HESI: Med/Surg

The nurse is preparing a client who is on metformin therapy and is scheduled to undergo renal computed tomography with contrast dye. What does the nurse anticipate the primary healthcare provider to inform the client regarding the procedure?

"Discontinue metformin 1 day prior to procedure." Metformin can react with the iodinated contrast dye that is given for a renal computed tomography (CT) and cause lactic acidosis. Therefore the nurse anticipates an instruction that the client should discontinue the metformin 1 day before the procedure

In clients with Goodpasture syndrome, what is the pathophysiology of this syndrome?

Goodpasture syndrome is an autoimmune disorder in which auto-antibodies attack the glomerular basement membrane and neutrophils, especially in the lungs and kidneys.

A client is admitted with a diagnosis of torsion of the testes. How should the nurse respond when the client asks, "Why do I have to have surgery right now?"

"The extreme swelling can cause the testicle to rupture."

A nurse is caring for a client who underwent a cervical biopsy. The nurse finds that the client has a body temperature of 100° F, increased abdominal pain, and increased drainage that is foul-smelling. Which action is priority?

A client who underwent a cervical biopsy may have a body temperature of 100° F, increased abdominal pain, and foul-smelling drainage due to infection. The nurse should report these findings regarding the client's condition to the primary healthcare provider to prevent sepsi

A registered nurse writes a care plan for a client undergoing a renal scan. Which of the following interventions should the nurse include?

A renal scan is performed to examine the structure, function, and perfusion of the kidneys using the intravenous (IV) administration of a radioisotope. During the procedure, furosemide should be administered after initial imaging to better visualize kidney function and blood flow. A peripheral intravenous (IV) catheter should be inserted to deliver the radioisotope.

A nurse prepares a client with kidney dysfunction for a cystoscopy. Which nursing intervention would be beneficial?

Asking the client to be NPO (nil per os) after midnight on the night before the procedure

A client is admitted to the hospital after sustaining a head injury. Which is the most reliable sign of increased intracranial pressure the nurse can monitor for?

Decrease in the level of consciousness Decreasing level of consciousness occurs because of the brain's acute sensitivity to hypoxia

What is the mechanism of action of delavirdine in a client with human immunodeficiency virus (HIV)?

Delavirdine is a nonnucleoside reverse transcriptase inhibitor that acts by inhibiting the action of reverse transcriptase

A client has a diagnosis of multiple sclerosis and is currently in remission. The client is a parent of two active preschoolers. What should the nurse encourage the client to do?

Develop a flexible schedule for completion of routine daily activities

The nurse suspects that a client with inhalation anthrax is in the prodromal stage of disease. Which symptoms support the nurse's conclusion? Select all that apply.

Dry cough Mild chest pain

A client with a supratentorial tumor is scheduled for external radiation therapy to the brain. What should the nurse plan to teach the client?

Feelings of extreme tiredness will occur

A female client is undergoing treatment for infertility. After therapy with clomiphene the client comes for follow-up visits and no results are seen. What further treatment does the nurse anticipate administering?

Human chorionic gonadotropin Clomiphene is used to induce pregnancy by triggering ovulation. If the desired result is not obtained, the second alternative is to administer human chorionic gonadotropin and gonadotropin-releasing hormone to stimulate ovulation

A nurse provides post-operative care to a client who has undergone a hypophysectomy. Which action should the nurse take if there is a yellowish discharge at the dressing site?

Inform the primary healthcare provider In order to reduce the risk of further complications, the nurse should inform the primary healthcare provider. Leakage of cerebrospinal fluid (CSF) may occur due to hypophysectomy. A yellowish discharge at the dressing site indicates the leakage of CSF. Changing the dressing, cleaning the wound with alcohol, and tightening the dressing may complicate the condition.

A client's laboratory report reveals an antigen-immunoglobulin (IgE) reaction. The nurse suspects the presence of allergic rhinitis. Which type of medication would treat this condition?

