HESI MED-SURG

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

Request the use of special hand scanning at airports Do not lean against the car while the engine is running Keep the regularly scheduled follow-up appointments

The practical nurse (PN) should place a client in which position for a thoracentesis?

Sitting right in a tripod position leaning on an overbed table

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

Change the transparent dressing q 72 hours

Which finding is most important for the PN to explore further for a client who had a total abdominal hysterectomy and bilateral oophorectomy yesterday?

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

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

Failing to follow medical recommendations

The PN is obtaining deep tendon reflexes for a client with type 1 DM. Which finding indicates to the PN that the client has peripheral neuropathy?

Hypoactive reflexes at the Achilles tendon

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

An older male with a history of emphysema arrives the emergent care center with complaints of increasing dyspnea on exertion. The client's chest has an increased anteroposterior diameter, a dry, hacking cough, and pulse oximetry of 89%. What action should the practical nurse take?

Apply oxygen per nasal cannula at 2L/min

Which instruction should the practical nurse reinforce with a female client about skin care after her first radiotherapy treatment?

Avoid using ice packs on the exposed area

A client is admitted with a C4 spinal cord injury (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 oximetry reading

After receiving report, the PN begins assessment for a client with COPD who has just completed a respiratory tx. The PN finds the client sitting upright in bed with O2: 6L/min per NC. Which intervention is most important for the PN to implement?

Decrease O2 flow rate to 2L/minute and attach pulse oximetry

A client who receives graphs for a full-thickness burn of the right arm is admitted to the rehab unit. Which action is important for the PN to reinforce with the client to prevent long-term complications?

Exercise the affected arm everyday

What complication is most important for the practical nurse to monitor for in a client who has a total hip replacement?

Infection

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 ration (INR) of 0.9

An older female client with osteoporosis asks the practical nurse (PN) to explain why she is now 2 inches shorter than when she was younger. What information is best for the practical nurse (PN) to provide?

It is a combination of wear and tear and calcium loss that causes the change

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

Notify the healthcare provider of the changes

A client arrives at the oncology clinic for the next treatment in the prescribed course of chemotherapy. The PN reviews the client's lab results: WBC: 700/mm RBC: 2.8 million/mm HgB: 7.9 G/dl HcT: 25.5% Platelet: 14,000/mm What action should the PN take first?

Place an isolation mask on the client

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

A client with newly diagnosed essential hypertension is learning to cope with stressful situations in his life. Which activity should the practical nurse (PN) implement to help the client learn constructive coping?

Role play a situation the client identifies as stressful

A client with HF takes a daily tablet of Furosemide and Lisinopril. Which finding during the clinic visit should indicate to the PN that the client's condition is worsening?

Sleeps with 2 additional pillows

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

A male client who has been taking a four-drug regimen for tuberculosis (TB) tells the practical nurse (PN) that he has finished the first drug, isoniazid, and will start taking rifampin next. How should the PN respond?

The four-drug protocol should be taken concurrently.

The practical nurse (PN) is reviewing discharge instructions with a client after out-patient surgery. Which client response indicates to the PN the need for teaching reinforcement?

Pain medication should be taken every day

The practical nurse (PN) is caring for a client with chronic obstructive pulmonary disease (COPD). To reduce carbon dioxide ( CO 2 ) retention in the lungs, which information should the PN reinforce?

Use pursed-lip and abdominal breathing

What is the immediate assessment the PN should implement for a client who returns to the unit after a cardiac catheterization?

Check the client's groin