Hesi- medical Surgical practice Quiz

The practical nurse (PN) is assisting the occupational health nurse with employee health screening. Which technique should the PN used to determine a clients visual acuity?

Have the client read the Snellen eye chart

Which action should the practical nurse (PN) implement to reduce the risk of infection for a client who is receiving total parental nutrition (TPN)?

Change the transparent dressing every 72 hours

A client with cholelithiasis is admitted with jaundice due to obstruction of the common bile duct. Which finding is most important for the practical nurse to report to the healthcare provider?

Hard, rigid abdomen

The practical nurse (PN) is reinforcing information to a older male client with a history of coronary artery disease about his prescribed daily medication regimen. Which medication is most likely to reduce the client's risk factors?

A low- dose aspirin given daily

The practical nurse (PN) is caring for a client with a chest tube connected to a closed chest drainage system to suction at 20 cm of water pressure. The sterile water in the suction chamber is gently bubbling at the water level of 15 cm. What action should the PN take?

Add sterile water to the suction control chamber to the 20 cm mark.

An adult male who is covered with "road rash" after falling off his bicycle arrives at the clinic. He holds his hand to his chest and tells the practical nurse (PN) that he hurts when he breathes. The PN hears an audible "slurping" sound each time the client takes a breath. Which intervention should the PN implement first?

Apply oxygen and inspect the chest wall.

The practical nurse (PN) is reviewing the health history of a client with coronary artery disease (CAD). Which finding should the PN identify that places the client at risk for stroke?

Atrial fibrillation

Which information should the practical nurse offer a female client who is at risk for recurrent urinary tract infection (UTI)? Select all that apply.

Avoid wearing tight fitting jeans Limit caffeine and alcohol Void before and after intercourse Wipe the perineum from front to back

The practical nurse is caring for a client who is admitted with signs of possible acute brain attack (stroke) three hours ago. The client's blood pressure is 170/96, regular radial pulse 76 beats/minute, respirations are nonlabored at 11 breaths/minute, and a SpO2 of 99%. What action is most important for the PN to implement?

Continue to monitor clients blood pressure

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?

Correct vision for reading, and close work

After receiving report, the practical nurse (PN) begins assessment for a client with chronic obstructive pulmonary disease (COPD) who has just completed a respiratory treatment. The PN finds the client sitting upright in bed with oxygen at 6 liters/minute per nasal cannula. Which intervention is most important for the PN to implement?

Decrease oxygen flow rate to 2 liter/minute and attach pulse oximeter.

What information should the practical nurse (PN) reinforce with a client who is recently diagnosed with diabetes mellitus (DM)?

Diabetes increases the risk for cardiovascular disease

The practical nurse (PN) is reviewing the plan of care for a client scheduled for a surgical amputation of the left lower leg. Which nursing diagnosis should the PN use as the highest priority for this client after the surgery?

Disturbed body image

A client who received graphs for full- thickness burn of the right are is admitted to the rehabilitation unit. Which action is important for the practical nurse to reinforce with the client to prevent long-term complications?

Exercise the affected arm everyday

Which behavior demonstrates hopelessness in an older client with a terminal disease?

Failing to follow medical recommendations.

Which intervention is most important for the practical nurse to implement after giving a client an initial injection for the screening for allergies?

Have the client remain on site for 30 minutes after the injections

Which finding should the practical nurse (PN) identify as typical for a client who is hypoxic?

Hemoglobin of 10 grams/dl

Which finding for a client who 1-day post operative for a partial thyroidectomy, requires immediate follow up by the practical(PN)?

High pitched expiratory sound

The practical nurse (PN) is obtaining deep tendon reflexes for a client with type 1 diabetes mellitus. Which finding indicates to the PN that the client has peripheral neuropathy?

Hypoactive reflexes at the Achilles tendon

A male client is one day postoperative for surgical repair of a fractured femur when he suddenly experiences dyspnea, coughing, chest pain, and hemoptysis. Based on this data, what nursing diagnoses should the practical nurse address for this client?

Impaired gas exchange related to altered blood flow to alveoli

The practical nurse (PN) is reviewing laboratory results for a client admitted with possible meningitis and identifies that the cerebrospinal fluid (CSF) findings are positive for bacteria. Which action is most important for the PN implement?

Implement droplet precautions

A client's results for this morning's platelet count is 30,000/mm 3 . What action should the practical nurse (PN) implement first?

