MedSurg 1 Hesi Practice Questions
The healthcare provider prescribes penicillin 200,000 units intramuscularly for a client with pneumonia. The available vial is labeled, "Penicillin 500,000 units/mL". How many mL should the nurse administer to this client?
0.4
A client receives a prescription for 1 liter of lactated Ringer's intravenously to be infused over 6 hours. How many mL/hr should the nurse program the infusion pump to deliver?
166.6 = 167
A client with cholelithiasis is admitted with jaundice due to obstruction of the common bile duct. Which finding is most important for the nurse to report to healthcare provider? A. Distended, hard, and rigid abdomen. B. Clay-colored stool. C. Radiating, sharp pain in right shoulder. D. Bile-stained emesis.
A
A client with a history of type 1 diabetes and asthma is readmitted to the unit for the third time in 2 months with a current fasting blood sugar is 325 mg/dL. The client describes to the nurse of not understanding why the blood glucose level continues to be out of control. Which interventions should the nurse implement? SATA A. Have the client describe a typical day at work, home, and social activities. B. Determine if the client is using a new insulin needle each administration. C. Evaluate the client's asthma medications that can elevate the blood glucose. D. Ask the client if they want a different manufacturer's glucose monitoring device E. Have the client demonstrate technique used to monitor blood glucose levels.
A and E
The nurse is caring for a client who is postoperative for a femoral head fracture repair. Which interventions should the nurse plan to administer for deep vein thrombosis prophylaxis? SATA A. Pnematic compression devices B. Incentive spirometry C. Assisted Ambulation D. Patient controlled analgesia E. Calf-pump exercises F. Prescribed anticoagulant therapy
A, E, F
A client arrives to the medical unit 4 hours after a transurethral resection of the prostate. A triple-lumen catheter for continuous bladder irrigation with normal saline is infusing and the nurse observes dark, tingled outflow with blood clots in the tubing and collection bag. Which action should the nurse take? A. Monitoring catheter drainage. B. Decreasing the flow rate. C. Irrigating the catheter manually. D. Discontinuing infusing solution.
A.
A client receives prescriptions for a multidrug regimen for the treatment of tuberculosis. Which information should the nurse prioritize? A. Adherence to the regimen is imperative. B. Medications should be taken with food. C. Serum liver panels are collected regularly. D. Enhanced sun protection measures will be needed.
A.
A client with chronic kidney disease is started on hemodialysis. During the first dialysis treatment, the client's blood pressure drops from 150/90 mmHg to 80/30 mmHg. Which action should the nurse take first? A. Stop the dialysis treatment. B. Administer 5% albumin IV. C. Monitor blood pressure q45 minutes. D. Lower the head of the chair and elevate feet.
A.
A nurse is caring for a client with diabetes insipidus (DI). Which data warrants the most immediate intervention by the nurse? A. Serum sodium of 185 mEq/L B. Dry skin with inelastic turgor C. Apical rate of 110 beats per minute D. Polyuria and excessive thirst
A.
An adult who was recently diagnosed with glaucoma tells the nurse, "it feels like I am driving through a tunnel." The client expresses great concern about going blind. Which nursing instruction is most important for the nurse to provide this client? A. Maintain prescribed eye drop regimen. B. Avoid frequent eye pressure measurements. C. Wear prescription glasses. D. Eat a diet high in carotene.
A.
An older adult client with a long history of COPD is admitted with progressive SOB and a persistent cough. The client is anxious and is complaining of a dry mouth. Which intervention should the nurse implement? A. Assist client to an upright position. B. Administer a prescribed sedative. C. Apply a high-flow venturi mask. D. Encourage client to drink water.
A.
During spring break, a young adult presents at the urgent care clinic and reports a stiff neck, fever for the past 6 hours, and a headache. Which intervention is most important for the nurse to implement? a. initiate isolation precuations b. prepare for a lumbar puncture c. admin an antipyretic d. draw blood cultures
A.
