Medical-Surgical Hesi Practice Quiz

Which instructions should the PN reinforce with a client who is preparing for discharge after placement of a permanent pacemaker implant?

A. Request the use of special hand scanning at the airports. C. Do not lean against the car while the engine is running D. Keep the regularly scheduled follow-up appointments. A client who has a pacemaker should receive reinforcement of instructions that prevent malfunction of the pacemaker

What equipment should the PN ensure is the room for a client after a thyroidectomy?

A. Tracheostomy tray A complication in the immediate postoperative period after a thyroidectomy is airway obstruction, so a tracheostomy tray

The PN is caring for a client with COPD. To reduce carbon dioxide (CO2) retention in the lungs, which information should the PN reinforce?

A. Use pursed-lip and abdominal breating Pursed-lip breathing used during diaphragmatic or abnormal breathing provides mild resistance through partially closed lips to prolong exhalation and increase airway pressure, which delays airway compression and reduces air trapping.

Which client should be practical nurse consider at greater risk for bacterial cystitis?

B. An older female who does not use estrogen replacement. Postmenopausal women who do not use hormone replacement therapy are at an increased risk for bacterial cystitis because of changes in the cells of the urethra and vagina.

The wife of a client with a large brain tumors asks the PN to explain why the tumor should be surgically removed. What is the best response for the PN to provide?

B. Bran tumors increase cerebral mass, resulting in increased intracranial pressure Local effects of cranial tumors are caused by tumor compression that decreases cerebral blood flow and increases intracranial pressure,

When completing preoperative preparation for a client admitted for same-day surgery, what evaluation statement should the PN identify as an important outcome?

B. asks questions regarding the surgical experience preoperative preparation should be planned to allow the client and family time to ask questions and receive appropriate feedback.

Which client should be practical nurse question a PRN prescription for sumatriptan (Imitrex) for migraine headaches?

C. 50-year-old with Prinzmetal's angina Imitrex reduces pain and other associated symptoms of migraine headache by binding to serotonin receptors and triggering generalized vasoconstriction, which can cause coronary vasospasm in clients with Prinzmetal's or variant angina.

Which assessment is most important for the practical nurse to implement for a client who returns from surgery for an arthroscopic repair of the right knee?

C. Palpation of both pedal pulse Although complications are uncommon after arthroscopic procedures, monitoring for neurovascular compromise is most important.

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 document to describe this behavior?

C. Unilateral neglect A client's failure to recognize or respond to stimuli on the affected side of the body after a stroke is an example of unilateral neglect

The 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?

C. What do you know about the surgery you are having? Although it is the surgeon's responsibility to explain the surgery to the client, it is a nursing responsibility to determine whether the client understands what he has been told about his surgery. Asking open-ended questions is an important step in eliciting what the client understands

A client who experienced a thrombolic stroke has received recombinant tissue plasminogen activator (TPA) (Alteplase) two hours ago in the emergency center. Which priority precaution should the practical nurse implement for this client on admission to medical unit?

D. Bleeding precautions TPA increases the client's risk for bleeding, so (D) should be implemented for thrombolytic and anticoagulant therapy.

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?

D. Fingerstick glucose level Poor would healing is often a sign of uncontrolled diabetes mellitus, so a fingerstick glucose level should be obtained first.

An older female client with osteoporosis asks the PN to explain why is not 2 inches shorter than when she was younger. What information is best for the practical nurse to provide?

D. It is a combination of wear and tear and calcium loss that causes the change. A biological theory of aging includes the wear-and-tear theory, which explains that after repeated use and damage, body structures and functions wear out because of stress. (D) calcium changes