Institute bleeding precautions

A client's prescription for warfarin (Coumadin) therapy was discontinued three weeks ago and returns to the clinic for follow-up laboratory tests. Which results should indicate to the practical nurse that the medication has been eliminated from the body?

International normalized ratio (INR) of 0.9.

An older male client with osteoarthritis complains of stiffness and pain in his hips, Niece, and fee each morning, and asks the practical nurse why just these joints bother him. Which explanation should a PN provide?

Joint damage can occur from years of weight-bearing stress

A male client is admitted with lower right abdominal pain for the past two days. During the focused assessment, the practical nurse (PN) observes that the client's abdomen is rigid with tense positioning. Which action should the PN implement?

Keep the client NPO for possible

A client with epilepsy it is having bilateral rhythmic, jerking movements of all extremities. After calling for help, which action should the practical nurse do next? (Arrange the interventions from first to last.)

Maintain the clients airway Apply pads to the bedside rails Observe the client for incontinence Avoid stimulation during post-ictal phase

The practical nurse (PN) is reviewing the side effects associated with chlopromazine(Thorazine) rectal suppository for a client with nausea and vomiting. Which information should the PN review with the client?

Minimize exposure to sunlight during therapy

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?

Notify Heath 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, threads pulse at 104 beats/minute, and blood pressures of 90/50. Which action should the PN implement?

Notify the healthcare provider

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?

Pinpoint rash on upper chest that does not blanch.

A client arrives at the oncology clinic for the next treatment in the prescribed course of chemotherapy (CT). The practical nurse (PN) reviews the client's laboratory results: white blood cells 700/mmd, red blood cells 2.8 million/mm3, hemoglobin 7.9 grams/dl, hematocrit 25.5%, and platelet count 14,000/mm3. Which action should the PN take first?

Place an isolation mask on the client.

Which factor should the practical nurse (PN) identify that indicates a client needs to be screened for an aggressive breast cancer?

Pre-menopausal breast cancer in her mother

What information should the practical nurse reinforce while reviewing discharge instructions with a client who has joint dislocation ?

Prescribed exercises should be performed daily

What is the priority data that the practical nurse (PN) should obtain for a client with a cervical spinal cord injury (SCI)?

Respiratory pattern and airway

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?

Right calf is 24 cm and left calf is 21 cm.

An older client who has had a cataract in the right eye for several years tells the practical nurse (PN), "Now I have lost the sight in my right eye because I waited too long for treatment." What information should the PN provide?

Surgery can restore vision with corrective lens implants or glasses.

The practical nurse (PN) is evaluating the self-care of a client who is recovering at home after a laryngectomy. Which finding indicates to the PN that the client needs additional information?

The salt water solution is dated 3 days ago

What equipment should the practical nurse (PN) ensure is the room for a client after a thyroidectomy?

Tracheostomy tray

A client is receiving a unit of packed red blood cells (RBC's). Which finding should the practical nurse (PN) report to the healthcare provider?

Urticaria on the neck and chest

Which client should the practical nurse consider at greatest risk for bacterial cystitis?

An older female, who does not use estrogen replacement

A client is admitted with Ac for spinal cord(SCI) after falling from a roof at a construction site. After returning to the unit for a CT scan to confirm the vertebral fracture, which assessment by the practical nurse has the highest priority?

Check the respiratory effort and pulse oximeter reading

A male client who is 6 ours post radical nephrectomy has a urine output of 20mL/hr and his blood pressure has changed from 134/90 to 100/56 in the past hour. Which action should the PN implement?

Notify the healthcare provider of changes

A male client who had a stroke is incontinent of urine. Which action should the practical nurse (PN) implement in providing bladder training?

Offer the client the commode or urinal every two hours.

The practical nurse is caring for a client with chronic obstructive pulmonary(COPD). To reduce(CO2) retention in the lungs, which information should the PN reinforce?

Use pursed-lip and abdominal breathing

A client with type 2 diabetes mellitus (DM) presents in the clinic with a leg laceration that has not healed in two weeks. Which client data is most important for the practical nurse to collect?

Finger stick glucose level

The practical nurse (PN) auscultates the abdomen of a client who had a barium swallow 24 hours ago and determines the client has decreased bowel sounds. The client reports having no bowel movements for 2 days. Which nursing intervention should the PN implement?

Check digitally for bowls impaction

The practical nurse(PN) is implementing a focused assessment of a clients musculoskeletal system. Which family history finding would the PN identify as an increased risk factor for the client?

Osteoporosis