The healthcare provider prescribes diagnostic tests for a client whose chest x-ray indicates pneumonia. Which diagnostic test should the nurse review for implementation in the most therapeutic treatment of the pneumonia? A. Sputum culture and sensitivity B. Blood cultures C. Arterial blood gases D. Computerized Tomography (CT) of the chest
A.
The nurse is caring for a client in the post anesthesia care unit who underwent a thoracotomy two hours ago. The nurse observes the following vital signs: heart rate 140 beats/ minute, respirations 26 breaths/ minute, and blood pressure 140/90 mmHg. Which intervention is most important for the nurse to implement? A. Medicate for pain and monitor vital signs according to protocol. B. Administer intravenous fluid bolus as prescribed by the healthcare provider. C. Apply oxygen at 10 L via non-rebreather mask and monitor pulse oximeter. D. Encourage the client to splint the incision with a pillow to cough and deep breathe.
A.
The nurse is caring for a client who is receiving teletherapy radiation for a malignant tumor. Which instructions regarding skin care of the portal site should the nurse provide? A. Protect the skin of the radiation portal site from sunlight exposure. B. Apply moisture lotions daily to the radiation portal site. C. Avoid washing the skin inside the radiation portal site. D. Remove the ink marks of the portal after each radiation treatment.
A.
The nurse is obtaining a health history from a new client who has a history of kidney stones. Which statement by the client indicates an increased risk for renal calculi? A. Eats a vegetarian diet with cheese 2 to 3 times a day. B. Experiences additional stress since adopting a child. C. Jogs more frequently than usual daily routine. D. Drinks several bottles of carbonated water daily.
A.
The nurse is preparing a client for surgery who was admitted to the emergency center following a motor vehicle collision. The client has an open fracture of the femur and is bleeding moderately form the bone protrusion site. During the preoperative assessment, the nurse determines that the client currently receives heparin sodium 5,000 units sub-q daily. What is the priority nursing action? A. Notify the healthcare provider of the client's medication history. B Observe the heparin injections sites for signs of bruising. C. Have the client sign the surgical and transfusion permits. D. Ensure that the potential for bleeding is explained to the client.
A.
The nurse is providing discharge instructions to a client who is receiving prednisone 5 mg PO daily for a rash due to contact with poison ivy. Which symptom should the nurse tell the client to report to the healthcare provider? A. Rapid weight gain. B. Abdominal striae. C. Moon face. D. Gastric irritation.
A.
The nurse is providing teaching to a client with type 2 diabetes and peripheral neuropathy. Which information should the nurse provide? A. Family members can help with regular foot exams. B. Heating pads are useful if on the lowest setting. C. Aching feet may be soaked in lukewarm water for one hour or more. D. Shoes should be worn outside the house, but it is fine to be barefoot inside.
A.
Which food is most important for the nurse to encourage a male client with osteomalacia to include in his daily diet? A. Fortified milk and cereals. B. Citrus fruits and juices. C. Green leafy vegetables. D. Red meats and eggs.
A.
While caring for a client with a full thickness burn covering 40% of the body, the nurse observes purulent drainage at the wound. Before reporting this finding to the healthcare provider, the nurse should review which of the client's laboratory values? A. WBC count B. Platelet count C. Blood pH level D. Hematocrit
A.
A client who was involved in a motor vehicle collision is admitted with a fractured left femur which is immobilized using a fracture traction splint in preparation for an open reduction internal fixation (ORIF). The nurse determines that the client's distal pulses are diminished in the left foot. Which interventions should the nurse implement? SATA A. Verify pedal pulses using a doppler pulse device. B. Evaluate the application of the splint to the left leg. C. Offer ice chips and oral clear liquids D. Monitor left leg for pain, pallor, paranesthesia, paralysis, pressure. E. Administer oral antispasmodics and narcotic analgesics
A., B., D.
