HESI MEDSURGE PRACTICE
1. 1.ID: 20127797414
An adult client who is hospitalized after surgery reports sudden onset of chest pain and dyspnea.
The client appears anxious, restless, and mildly cyanotic. The nurse should further assess the
client for which condition?
A. Pulmonary embolism. Correct
B. Heart failure.
C. Tuberculosis.
D. Bronchitis.
Post-surgical clients are at an increased risk for deep vein thrombosis (DVT), which may
result in pulmonary embolism if the clot breaks off and travels to the lungs. Signs and
symptoms of pulmonary embolism include chest pain, dyspnea, anxiety, restlessness, and - in
severe cases - cyanosis.
Jarvis, Physical Examination and Health Assessment, 7th ed., p.493
Awarded 0.0 points out of 1.0 possible points.
2. 2.ID: 20127797411
Which information should the nurse obtain when performing an initial assessment of a client
who presents to the emergency department with a painful ankle injury? (Select all that apply.)
A. Quality of the pain. Correct
B. Signs of inflammation. Correct
C. Ankle range of motion. Correct
D. Muscle strength testing.
E. Visible deformities of the joint. Correct
Initial assessment of a joint injury is performed to determine the extent of the damage. The
nurse's initial assessment of a painful ankle injury should include pain quality, the presence of
deformities, evidence of inflammation, and range of motion.
Jarvis Physical Examination and Health Assessment, 7th ed. p. 586-8
Awarded 0.0 points out of 1.0 possible points.
3. 3.ID: 20127797408
Which description of pain is consistent with a diagnosis of rheumatoid arthritis?
A. Joint pain is worse in the morning and involves symmetric joints. Correct
B. Joint pain is better in the morning and worsens throughout the day.
C. Joint pain is consistent throughout the day and is relieved by pain medication.
D. Joint pain is worse during the day and involves unilateral joints.
Rheumatoid arthritis (RA) is an autoimmune disease that causes joint pain and swelling. RA
is characterized by pain that is worse when arising and involves symmetric joints.
Jarvis. (2016), Physical Examination and Health Assessment, 7th Ed., Chapter 22; p. 586
, Awarded 0.0 points out of 1.0 possible points.
4. 4.ID: 20127797405
Which physical assessment finding should the nurse anticipate in a client with long-term
gastroesophagealreflux disease (GERD)?
A. Hoarseness. Correct
B. Dry mouth.
C. Mouth ulcers.
D. Weight loss.
Dyspepsia and regurgitation are the main symptoms of gastroesophageal reflux disease
(GERD); however, hoarseness is one of the most common long-term symptoms of GERD due
to the irritation of the reflux of gastric secretions.
Ignatavicius, (2016). Medical-surgical nursing: Patient-centered collaborative care, eight
edition., Ch. 49, p. 1111.
Awarded 0.0 points out of 1.0 possible points.
5. 5.ID: 20127797402
A client presents with chronic venous insufficiency. Which assessment finding should the nurse
anticipate?
A. Bilateral lower leg stasis dermatitis. Correct
B. Clubbing of fingers and toes.
C. Intermittent claudication.
D. Peripheral cyanosis.
Clients who suffer from chroninc venous insufficiency often develop statsis dermatitis in the
lower extremities. Statis dermatitis appear as brownish-red discoloration on the lower
extremities at the ankles which can develop into stasis ulcers due to the pooling of the venous
blood flow back to the heart.
Ignatavicius, (2013). Medical-surgical nursing: Patient-centered collaborative care, 7th ed.., Ch.
33, p. 803.
Awarded 0.0 points out of 1.0 possible points.
6. 6.ID: 20127796899
A client has been hospitalized with a femur fracture and is being treated with traction. Which
action by the nurse is the priority when caring for this client?
A. Assess neurovascular status. Correct
B. Change the client's position.
C. Inspect the traction equipment.
D. Review pain medication orders.
The use of traction for long bone fractures reduces the potential for damage to the surrounding
tissues. Reports of increased pain may indicate circulatory compromise or tissue damage
, (compartment syndrome). Assessing the client's neurovascular status is the nurse's highest
priority.
