HESI PN Medical Surgical Exam
The practical nurse is reviewing pre-op 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?
What do you know about the surgery you are having?
An adult client with otitis media has thick, yellow drainage from the right ear
canal. What additional findings should the PN expect to identify?
Pain relief after ear drainage begins
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?
Palpation of both pedal pulses
A client who was hit in the head with a baseball is admitted to the hosp for
observation. Which finding requires the PN to follow-up with further
assessment?
Reports the hospital room is an office
Which actions should the PN implement for a client whose fractured tibia is
causing swelling of the lower leg?
Ice application and elevation
A male client is admitted with lower right abdominal pain for the past two days.
During the focused assessment, the PN observes that the client's abdomen is
rigid with tense positioning. Which action should the PN implement?
Keep the client NPO for possible surgery
An older female client with osteoporosis asks the PN to explain why she is now 2
inches shorter than when she was younger. What info is best for the PN to
provide?
It is a combo of wear and tear and calcium loss that causes the damage
During the daily assessment of a client with emphysema, the PN identifies that
the client's chest is barrel-shaped and he is demonstrating pursed-lip breathing.
Which additional finding requires follow up by the PN?
,Rales auscultated bilaterally
An older client who has had a cataract in the right eye for several years tells the
PN, "Now i have lost the sight in my right eye because I waited too long for
treatment." What info should the PN provide?
Surgery can restore vision with corrective lens implants or glasses
While completing pre-op prep for a client is admitted for same-day surgery,
what eval statement should the PN identify as an important outcome?
Asks questions regarding the surgical experience
A client's prescription for warfarin (Coumadin) therapy was d/c 3 weeks ago
and returns to the clinic for follow-up lab tests.
Which results should indicate to the PN that the meds has been eliminated from
the body?
International normalized ratio (INR) or 0.9
What info should the PN reinforce with a client who is recently diagnosed with
DM?
Diabetes increase the risk for cardiovascular disease
A male client returns to the surgical nursing unit after having a thyroidectomy.
Which action is most important for the PN to implement?
Assess the client's resp status
Which finding for a client who is 1-day post op for a partial thyroidectomy
requires immediate follow-up by the PN?
High pitched expiratory sound
A male client is one day post-op for surgical repair of a fractured femur when he
suddenly experiences dyspnea, coughing, chest pain, and hemoptysis. Based on
this data, what nursing diagnosis should the practical nurse address for this
client?
Impaired gas exchanged R/T altered blood flow to alveoli
A male client who has been taking a 4-drug regimen for TB tells the PN that he
has finished the first drug, isoniazid, and will start taking rifampin next.
,How should the PN respond?
The 4 drug protocol should be taken concurrently
The PN is performing a focused assessment for a post-op client who returns to
the unit after receiving general anesthesia. Which finding should the PN identify
as an indicator that the client is free of resp complication?
Breath sounds are clear bilaterally
The PN is evaluating the self-care of a client who is recovering at home after a
laryngectomy. Which finding indicates to the PN that the client needs additional
info?
The salt water solution is dated 3 days ago
Which findings should the PN identify in a client with anemia due to a vitamin
B12 deficiency?
- Smooth, beefy-red oral cavity
- Paresthesia of hands and feet
Which client should the PN question the PRN prescription for sumatriptan
(Imitrax) for migraine headaches?
50-year-old with Prinzmetal's angina
Which instruction should the PN reinforce with a female client about skin care
after her first radiotherapy treatment?
Avoid using ice packs on the exposed area
A male client who had a stroke is incontinent of urine. Which action should the P
implement in providing bladder training?
Offer the client the commode or urinal every 2 hrs
A client is admitted with a C4 spinal cord injury 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 PN has the highest priority?
Check the resp effort and pulse ox reading
The PN is reviewing the admission lab results for a client with cirrhosis of the
liver. Which finding should the PN report to the MD?
, Elevated serum ammonia
The PN is assisting the occpational health nurse with employee health screening.
Which technique should the PN use to determine a client's visual acuity?
Have the client read the snellen eye chart
The PN receives a report on a group of clients assigned for the day. Which
priority assessment should the PN implement?
Check the pulse ox for a client with myasthenia gravis
A client who is 2 days post op for abd surgery has an NGT to low continuous
suction. Which imbalance?
Metabolic alkalosis
The wife of a client with a large brain tumor asks the PN to explain why the
tumor should be surgically removed. What is the best response for the PN to
provide?
Brain tumors increase cerebral mass, resulting in increased intracranial pressure
The PN is caring for a client who is receiving radiotherapy for cancer of the
larynx. Which info should the PN provide the client to reduce effects of
radiation?
Use sugarless gum
Which instructions should the PN reinforce with a client who is preparing for
dishcharge. S.A.T.A
- Request the use of special hand scanning
- Do not lean against the car
- Keep regularly scheduled appts
Which client should the PN question a PRN Imitrex?
50 year old with prinzmetals angina
The PN is reviewing discharge instructions with a client after out-patient. Which
client response indicates to the PN the need for teaching reinforcement?