To reduce the risk for pulmonary complication for a client with Amyotrophic Lateral Sclerosis (ALS), which interventions should the nurse implement? SATA A. Perform chest physiotherapy B. Teach the client breathing exercises C. Initiate passive range of motion exercises D. Establish a regular bladder routine E. Encourage use of incentive spirometer.
A., B., E.
A client is hospitalized with heart failure. Which intervention should the nurse implement to improve ventilation and reduce venous return? A. Perform Passive range of motion exercises B. Place the client in High Fowler Position C. Administer oxygen per nasal cannula D. Increase the client's activity level.
B
An older client with long term type 2 diabetes is seen in the clinic for a routine health assessment. Which assessments would the nurse complete to determine if a patient with type 2 diabetes is experiencing long term complications? SATA A. Signs of respiratory tract infection. B. Sensation in feet and legs. C. Skin condition of lower extremities. D. Serum creatine and BUN E. Visual acuity
B, C, E
A client in the operating room received succinylcholine. The client is experiencing muscle rigidity and has an extremely high temperature. Which action should the nurse implement? A. Hold a prescription for dantrolene until fever is reduced. B. Prepare ice packs for placement in the client's axillary area. C. Call the PACU nurse to prepare for prolonged ventilatory support. D. Determine if prescribed antibiotics were administered preoperatively.
B.
A client tells the clinic nurse about experiencing burning on urination, and assessment reveals that the client had sexual intercourse four days ago with a person who was casually met. Which action should the nurse implement? A. Observe the perineal area for a chancroid-like lesion. B. Obtain a specimen of urethral drainage for culture. C. Assess for perineal itching, erythema, and excoriation. D. Identify all sexual partners in the last four days.
B.
A client with AKI weighs 50 kg and has potassium level of 6.7 mEq/L is admitted to the hospital. Which prescribed medication should the nurse administer first? A. Calcium acetate one tablet by mouth. B. Sodium polystyrene sulfonate 15 grams by mouth. C. Epoetin alfa, recombinant 2,500 units subcutaneously. D. Sevelamer one tablet by mouth.
B.
A client with Cushing's syndrome is recovering from an elective laparoscopic procedure. Which assessment finding warrants immediate intervention by the nurse? A. Purple marks on skin of the abdomen. B. Irregular apical pulse. C. Quarter size blood spot on dressing. D. Pitting ankle edema.
B.
A client with Herpes Zoster (shingles) on the thorax tells the nurse of having difficulty sleeping. Which is the probable etiology of this problem? A. Frequent Cough. B. Pain. C. Nocturia. D. Dyspnea.
B.
A client with a history of peptic ulcer disease is admitted after vomiting bright red blood several times over the course of 2 hours. In reviewing the laboratory results, the nurse finds client's hemoglobin is 12 g/dL and the hematocrit is 35%. Which action should the nurse prepare to take? A. Continue to monitor for blood loss. B. Administer 1,000 mL normal saline. C. Transfuse 2 units of platelets. D. Prepare the client for emergency surgery.
B.
A client with gouty arthritis reports tenderness and swelling of the right ankle and great toe. The nurse observes the area of inflammation extends above the ankle area. The client receives prescriptions for colchicine and indomethacin. Which instruction should the nurse include in the discharge teaching? A. Eat high protein foods to achieve ideal body weight. B. Drink at least 8 cups (1920 mL) of water per day. C. Use electric heating pad when pain is at its worse. D. Encourage active range of motion to limit stiffness.
B.
A client with lung cancer who wears a subcutaneous morphine sulfate patch for pain is dealing with SOB and is difficult to arouse. When performing a head to toe assessment, the nurse discovers four analgesic patches on the client's body. Which intervention should the nurse implement first? A. Remove all the morphine patches. B. Administer a narcotic antagonist. C. Apply oxygen per face mask. D. Measure the client's BP.
B.