Ignatavicius, (2016). Medical-surgical nursing: Patient-centered collaborative care, eight
edition., Ch. 51, pp. 1051-80.
Awarded 0.0 points out of 1.0 possible points.
7. 7.ID: 20127796896
Which statement made by a client with chronic pancreatitis indicates that further education is
needed?
A. I will cut back on smoking cigarettes daily. Correct
B. I will avoid drinking caffeinated beverages.
C. I will rest frequently and avoid vigorous exercise.
D. I will eat a bland, low-fat, high-protein diet.
To prevent exacerbations of chronic pancreatitis, clients should be instructed to avoid nicotine
entirely. Additional teaching includes avoiding caffeinated beverages, resting frequently as
needed, and eating a bland diet low fat and high in protein.
Ignatavicius, (2016). Medical-surgical nursing: Patient-centered collaborative care, 8th ed., Ch.
59, pp. 1084-98.
Awarded 0.0 points out of 1.0 possible points.
8. 8.ID: 20127796893
The nurse is teaching a female client who uses a contraceptive diaphragm about reducing the
risk for toxic shock syndrome (TSS). Which information should the nurse include? (Select
all that apply.)
A. Remove the diaphragm immediately after intercourse.
B. Wash the diaphragm with an alcohol solution.
C. Use the diaphragm to prevent conception during the menstrual cycle.
D. Do not leave the diaphragm in place longer than 8 hours after intercourse. Correct
E. Replace the old diaphragm every 3 months. Correct
The diaphragm needs to remain against the cervix for 6 to 8 hours to prevent pregnancy but
should not remain for longer than 8 hours to avoid the risk of toxic shock syndrome. The
diaphragm should be replaced every 3 months to maintain integrity.
Awarded 0.0 points out of 1.0 possible points.
9. 9.ID: 20127796890
A male client who smokes two packs of cigarettes a day states he understands that smoking
cigarettes is contributing to the difficulty that he and his wife are having in getting pregnant
and wants to know if other factors could be contributing to their difficulty. What information is
best for the nurse to provide? (Select all that apply.)
A. Marijuana cigarettes do not affect sperm count.
B. Alcohol consumption can cause erectile dysfunction. Correct
C. Low testosterone levels affect sperm production. Correct
D. Cessation of smoking improves general health and fertility. Correct
, E. Obesity has no effect on sperm production.
Use of tobacco, alcohol, and marijuana may affect sperm counts. Sperm count is also negatively
affected by low testerone levels and obesity.
Awarded 0.0 points out of 0.99 possible points.
10. 10.ID: 20127796887
Twenty four hours after a client returns from surgical gastric bypass, the registered nurse (RN)
observes large amounts of blood in the nasogastric tube (NGT) cannister. Which assessment
finding should the RN report as early signs of hypovolemic shock?
A. Faint pedal pulses.
B. Decrease in blood pressure.
C. Lethargy. Correct
D. Slow breathing.
One of the early signs of hypovolemic shock is changes in the client's level of consciousness
due to the decrease perfusion to the brain which can manifests as lethargy or confusion.
Awarded 0.0 points out of 1.0 possible points.
11. 11.ID: 20127796884
The registered nurse (RN) is assessing a male client who arrives at the clinic with severe
abdominal cramping, pain, tenesmus, and dehydration. The RN discovers that the client has
had 14 to 20 loose stools with rectal bleeding. When taking the client's medical history, which
information is most for the nurse to obtain?
A. Irritable bowel syndrome.
B. Diverticulitis.
C. Crohn's disease.
D. Ulcerative colitis. Correct
The RN should ask the client if he has a history of ulcerative colitis, which is characterized by
severe abdominal cramping, pain, tenesmus, and dehydration .
Awarded 0.0 points out of 1.0 possible points.
12. 12.ID: 20127796881
A client is newly diagnosed with diverticulosis. The registered nurse (RN) is assessing the
client's basic knowledge about the disease process. Which statement by the client conveys an
understanding of the etiology of diverticula?
A. Over use of laxatives for bowel regularity result in loss of peristaltic tone.
B. Inflammation of the colon mucosa cause growths that protrude into the colon
lumen.