Mast cell stabilizing An antigen-immunoglobulin (IgE) interaction may result in allergic rhinitis. Mast cell stabilizing drugs inhibit the release of histamines, leukotrienes, and other agents from the mast cell after antigen-IgE interactions

Which leukocyte values should be assessed to determine the adequacy of a client's response to inflammation?

Monocytes Macrophages Neutrophils

A client's laboratory report shows severe neutropenia and thrombocytopenia. Which medication may have caused this condition?

Mycophenolate mofetil is a cytotoxic drug that may cause neutropenia and thrombocytopenia.

While assessing a client, the nurse suspects that the client has acute osteomyelitis. Which symptoms in the client support the nurse's suspicion?

Osteomyelitis is the infection of bone caused by bacteria, viruses, or fungi. The symptoms of acute osteomyelitis are fever (temperature above 101° F), erythema, and tenderness near the affected area. The symptoms of chronic osteomyelitis are the presence of foot ulcers and drainage from the affected area.

A client is scheduled for a below-the-knee amputation. When should the nurse begin rehabilitation planning for the client?

Rehabilitation should begin immediately. This includes preoperative discussion of the nature of the operation and rehabilitation techniques.

A nurse teaches a client with chronic renal failure that salt substitutes cannot be used in the diet. What is the rationale for the nurse's instruction?

Salt substitutes usually contain potassium, which can lead to hyperkalemia; dysrhythmias are associated with hyperkalemia.

Which information indicates a nurse has a correct understanding about skeletal muscles?

Skeletal muscle accounts for about half of a human being's body weight Skeletal muscle is a type of striated voluntary muscle that accounts for about half of a human being's body weight. Cardiac muscle contraction propels blood through the circulatory system. Skeletal muscle contraction requires neuronal stimulation only. Smooth muscle, not skeletal, is found in the walls of hollow structures such as airways and arteries.

A nurse is caring for a client who had a traumatic brain injury with increased intracranial pressure. Which healthcare provider prescription should the nurse question?

Teach isometric exercises The prescription for isometric exercises should be questioned; isometric exercises increase the basal metabolic rate and intracranial pressure

A client has had a resection of an aldosterone-secreting tumor of an adrenal gland. The client says to the nurse, "It will be good for me to return to work soon." Based on an understanding of the problem, what is the nurse's response?

Tell the client that returning to work is okay because the body has two adrenal glands; the tumor was on just one of the glands.

While assessing a postpartum client who is suspected of having a thyroid disorder, the nurse suspects that the client has autoimmune thyroiditis. Which diagnostic studies are most suitable for confirming the diagnosis?

The postpartum client may have silent, painless thyroiditis. Radioactive iodine uptake is suppressed in silent thyroiditis, so this test would be beneficial in diagnosing the thyroiditis.

While reviewing the urinalysis reports of an elderly client, the nurse finds white blood cells (WBCs) in the urine. Which condition might the client have?

The presence of white blood cells (WBCs) in the urine is indicates a kidney or urinary tract infection. The presence of red blood cells (RBCs) in the urine indicates pyelonephritis, kidney trauma, or acute tubular necrosis.

When performing a neurologic assessment of a client, a nurse identifies that the client has a dilated right pupil. The nurse concludes that this suggests a problem with which cranial nerve?

The third cranial nerve (oculomotor) contains autonomic fibers that innervate the smooth muscle responsible for constriction of pupils.

The nurse is caring for a client with hypothyroidism. Which instruction is most important to provide to the client to help in managing their condition?

Thyroxin levels decrease during cold temperatures, thus hypothyroidism causes the client to become very sensitive to cold. Clients are advised to dress warmly in cold weather to prevent worsening the situation

The nurse teaches a group of clients that nutritional support of natural defense mechanisms indicates the need for a diet high in what nutrient or nutrients?

Vitamins A, C, E, and selenium Vitamins A, C, E, and selenium stimulate the immune system.

The nurse is caring for a client who was just admitted to the hospital with the diagnosis of head trauma. Which clinical indicators should the nurse consider as evidence of increasing intracranial pressure? Select all that apply.

Vomiting Irritability Decreased Level of Consciousness