A hospitalized client with peripheral arterial disease is instructed regarding leg and foot care. Which statement by the client indicates to the nurse that learning has occurred? A. "Whenever I am sitting in a chair I will keep my legs up to reduce swelling." B. "I can use a mirror to check the bottoms of my feet for any signs of breakdown." C. "I will try to keep moving if leg pain occurs to help promote good circulation." D. "I will use my swimming pool early in the day while the water is still very cool."
B.
An obese client with emphysema who smokes at least a pack of cigarettes daily is admitted after experiencing a sudden increase in dyspnea and activity intolerance. Oxygen therapy is initiated and it is determined that the client will be discharged with oxygen. Which information is most important in the discharge plan? A. Methods for weight loss. B. Guidelines for oxygen use. C. Approaches to conserve energy. D. Strategies for smoking cessation.
B.
The family suspects that acquired immune deficiency syndrome (AIDS) dementia is occurring in their son who is HIV positive. Which symptom confirms their suspicions? A. He has begun to sleep 18 out of 24 hours. B. A change has recently occurred in his handwriting. C. He refuses to see any of his friends to to return their phone calls. D. He exhibits angry outbursts when the subject of dying is approached.
B.
The nurse assesses a client with petechiae and ecchymosis scattered across the arms and legs. Which laboratory result should the nurse review? A. Red Blood cell count. B. Platelet count. C. Hemoglobin levels. D. White blood cell count.
B.
Which client has the highest risk for developing skin cancer? A. A 70-year-old fair skinned client who works as a secretary. B. A 65-year-old fair skinned client who is a construction worker. C. A 16-year-old dark skinned who tans in tanning beds once a week. D. A 25-year-old dark skinned client whose mother had skin cancer.
B.
A client with a history of asthma and bronchitis arrives at the clinic with SOB, productive cough, with thickened, tenacious mucous, and the inability to walk up a flight of stairs without experiencing breathlessness. Which action is most important for the nurse to instruct the client about self-care? A. Call the clinic if undesirable side effects of medications occur. B. Avoid crowded enclosed areas to reduce pathogen exposure. C. Increase the daily intake or oral fluids to liquefy secretions. D. Teach anxiety reduction methods for feelings of suffocation
C.
A client with orthopnea expresses concern about the ability to "get enough air" during the scheduled thoracentesis. On which information should the nurse's response be based? A. A thoracentesis is a brief procedure that has minimal discomfort. B. Orthopnea is frequently caused by a client's uncontrolled anxiety. C. The procedure is performed with the client in an upright posotion. D. Extra pillows can be used if needed to elevate the client's head.
C.
A nurse is developing a plan of care for a client who reports blurred vision and who is newly diagnosed with cardiovascular disease. Which outcomes should the nurse include in the plan of care for this client? A. The nurse will encourage the client to walk 30 minutes every day. B. The client's family will state signs and symptoms about the disease. C. The client's daily blood pressure will be less than 140/80 mmHg this month. D. The client's blood pressure readings will be less than 160/90 mmHG.
C.
After three days of persistent epigastric pain, a female client presents to the clinic. She has been taking oral antacids without relief. Her vital signs are heart rate 122 beats/ minute, respirations 16 breaths/ minute, oxygen saturation 96%, and blood pressure 116/70 mmHg. The nurse obtains a 12-lead electrocardiogram (ECG). Which assessment finding is most critical? A. Irregular pulse rate. B. Bile colored emesis. C. ST elevation in three leads. D. Compliant of radiating jaw pain.
C.
An adult client is admitted with flank pain and is diagnosed with acute pyelonephritis. What is the priority nursing action? A. Monitor hemoglobin and hematocrit. B. Encourage turning and deep breathing. C. Administer IV antibiotics as prescribed. D. Auscultate for presence of bowel sounds.
C.
An adult client is diagnosed with restless leg syndrome and is referred to the sleep clinic. The healthcare provider prescribes ferrous sulfate 325 mg PO daily. Which laboratory values should the nurse monitor? A. Platelet count and hematocrit B. Serum electrolytes C. Serum Iron and ferritin D. Neutrophils and eosinophils
C.