C. Diverticulosis is the result of high fiber diet and sedentary life style.
1. 1.ID: 20127797414
An adult client who is hospitalized after surgery reports sudden onset of chest pain and dyspnea.
The client appears anxious, restless, and mildly cyanotic. The nurse should further assess the
client for which condition?
A. Pulmonary embolism. Correct
B. Heart failure.
C. Tuberculosis.
D. Bronchitis.
Post-surgical clients are at an increased risk for deep vein thrombosis (DVT), which may
result in pulmonary embolism if the clot breaks off and travels to the lungs. Signs and
symptoms of pulmonary embolism include chest pain, dyspnea, anxiety, restlessness, and - in
severe cases - cyanosis.
Jarvis, Physical Examination and Health Assessment, 7th ed., p.493
Awarded 0.0 points out of 1.0 possible points.
2. 2.ID: 20127797411
Which information should the nurse obtain when performing an initial assessment of a client
who presents to the emergency department with a painful ankle injury? (Select all that apply.)
A. Quality of the pain. Correct
B. Signs of inflammation. Correct
C. Ankle range of motion. Correct
D. Muscle strength testing.
E. Visible deformities of the joint. Correct
Initial assessment of a joint injury is performed to determine the extent of the damage. The
nurse's initial assessment of a painful ankle injury should include pain quality, the presence of
deformities, evidence of inflammation, and range of motion.
Jarvis Physical Examination and Health Assessment, 7th ed. p. 586-8
Awarded 0.0 points out of 1.0 possible points.
3. 3.ID: 20127797408
Which description of pain is consistent with a diagnosis of rheumatoid arthritis?
A. Joint pain is worse in the morning and involves symmetric joints. Correct
B. Joint pain is better in the morning and worsens throughout the day.
C. Joint pain is consistent throughout the day and is relieved by pain medication.
D. Joint pain is worse during the day and involves unilateral joints.
Rheumatoid arthritis (RA) is an autoimmune disease that causes joint pain and swelling. RA
is characterized by pain that is worse when arising and involves symmetric joints.
Jarvis. (2016), Physical Examination and Health Assessment, 7th Ed., Chapter 22; p. 586
, Awarded 0.0 points out of 1.0 possible points.
4. 4.ID: 20127797405
Which physical assessment finding should the nurse anticipate in a client with long-term
gastroesophagealreflux disease (GERD)?
A. Hoarseness. Correct
B. Dry mouth.
C. Mouth ulcers.
D. Weight loss.
Dyspepsia and regurgitation are the main symptoms of gastroesophageal reflux disease
(GERD); however, hoarseness is one of the most common long-term symptoms of GERD due
to the irritation of the reflux of gastric secretions.
Ignatavicius, (2016). Medical-surgical nursing: Patient-centered collaborative care, eight
edition., Ch. 49, p. 1111.
Awarded 0.0 points out of 1.0 possible points.
5. 5.ID: 20127797402
A client presents with chronic venous insufficiency. Which assessment finding should the nurse
anticipate?
A. Bilateral lower leg stasis dermatitis. Correct
B. Clubbing of fingers and toes.
C. Intermittent claudication.
D. Peripheral cyanosis.
Clients who suffer from chroninc venous insufficiency often develop statsis dermatitis in the
lower extremities. Statis dermatitis appear as brownish-red discoloration on the lower
extremities at the ankles which can develop into stasis ulcers due to the pooling of the venous
blood flow back to the heart.
Ignatavicius, (2013). Medical-surgical nursing: Patient-centered collaborative care, 7th ed.., Ch.
33, p. 803.
Awarded 0.0 points out of 1.0 possible points.
6. 6.ID: 20127796899
A client has been hospitalized with a femur fracture and is being treated with traction. Which
action by the nurse is the priority when caring for this client?
A. Assess neurovascular status. Correct
B. Change the client's position.
C. Inspect the traction equipment.
D. Review pain medication orders.
The use of traction for long bone fractures reduces the potential for damage to the surrounding
tissues. Reports of increased pain may indicate circulatory compromise or tissue damage
, (compartment syndrome). Assessing the client's neurovascular status is the nurse's highest
priority.
