HESI: MED SURG

Which instruction would the nurse include when teaching a client with asthma how to use a peak flow meter? 1 Sit up straight in a firm chair. 2 Check peak flow early in the morning. 3 Take the deepest breath you can, then blow out hard and fast. 4 Calculate the average of 3 readings to obtain your peak flow.

3 Take the deepest breath you can, then blow out hard and fast.

Which classic sign will a nurse find in a client with Addison disease? 1 Ecchymosis 2 Hyperreflexia 3 Explothomos 4 Hyperpigmentation

Hyperpigmentation

Which symptoms would the nurse include when teaching a client to recognize symptoms of hypoglycemia? Select all that apply. One, some, or all responses may be correct. 1 Rapid heartbeat 2 Emotional changes 3 Abdominal cramping 4 Nausea and vomiting 5 Weakness and fatigue 6 Numbness of fingers, toes, or mouth

1 Rapid heartbeat 2 Emotional changes 6 Numbness of fingers, toes, or mouth

Which signs and symptoms will a client admitted to the hospital with a diagnosis of Cushing syndrome exhibit? 1 Hyperkalemia and edema 2 Hypotension and sodium loss 3 Muscle wasting and hypoglycemia 4 Muscle weakness and frequent urination

4 Muscle weakness and frequent urination

Which rationale would the nurse use when teaching a client with chronic obstructive pulmonary disease (COPD) to use pursed-lip breathing? 1 Decrease air trapping 2 Prevent bronchial dilation 3 Strengthen intercostal muscles 4 Reduce diaphragmatic excursion

1 Decrease air trapping

Which action would the clinic nurse take when a client with chronic obstructive pulmonary disease (COPD) has a 10-mm area of induration after Mantoux testing? 1 Document the result as a negative finding. 2 Teach the client about need for a chest x-ray. 3 Discuss latent tuberculosis with client. 4 Notify the local public health department.

1 Document the result as a negative finding.

Which is a secondary cause of adrenal insufficiency? 1 Hemorrhage 2 Tuberculosis 3 Pituitary tumors 4 Metastatic cancer

3 Pituitary tumors

When assessing a client with diabetes insipidus, which signs would the nurse anticipate finding? Select all that apply. One, some, or all responses may be correct. 1 Excessive thirst 2 Increased blood glucose 3 Dry mucous membranes 4 Increased blood pressure 5 Decreased serum osmolarity 6 Decreased urine specific gravity

1 Excessive thirst 3 Dry mucous membranes 6 Decreased urine specific gravity

When a nurse needs to administer oxygen at a fraction of inspired oxygen (FiO2) of about 40% to keep a client's oxygen saturation greater than 94%, which method would be best? 1 Face tent 2 Venturi mask 3 Nasal cannula 4 Simple face mask

3 Nasal cannula

Which parameter monitoring would be the nurse's priority while caring for a client with hypothyroidism? 1 Pulse rate 2 Blood pressure 3 Respiratory rate 4 Body temperature

3 Respiratory rate

Which neurological manifestation is associated with hyperthyroidism? 1 Confusion 2 Hearing loss 3 Tremors 4 Slowness of speech

3 Tremors

Which client is at risk for developing type 2 diabetes mellitus (DM)? Select all that apply. One, some, or all responses may be correct. 1 15-year-old male who plays video games 6 hours per day 2 36-year-old female with a history of gestational diabetes 3 47-year-old male who weighs 250 pounds and is 5' 9" tall 4 28-year-old female with polycystic ovarian syndrome (POS) 5 60-year-old male of Native American descent who abuses alcohol

All are correct

After the nurse has taught a client with asthma about use of a peak flow meter, which client statements indicate that the teaching has been effective? Select all that apply. One, some, or all responses may be correct. 1 "Readings in the green zone mean that my asthma is under control." 2 "If I get a reading in the yellow zone, I need to stop what I'm doing and rest for a while." 3 "If I get a reading in the red zone, then I need to use the quick relief inhaler and have my family take me to the hospital." 4 "I should check the peak flow readings at least twice a day until my baseline is established." 5 "I don't need to check my peak flow readings if I use the quick relief medication."

1 "Readings in the green zone mean that my asthma is under control." 3 "If I get a reading in the red zone, then I need to use the quick relief inhaler and have my family take me to the hospital." 4 "I should check the peak flow readings at least twice a day until my baseline is established."