Four days following an abdominal aortic aneurysm repair, the client is exhibiting edema of both lower extremities, and pedal pulses are not palpable. Which action should the nurse implement first? A. Elevate extremities on pillows. B. Evaluate edema for pitting. C. Assess pulses with a vascular doppler. D. Wrap the feet with warmed blankets.
C.
The nurse is collecting information from a client with chronic pancreatitis who reports persistent gnawing abdominal pain. To help the client manage the pain, which assessment data is most important for the nurse to obtain? A. Presence and activity of bowel sounds. B. Color and consistency of feces. C. Eating patterns and dietary intake. D. Level and amount of physical activity.
C.
The nurse is obtaining the admission history for a client with suspected peptic ulcer disease. Which subjective data reported by the client supports the medical diagnosis? A. Frequent use of chewable and liquid antacids for indigestion. B. Severe abdominal cramps and diarrhea after eating spicy foods. C. Upper mid-abdominal pain described as gnawing and burning. D. Marked loss of weight and appetite over the last 3-4 months
C.
The nurse is planning care for an older adult client who experienced a cerebrovascular accident several weeks ago. The client has expressive aphasia and often becomes frustrated with the nursing staff. Which intervention should the nurse implement? A. Teach the client use of basic sign language. B. Speak slowly to the client. C. Encourage client's use of picture charts. D. Ask the client simple questions.
C.
The nurse observes a increased number of blood clots in the drainage tubing of a client with continuous bladder irrigation following a trans-urethral resection of the prostate (TURP). What is the best initial nursing action? A. Provide additional oral fluid intake. B. Measure the client's intake and output. C. Increase the flow of the bladder irrigation. D. Administer a PRN dose of an antispasmodic agent.
C.
When conducting discharge teaching for a client diagnosed with diverticulosis, which diet instruction should the nurse include? A. Have small frequent meals and sit up for at least 2 hours after meals. B. Eat a bland diet and avoid spicy foods. C. Eat a high-fiber diet and increase fluid intake. D. Eat a soft diet with increased intake of milk and milk products.
C.
A client who had a C5 spinal cord injury 2 years ago is admitted to the emergency department with the diagnosis of autonomic dysreflexia secondary to a full bladder. Which assessment finding should the nurse expect this client to exhibit? A. Complaints of the chest pain and shortness of breath. B. Hypotension and venous pooling in the extremities. C. Profuse diaphoresis and severe, pounding headache. D. Pain and a burning sensation upon urination and hematuria.
D.
The nurse assesses a client who is newly diagnosed with hyperthyroidism and observes that the client's eyeballs are protuberant, causing a wide-eyed appearance and eye discomfort. Based on this finding, which action should the nurse include in this client's plan of care? A. Assess for signs of increased intracranial pressure. B. Prepare to administer intravenous levothyroxine C. Review the client's serum electrolyte values D. Obtain a prescription for artificial tear drops.
D.
The nurse assesses a client with cirrhosis and finds 4+ pitting edema of the feet and legs, and massive ascites. Which mechanism contributes to edema and ascites in clients with cirrhosis? A. Hyperaldosteronism causing an increased sodium reabsorption in renal tubules. B. Decreased portocaval pressure with greater collateral circulation. C. Decreased renin-angiotensin response related to an increase in renal blood flow. D. Hypoalbuminemia that results in a decreased colloidal oncotic pressure.
D.
While completing a health assessment for a client with migraine headaches, the nurse assesses bilateral weakness in the client's hand grisps. The client reports joint pain and trouble twisting a door knob due to weakness. Which action should the nurse take in response to these findings? A. Explain that relief of the migraine pain will reduce related symptoms. B. Gather additional assessment data about the pain and weakness C. Implement fall precautions to reduce the client's risk for injury. D. Consult with the occupational therapist for a functional assessment.
D.