Pain meds every day
The practical nurse is reviewing pre-op 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?
What do you know about the surgery you are having?
An adult client with otitis media has thick, yellow drainage from the right ear
canal. What additional findings should the PN expect to identify?
Pain relief after ear drainage begins
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?
Palpation of both pedal pulses
A client who was hit in the head with a baseball is admitted to the hosp for
observation. Which finding requires the PN to follow-up with further
assessment?
Reports the hospital room is an office
Which actions should the PN implement for a client whose fractured tibia is
causing swelling of the lower leg?
Ice application and elevation
A male client is admitted with lower right abdominal pain for the past two days.
During the focused assessment, the PN observes that the client's abdomen is
rigid with tense positioning. Which action should the PN implement?
Keep the client NPO for possible surgery
An older female client with osteoporosis asks the PN to explain why she is now 2
inches shorter than when she was younger. What info is best for the PN to
provide?
It is a combo of wear and tear and calcium loss that causes the damage
During the daily assessment of a client with emphysema, the PN identifies that
the client's chest is barrel-shaped and he is demonstrating pursed-lip breathing.
Which additional finding requires follow up by the PN?
,Rales auscultated bilaterally
An older client who has had a cataract in the right eye for several years tells the
PN, "Now i have lost the sight in my right eye because I waited too long for
treatment." What info should the PN provide?
Surgery can restore vision with corrective lens implants or glasses
While completing pre-op prep for a client is admitted for same-day surgery,
what eval statement should the PN identify as an important outcome?
Asks questions regarding the surgical experience
A client's prescription for warfarin (Coumadin) therapy was d/c 3 weeks ago
and returns to the clinic for follow-up lab tests.
Which results should indicate to the PN that the meds has been eliminated from
the body?
International normalized ratio (INR) or 0.9
What info should the PN reinforce with a client who is recently diagnosed with
DM?
Diabetes increase the risk for cardiovascular disease
A male client returns to the surgical nursing unit after having a thyroidectomy.
Which action is most important for the PN to implement?
Assess the client's resp status
Which finding for a client who is 1-day post op for a partial thyroidectomy
requires immediate follow-up by the PN?
High pitched expiratory sound
A male client is one day post-op for surgical repair of a fractured femur when he
suddenly experiences dyspnea, coughing, chest pain, and hemoptysis. Based on
this data, what nursing diagnosis should the practical nurse address for this
client?
Impaired gas exchanged R/T altered blood flow to alveoli
A male client who has been taking a 4-drug regimen for TB tells the PN that he
has finished the first drug, isoniazid, and will start taking rifampin next.
,How should the PN respond?
The 4 drug protocol should be taken concurrently
The PN is performing a focused assessment for a post-op client who returns to
the unit after receiving general anesthesia. Which finding should the PN identify
as an indicator that the client is free of resp complication?
Breath sounds are clear bilaterally
The PN is evaluating the self-care of a client who is recovering at home after a
laryngectomy. Which finding indicates to the PN that the client needs additional
info?
The salt water solution is dated 3 days ago
Which findings should the PN identify in a client with anemia due to a vitamin
B12 deficiency?
- Smooth, beefy-red oral cavity
- Paresthesia of hands and feet
Which client should the PN question the PRN prescription for sumatriptan
(Imitrax) for migraine headaches?
50-year-old with Prinzmetal's angina
Which instruction should the PN reinforce with a female client about skin care
after her first radiotherapy treatment?
Avoid using ice packs on the exposed area
A male client who had a stroke is incontinent of urine. Which action should the P
implement in providing bladder training?
Offer the client the commode or urinal every 2 hrs
A client is admitted with a C4 spinal cord injury 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 PN has the highest priority?
Check the resp effort and pulse ox reading
The PN is reviewing the admission lab results for a client with cirrhosis of the
liver. Which finding should the PN report to the MD?
, Elevated serum ammonia
The PN is assisting the occpational health nurse with employee health screening.
Which technique should the PN use to determine a client's visual acuity?
Have the client read the snellen eye chart
The PN receives a report on a group of clients assigned for the day. Which
priority assessment should the PN implement?
Check the pulse ox for a client with myasthenia gravis
A client who is 2 days post op for abd surgery has an NGT to low continuous
suction. Which imbalance?
Metabolic alkalosis
The wife of a client with a large brain tumor asks the PN to explain why the
tumor should be surgically removed. What is the best response for the PN to
provide?
Brain tumors increase cerebral mass, resulting in increased intracranial pressure
The PN is caring for a client who is receiving radiotherapy for cancer of the
larynx. Which info should the PN provide the client to reduce effects of
radiation?
Use sugarless gum
Which instructions should the PN reinforce with a client who is preparing for
dishcharge. S.A.T.A
- Request the use of special hand scanning
- Do not lean against the car
- Keep regularly scheduled appts
Which client should the PN question a PRN Imitrex?
50 year old with prinzmetals angina
The PN is reviewing discharge instructions with a client after out-patient. Which
client response indicates to the PN the need for teaching reinforcement?
Pain meds every day