Which action will the nurse include in the plan for care for a client after a bronchoscopy examination? 1 Check for the gag reflex. 2 Send the client for a chest x-ray examination. 3 Assess breathing every 30 minutes. 4 Have the client avoid the Valsalva maneuver

1 Check for the gag reflex.

Which symptom might the nurse identify when assessing a client with hyperthyroidism? 1 Fatigue 2 Dry skin 3 Anorexia 4 Bradycardia

1 Fatigue

After a client has had bronchoscopy, which finding indicates that the client's gag reflex has returned? 1 Alert and oriented 2 Able to swallow saliva 3 Speaks without difficulty 4 Denies sore throa

2 Able to swallow saliva

Which information is needed to determine oxygen administration for a client with chronic obstructive pulmonary disease (COPD) and an oxygen saturation of 87%? Select all that apply. One, some, or all responses may be correct. 1 Level of orientation 2 Arterial blood gases 3 Bilateral lung sounds 4 Complete blood count 5 Pulmonary function test

2 Arterial blood gases

Which rationale would the nurse use when explaining the purpose of pursed-lip breathing to a client with emphysema? 1 Prevents bronchial spasm 2 Decreases air trapping in lung 3 Improves alveolar surface area 4 Strengthens diaphragmatic contraction

2 Decreases air trapping in lung

Which intervention would the nurse include in the plan of care for a client with Addison disease? 1 Encourage exercise 2 Protect from exertion 3 Restrict fluid intake 4 Monitor for hypokalemia

2 Protect from exertion

Which finding for a client who has just returned to the nursing unit after bronchoscopy and lung biopsy would be most important to report to the health care provider? 1 Client arousable, but lethargic 2 Cough productive of bloody mucus 3 Heart rate 126 beats per minute 4 Client report of dry and sore throat

3 Heart rate 126 beats per minute

A client is diagnosed with Cushing syndrome. The nurse would monitor the client for which cardiovascular complication? 1 Chest pain 2 Tachycardia 3 Hypertension 4 Atrial fibrillation

3 Hypertension

A client has chronic obstructive pulmonary disease (COPD). To decrease the risk of CO2 intoxication (CO2 narcosis), which would the nurse do? 1 Initiate pulmonary hygiene to clear air passages of trapped mucus. 2 Instruct to deep-breathe slowly with inhalation longer than exhalation. 3 Encourage continuous rapid panting to promote respiratory exchange. 4 Administer oxygen at a low concentration to maintain respiratory drive.

4 Administer oxygen at a low concentration to maintain respiratory drive.

The nurse is caring for a client with Addison disease. Which dietary modification should the nurse include in the client's teaching plan? 1 Increase potassium intake to replace renal losses. 2 Increase protein intake to heal the adrenal tissue and thus cure the disease. 3 Take supplemental vitamins to supply energy and assist in regaining the weight that was lost. 4 Consume extra salt to replace the amount being lost due to a lack of sufficient aldosterone needed to conserve sodium

4 Consume extra salt to replace the amount being lost due to a lack of sufficient aldosterone needed to conserve sodium

Which finding would be expected in a client with a history of hypothyroidism? Select all that apply. One, some, or all responses may be correct. 1 Cold intolerance 2 Lethargy and fatigue 3 Hemoglobin 11.2 g/dL 4 15-pound weight gain 5 Heart rate 59 beats/min

1 Cold intolerance 2 Lethargy and fatigue 3 Hemoglobin 11.2 g/dL 4 15-pound weight gain 5 Heart rate 59 beats/min

Which clinical manifestations would the nurse expect a client with hypothyroidism to exhibit? Select all that apply. One, some, or all responses may be correct. 1 Cool skin 2 Photophobia 3 Constipation 4 Periorbital edema 5 Decreased appetite

1 Cool skin 3 Constipation 4 Periorbital edema 5 Decreased appetite

The nurse is assessing a client with a moon-shaped face and thin arms and legs. The nurse expects which other assessment findings? Select all that apply. One, some, or all responses may be correct. 1 Weight loss 2 Gastric ulcer 3 Pain in bones 4 Poor appetite 5 Muscle weakness

2 Gastric ulcer 3 Pain in bones 5 Muscle weakness

Which diagnostic testing is most useful in evaluating the effectiveness of treatment for asthma? 1 Chest x-ray 2 Pulmonary function tests 3 Serum eosinophil counts 4 Immunoglobulin E level

2 Pulmonary function tests

When caring for a client who has had a bronchoscopy in the ambulatory surgery unit, which action would the nurse take? 1 Offer ice chips to decrease throat pain. 2 Avoid turning the head from side to side. 3 Keep the client in the semi-Fowler position 4 Suggest medicated lozenges for sore throat.