Ignatavicius, (2016). Medical-surgical nursing: Patient-centered collaborative care, eight
edition., Ch. 51, pp. 1051-80.
Awarded 0.0 points out of 1.0 possible points.
7. 7.ID: 20127796896
Which statement made by a client with chronic pancreatitis indicates that further education is
needed?
A. I will cut back on smoking cigarettes daily. Correct
B. I will avoid drinking caffeinated beverages.
C. I will rest frequently and avoid vigorous exercise.
D. I will eat a bland, low-fat, high-protein diet.
To prevent exacerbations of chronic pancreatitis, clients should be instructed to avoid nicotine
entirely. Additional teaching includes avoiding caffeinated beverages, resting frequently as
needed, and eating a bland diet low fat and high in protein.
Ignatavicius, (2016). Medical-surgical nursing: Patient-centered collaborative care, 8th ed., Ch.
59, pp. 1084-98.
Awarded 0.0 points out of 1.0 possible points.
8. 8.ID: 20127796893
The nurse is teaching a female client who uses a contraceptive diaphragm about reducing the
risk for toxic shock syndrome (TSS). Which information should the nurse include? (Select
all that apply.)
A. Remove the diaphragm immediately after intercourse.
B. Wash the diaphragm with an alcohol solution.
C. Use the diaphragm to prevent conception during the menstrual cycle.
D. Do not leave the diaphragm in place longer than 8 hours after intercourse. Correct
E. Replace the old diaphragm every 3 months. Correct
The diaphragm needs to remain against the cervix for 6 to 8 hours to prevent pregnancy but
should not remain for longer than 8 hours to avoid the risk of toxic shock syndrome. The
diaphragm should be replaced every 3 months to maintain integrity.
Awarded 0.0 points out of 1.0 possible points.
9. 9.ID: 20127796890
A male client who smokes two packs of cigarettes a day states he understands that smoking
cigarettes is contributing to the difficulty that he and his wife are having in getting pregnant
and wants to know if other factors could be contributing to their difficulty. What information is
best for the nurse to provide? (Select all that apply.)
A. Marijuana cigarettes do not affect sperm count.
B. Alcohol consumption can cause erectile dysfunction. Correct
C. Low testosterone levels affect sperm production. Correct
D. Cessation of smoking improves general health and fertility. Correct
, E. Obesity has no effect on sperm production.
Use of tobacco, alcohol, and marijuana may affect sperm counts. Sperm count is also negatively
affected by low testerone levels and obesity.
Awarded 0.0 points out of 0.99 possible points.
10. 10.ID: 20127796887
Twenty four hours after a client returns from surgical gastric bypass, the registered nurse (RN)
observes large amounts of blood in the nasogastric tube (NGT) cannister. Which assessment
finding should the RN report as early signs of hypovolemic shock?
A. Faint pedal pulses.
B. Decrease in blood pressure.
C. Lethargy. Correct
D. Slow breathing.
One of the early signs of hypovolemic shock is changes in the client's level of consciousness
due to the decrease perfusion to the brain which can manifests as lethargy or confusion.
Awarded 0.0 points out of 1.0 possible points.
11. 11.ID: 20127796884
The registered nurse (RN) is assessing a male client who arrives at the clinic with severe
abdominal cramping, pain, tenesmus, and dehydration. The RN discovers that the client has
had 14 to 20 loose stools with rectal bleeding. When taking the client's medical history, which
information is most for the nurse to obtain?
A. Irritable bowel syndrome.
B. Diverticulitis.
C. Crohn's disease.
D. Ulcerative colitis. Correct
The RN should ask the client if he has a history of ulcerative colitis, which is characterized by
severe abdominal cramping, pain, tenesmus, and dehydration .
Awarded 0.0 points out of 1.0 possible points.
12. 12.ID: 20127796881
A client is newly diagnosed with diverticulosis. The registered nurse (RN) is assessing the
client's basic knowledge about the disease process. Which statement by the client conveys an
understanding of the etiology of diverticula?
A. Over use of laxatives for bowel regularity result in loss of peristaltic tone.
B. Inflammation of the colon mucosa cause growths that protrude into the colon
lumen.
C. Diverticulosis is the result of high fiber diet and sedentary life style.
