HESI REVIEW #1 BSN 266 MED SURG EXAM
QUESTIONS AND ANSWERS
1. A client with acute osteomyelitis has undergone surgical
debridement of the diseased bone and asks the nurse how long
will antibiotics have to be administered. Which information
should the nurse communicate?
A. Oral antibiotics for 2 to 4 months, then for dental procedure
prophylaxis.
B. Parenteral antibiotics for 4 to 6 weeks, then oral antibiotics for up to
1 year.
C. Parenteral antibiotics for 4 to 8 weeks, then oral antibiotics for 4 to
8 weeks. Parenteral antibiotics for 2 to 3 weeks, then oral antibiotics
for 4 weeks: C Treatment of acute osteomyelitis requires the administration of high doses of
parenteral antibiotics for 4 to 8 weeks, followed by oral antibiotics for another 4 to 8 weeks
2. In planning care for a client with an acute stroke resulting in right-
sided
hemiplegia, which positioning should the nurse should use to
maintain optimal functioning?
A. Mid-Fowlers with knees supported.
B. Supine with trochanter rolls to the hips.
C. Sim's position alternated with right lateral position q2
hours. Left lateral, supine, brief periods on the right
,side, and prone: D Rationale
After an acute stroke, a positioning and turning schedule that minimizes lying on the attected side,
which can impair circulation and cause pain, and includes the prone position to help prevent flexion
contractures of the hips, prepares the client for optimal functioning and ambulation.
3. Which preexisting diagnosis places a client at the greatest risk of
developing
superior vena cava syndrome?
A. Carotid stenosis.
B. Steatosis hepatitis.
C. Metastatic cancer.
D. Clavicular
fracture.: C Rationale
Superior vena cava syndrome occurs when the superior vena cava (SVC) is compressed by outside
structures, such as a growing tumor that impedes the return blood flow to the heart. Superior vena cava
syndrome is likely to occur with metastatic cancer from a primary tumor in the upper lobe of the right
lung that compresses the superior vena cava.
4. The nurse is giving discharge instructions to a client with chronic
prostatitis.
What instruction should the nurse provide the client to reduce the risk
of
spreading the infection to other areas of the client's urinary tract?
A. Wear a condom when having sexual intercourse.
,B. Avoid consuming alcohol and caffeinated beverages.
C. Empty the bladder completely with each voiding.
D. Have intercourse or masturbate at least twice a
week.: D Rationale
The prostate is not easily penetrated by antibiotics and can serve as a reservoir for microorganisms,
which can infect other areas of the genitourinary tract. Draining the prostate regularly through
intercourse or masturbation decreases the number of microorganisms present and reduces the risk for
further infection from stored contaminated seminal fluids
5. During the initial outbreak of genital herpes simplex for a female
client, what
should be the nurse's primary focus in planning care?
A. Promotion of comfort.
B. Prevention of pregnancy.
C. Instruction in condom use.
Information about
transmission: A Rationale
The initial outbreak of genital herpes simplex in a woman causes severe discomfort. Promotion of comfort is
the first priority
6. A client who has a chronic cough with blood-tinged sputum returns
to the
unit after a bronchoscopy. What nursing interventions should be
implemented in the immediate post-procedural period?
A. Keep the client on bed rest for eight hours.
, B. Check vital signs every 15 minutes for two hours.
C. Allow the client nothing by mouth until the gag reflex returns.
D. Encourage fluid intake to promote elimination of the contrast
media.: C Rationale
The nasal pharynx and oral pharynx are anesthetized with local anesthetic spray prior to bronchoscopy,
and the bronchoscope is coated with lidocaine (Xylocaine) gel to inhibit the gag reflex and prevent
laryngeal spasm during insertion. The client should be NPO until the client's gag reflex returns to prevent
aspiration from any oral intake or secretions.
7. The nurse is assessing a client admitted from the emergency room
with gas- trointestinal bleeding related to peptic ulcer disease (PUD).
Which physiological factors can produce ulceration? (Select all that
apply.)
Select all that apply
A. Vagal stimulation.
B. An increased level of stress.
C. Decreased duodenal inhibition.
D. Hypersecretion of hydrochloric
acid. An increased number of
parietal cells: D,E Rationale
Hypersecretion of gastric juices and an increased number of parietal cells that stimulate secretion are most
often the causes of ulceration. Vagal stimulation and decreased duodenal inhibition also increase the
secretion of caustic fluids.