3 Keep the client in the semi-Fowler position

A client with chronic obstructive pulmonary disease (COPD) is breathing rapidly and using accessory muscles of respiration. The nurse auscultates the lungs and hears crackles and wheezes. Which action would the nurse take? 1 Encourage the client to take slow, deep breaths and administer 5 L/min oxygen per nasal cannula. 2 Place the client in a side-lying position and perform chest physiotherapy using clapping and vibration. 3 Raise the head of the bed to a high-Fowler position and administer 2 L/min oxygen per nasal cannula. 4 Assist the client in assuming a position of comfort and perform postural drainage.

3 Raise the head of the bed to a high-Fowler position and administer 2 L/min oxygen per nasal cannula.

A client is admitted to the hospital with a diagnosis of chronic obstructive pulmonary disease (COPD). Which action would the nurse take to prevent client fatigue? 1 Provide small, frequent meals. 2 Encourage pursed-lip breathing. 3 Schedule nursing activities to allow for rest. 4 Encourage bed rest until energy level improves

3 Schedule nursing activities to allow for rest.

Which method of oxygen delivery would the nurse anticipate will be prescribed for a client with a pulse oximetry reading of 65%? 1 Face tent 2 Venturi mask 3 Nasal cannula 4 Nonrebreather mask

4 Nonrebreather mask

When the nurse manager is evaluating the care of a client receiving oxygen through a nasal cannula, which finding indicates a need for more staff education about oxygen therapy? 1 Oxygen flow rate is set to 8 L/min. 2 There is bubbling present in the humidifier. 3 Pressure areas of tubing along the ears are padded. 4 Smoking and open flame prohibited signs are clearly posted.

1 Oxygen flow rate is set to 8 L/min.

Which assessment findings are associated with Cushing disease? Select all that apply. One, some, or all responses may be correct. 1 Round face 2 Dependent edema in the feet and ankles 3 Increased fatty deposition in the extremities 4 Thin, translucent skin with bruising 5 Increased fatty deposition in the neck and back

1 Round face 2 Dependent edema in the feet and ankles 4 Thin, translucent skin with bruising 5 Increased fatty deposition in the neck and back

The nurse is educating a client with hypothyroidism about the use of levothyroxine. Which information would the nurse provide? Select all that apply. One, some, or all responses may be correct. 1 Take dose same time each day. 2 Refrain from switching brands. 3 Have regular bloodwork drawn. 4 Hold medication for pulse >60 beats per minute. 5 Report weight loss more than 3 pounds

1 Take dose same time each day. 2 Refrain from switching brands. 3 Have regular bloodwork drawn.

The nurse is caring for a client with type 2 diabetes mellitus and renal insufficiency. The client is scheduled for a computerized tomography (CT) scan with contrast. Which medication would the nurse withhold to prevent lactic acidosis? 1 Pioglitazone 2 Insulin 3 Glyburide 4 Metformin

4 Metformin

Which action by a client with asthma indicates that the client teaching about use of a peak flow meter has been effective? 1 Calls the health care provider when peak flows are in the green zone 2 Does deep breathing and relaxation exercises when peak flow is in the red zone 3 Uses a quick relief inhaled medication when peak flow is in the yellow zone 4 Stops taking the daily inhaled corticosteroid when peak flow is in the yellow zone

3 Uses a quick relief inhaled medication when peak flow is in the yellow zone

Which finding in a client with asthma exacerbation requires the most rapid action by the nurse? 1 Report of chest tightness 2 Heart rate of 112 beats per minute 3 Expiratory wheezes in both lungs 4 Markedly decreased breath sounds

4 Markedly decreased breath sounds

Which symptom would the nurse expect a client diagnosed with Cushing syndrome to exhibit? 1 Lability of mood 2 Postural hypotension 3 Increased skin thickness 4 Ectomorphism with a moon face

1 Lability of mood

Which trigger would the nurse instruct a client to avoid to decrease the incidence of asthma attacks? Select all that apply. One, some, or all responses may be correct. 1 Mold 2 Cold air 3 Pet dander 4 Air pollution 5 Cigarette smoke

1 Mold 2 Cold air 3 Pet dander 4 Air pollution 5 Cigarette smoke