken every day
The practical nurse (PN) is reviewing discharge instructions with a client after out-patient surgery. Which client response indicates to the PN the need for teaching reinforcement?
What do you know about the surgery you are having?
The practical nurse (PN) is reviewing preoperative instructions with a male client who is having surgery today. What question should the PN ask the client to best evaluate his understanding of the surgery?
Check the pulse oximeter for a patient with myasthenia gravis
The practical nurse (PN) receives a report on a group of clients assigned for the day. Which priority assessment should the PN implement?
Sitting upright in a tripod position leaning on and overbed table
The practical nurse (PN) should place a client in which position for a thoracentesis?
Failing to follow medical recommendations
Which behavior demonstrates hopelessness in an older client with a terminal disease?
An older female who does not use estrogen replacement
Which client should the practical nurse consider at greatest risk for bacterial cystitis?
Respiratory pattern and airway
What is the priority data that the practical nurse (PN) should obtain for a client with a cervical spinal cord injury (SCI)?
implement standard precautions with the cerebral spinal fluid
Which action should the practical nurse take when handling a sample of cerebrospinal fluid (csf) collected for diagnostic testing from a client?
Increase the flow of oxygen by 2 L/minute
A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 L/minute. During the bed bath, the client complains of shortness of breath. Which action should the practical nurse (PN) implement?
50-year-old with Prinzmetal's angina
Which client should the practical nurse question a PRN prescription for sumatriptan (Imitrex) for migraine headaches?
A. Pain relief after ear drainage begins.
An adult client with otitis media has thick, yellow drainage from the right ear canal. What additional findings should the practical nurse (PN) expect to identify?
A. Use pursed-lip and abdominal breathing.
The practical nurse (PN) is caring for a client with chronic obstructive pulmonary disease (COPD). To reduce carbon dioxide ( CO 2 ) retention in the lungs, which information should the PN reinforce?
Corrects vision for reading and close reading
An older client with presbyopia receives a prescription for corrective lenses. Which information should the practical nurse provide that explains the expected results of the corrective lenses?