QUESTIONS AND ANSWERS
1. A client with acute osteomyelitis has undergone surgical
debridement of the diseased bone and asks the nurse how long
will antibiotics have to be administered. Which information
should the nurse communicate?
A. Oral antibiotics for 2 to 4 months, then for dental procedure
prophylaxis.
B. Parenteral antibiotics for 4 to 6 weeks, then oral antibiotics for up to
1 year.
C. Parenteral antibiotics for 4 to 8 weeks, then oral antibiotics for 4 to
8 weeks. Parenteral antibiotics for 2 to 3 weeks, then oral antibiotics
for 4 weeks: C Treatment of acute osteomyelitis requires the administration of high doses of
parenteral antibiotics for 4 to 8 weeks, followed by oral antibiotics for another 4 to 8 weeks
2. In planning care for a client with an acute stroke resulting in right-
sided
hemiplegia, which positioning should the nurse should use to
maintain optimal functioning?
A. Mid-Fowlers with knees supported.
B. Supine with trochanter rolls to the hips.
C. Sim's position alternated with right lateral position q2
hours. Left lateral, supine, brief periods on the right
,side, and prone: D Rationale
After an acute stroke, a positioning and turning schedule that minimizes lying on the attected side,
which can impair circulation and cause pain, and includes the prone position to help prevent flexion
contractures of the hips, prepares the client for optimal functioning and ambulation.
3. Which preexisting diagnosis places a client at the greatest risk of
developing
superior vena cava syndrome?
A. Carotid stenosis.
B. Steatosis hepatitis.
C. Metastatic cancer.
D. Clavicular
fracture.: C Rationale
Superior vena cava syndrome occurs when the superior vena cava (SVC) is compressed by outside
structures, such as a growing tumor that impedes the return blood flow to the heart. Superior vena cava
syndrome is likely to occur with metastatic cancer from a primary tumor in the upper lobe of the right
lung that compresses the superior vena cava.
4. The nurse is giving discharge instructions to a client with chronic
prostatitis.
What instruction should the nurse provide the client to reduce the risk
of
spreading the infection to other areas of the client's urinary tract?
A. Wear a condom when having sexual intercourse.
,B. Avoid consuming alcohol and caffeinated beverages.
C. Empty the bladder completely with each voiding.
D. Have intercourse or masturbate at least twice a
week.: D Rationale
The prostate is not easily penetrated by antibiotics and can serve as a reservoir for microorganisms,
which can infect other areas of the genitourinary tract. Draining the prostate regularly through
intercourse or masturbation decreases the number of microorganisms present and reduces the risk for
further infection from stored contaminated seminal fluids
5. During the initial outbreak of genital herpes simplex for a female
client, what
should be the nurse's primary focus in planning care?
A. Promotion of comfort.
B. Prevention of pregnancy.
C. Instruction in condom use.
Information about
transmission: A Rationale
The initial outbreak of genital herpes simplex in a woman causes severe discomfort. Promotion of comfort is
the first priority
6. A client who has a chronic cough with blood-tinged sputum returns
to the
unit after a bronchoscopy. What nursing interventions should be
implemented in the immediate post-procedural period?
A. Keep the client on bed rest for eight hours.
, B. Check vital signs every 15 minutes for two hours.
C. Allow the client nothing by mouth until the gag reflex returns.
D. Encourage fluid intake to promote elimination of the contrast
media.: C Rationale
The nasal pharynx and oral pharynx are anesthetized with local anesthetic spray prior to bronchoscopy,
and the bronchoscope is coated with lidocaine (Xylocaine) gel to inhibit the gag reflex and prevent
laryngeal spasm during insertion. The client should be NPO until the client's gag reflex returns to prevent
aspiration from any oral intake or secretions.
7. The nurse is assessing a client admitted from the emergency room
with gas- trointestinal bleeding related to peptic ulcer disease (PUD).
Which physiological factors can produce ulceration? (Select all that
apply.)
Select all that apply
A. Vagal stimulation.
B. An increased level of stress.
C. Decreased duodenal inhibition.
D. Hypersecretion of hydrochloric
acid. An increased number of
parietal cells: D,E Rationale
Hypersecretion of gastric juices and an increased number of parietal cells that stimulate secretion are most
often the causes of ulceration. Vagal stimulation and decreased duodenal inhibition also increase the
secretion of caustic fluids.
