HESI MEDSURG VERSION 1 TO 4 EXAM QUESTION AND ANSWERS /TESTBANK 2020/2021

HESI MEDSURG VERSION 1 TO 4 EXAM QUESTION AND ANSWERS 1. Nurse in ED caring for a client who is having an acute asthma attack. How can she tell the client in in respiratory distress (Select all) A. 95% O2 B. Wheezing C. Retraction of sternal muscles D. Pink mucous membranes E. Premature ventricular complexes (PVCs) 2. Newly admitted patient w/diagnosis of ascites. What order would the nurse question? (select all) a. High sodium b. Spironolactone c. Paracentesis d. Administration of salt-poor albumin e. Assisted ambulation 3. A client is administered to the emergency department with several large kidney stones. What is the nursing priority of this patient? a. Administer a Foley catheter b. Have the patient transferred to the ER to have the stones surgically removed c. Administer hydrochlorothiazide d. Administer acetaminophen 4. A student nurse is completing a pain assessment. The patient states that the pain is located in his abdomen, and relieved by defecation. After reviewing his chart she noticed the consistency of his stools also changed. What would the student suspect his diagnosis to be? a. Appendicitis b. Irritable bowel syndrome c. Irregular diet d. Abdominal hernia 5. The nurse obtains a diet history from a pregnant 16 yr old girl. The girl tells the nurse her typical daily diet includes cereal and milk for breakfast, pizza and soda for lunch, and a cheeseburger, milkshake, fries and a salad for dinner. Which of the following is the MOST accurate nursing diagnosis based on the data? a. Altered nutrition: more than body requirements related to high-fat diet b. Knowledge deficit: nutrition in pregnancy c. Altered nutrition: less that body requirements related to increased nutritional demands of pregnancy d. Risk for injury: fetal malnutrition related to poor maternal diet