HESI MEDSURG EXAM 2022 ACTUAL EXAM

HESI MEDSURG EXAM 2022 ACTUAL EXAM 1. An adult client is diagnosed with restless leg syndrome and is referred to the sleep clinic. The healthcare provider prescribes ferrous sulfate 325 mg pO daily. Which laboratory values should the nurse monitor? a. Serum iron and ferritin b. Platelet count and hematocrit c. Neutrophils and eosinophils d. Serum electrolytes 2. The nurse is caring for a client who is newly diagnosed with adrenocortical insufficiency. The client is experiencing chronic fatigue and weakness. Which intervention should the nurse implement? a. Begin education about fluid restriction and waysto incorporate into ongoing therapy b. Explain that the hormone therapy will be needed for a time until adrenal glands are stimulated c. Provide encouragement that symptoms will rapidly improve as hormone therapy is initiated d. Advise the client to schedule energy intensive activities for later in the day 3. the nurse is caring for an immobile client after spinal surgery. Which action is most important for the nurse to take to prevent postoperative complications? a. Maintain intervascular infusion rate b. Progress diet slowly from ice chips to clear liquid c. Apply intermittent pneumatic compression devices d. Obtain frequent pain level assessments 4. An adult client is admitted with flank pain and is diagnosed with acute pyelonephritis. What is the priority nursing action? a. Encourage turning and deep breathing b. Auscultate for presence of bowel sounds c. Administer IV antibiotics as prescribed d. Monitor hemoglobin and hematocrit 5. The nurse is obtaining a health history from a new client who has a history of kidney stones. Which statement by the client indicates an increased risk for renal calculi? a. Eats a vegetarian diet with cheese 2 to 3 times a day b. Experiences additional stress since adopting a child c. Jogs more frequently than usual daily routine d. Drinks several bottles of carbonated water daily 6. A client with orthopnea expresses concern about the ability to “get enough air” during a scheduled thoracentesis. On which information should the nurse’s response be based on? a. Extra pillows can be used if needed to elevate the client’s head b. Orthopnea is frequently caused by a clients uncontrolled anxiety c. The procedure is performed with the client in an upright position d. A thoracentesis is a brief procedure that has minimal discomfort This study source was downloaded by from CourseH on :44:41 GMT -05:00 7. The nurse is performing the postoperative assessment of a client with an abdominal aortic aneurysm. Which finding is most important for the nurse to provide in the preoperative report? This study source was downloaded by from CourseH on :44:41 GMT -05:00 a. Respirations 20 breaths/minute b. Diminished peripheral pulses c. Hypoactive bowel sounds d. S3 hear sound on auscultation 8. The nurse is providing teaching to a client with type 2 diabetes mellitus about managing care at home. Which information stated by the client indicates understanding? a. Avoid seasoning foods with salt and salt-containing spices b. Keep any wounds covered with an antibiotic ointment c. Check blood sugar levels every four to six hours every day d. Soak feet daily in hot water no longer than 10 minutes 9. The home health nurse providesteaching about insulin self-injecting to a client who was recently diagnosed with diabetes mellitus. When the client begins to perform a return demonstration of an insulin injection into the abdomen as seen in the video, which instruction should the nurse provide? a. Lie down flat for better skin exposure b. Select a different injection site c. Keep the skin flat rather than bunched d. Continue with the insulin injection 10. The nurse is collecting information from a client with chronic pancreatitis who reports persistent gnawing abdominal pain. To help the client manage the pain, which assessment data is most important for the nurse to obtain? a. Color and consistency of feces b. Eating patterns and dietary intake c. Level and amount of physical activity d. Presence and activity of bowel sounds 11. A client with herpes zoster (shingles) on the thorax tells the nurse of having difficulty sleeping. Which is the probable etiology of this problem? a. Noctuia b. Dyspnea c. Frequent cough d. Pain 12. The nurse is obtaining the admission history for a client with suspected peptic ulcer disease (PUD). Which subjective data reported by the client supports this medical diagnosis? a. Marked loss of weight and appetite over the last 3 or 4 months b. Upper mid-abdominal pain described as gnawing and burning c. Frequent use of chewable and liquid antacids for indigestion d. Severe abdominal cramps and diarrhea after eating spicy foods 13. An obese client with emphysema who smokes at least a pack of cigarettes daily is admitted after experiencing a sudden increase in dyspnea and activity intolerance. Oxygen therapy is initiated and is determined that the client will be discharged with oxygen. Which information is most important for the nurse to emphasize in the discharge teaching plan? a. Methodsfor weight gain This study source was downloaded by from CourseH on :44:41 GMT -05:00 b. Guidelinesfor oxygen used c. Strategiesforsmoking cessation d. Approachesto conserve energy 14. A hospitalized client with peripheral arterial disease (PAD) isinstructed regarding leg and foot care. Which statement by the client indicates to the nurse that learning has occurred? a. “whenever I am sitting in a chair I will keep my legs up to reduce swelling” b. “I can use a mirror to check the bottoms of my feet for any signs of breakdown” c. “I will try to keep moving if leg pain occurs to help promote good circulation” d. “I will use my swimming pool early in the day while the water is still very cool. 15. To reduce the risk for pulmonary complication for a client with amyotrophic lateral sclerosis (ALS), which interventions should the nurse implement? SATA a. Perform chest physiotherapy b. Initiate passive range of motion exercise e. Establish a regular bladder routine 16. An adult who was recently diagnosed with glaucoma tells the nurse, “It feels like I am driving through a tunnel”. The client expresses great concern about going blind. Which nursing instruction is most important for the nurse to provide this client? a. Wear prescription glasses b. Maintain prescribed eye drop regimen c. Avoid frequent eye pressure measurements d. Eat a diet high in carotene (vit C) 17. The nurse observes an increase number of blood clots in the drainage tubing of a client with continuous bladder irrigation following a trans-urethral resection of the prostate (TURP). What is the best initial nursing action? a. Provide additional oral fluid intake b. Administer a PRN dose of an antispasmodic agent c. Measure the clientsintake and output d. Increase the flow of bladder irrigation 18. The healthcare provider prescribes diagnostic test for a client whose chest xray indicates pneumonia. Which diagnostic test should the nurse review for implementation in the most therapeutic treatment of the pneumonia? a. Arterial blood gases (ABG) b. Sputum culture and sensitivity c. Computerized tomography (CT) of the chest d. Blood cultures 19. The family suspects that acquired immune deficiency syndrome (AIDS) dementia is occurring in their son who is human immunodeficiency virus (HIV) positive. Which symptom confirms their suspicions? a. He refuses to see any of his friends or to return their phone calls b. He has begun to sleep 19 out of 24 hours c. He exhibits angry outburst when the subject of dying is approached c. Encourage use of incentive spirometer d. Teach the client breathing exercises This study source was downloaded by from CourseH on :44:41 GMT -05:00 d. A change has recently occurred in his handwriting 20. The nurse is providing discharge instructions to a client who is receiving prednisone 5 mg PO daily for a rash due to contact with poison ivy. Which symptom should the nurse tell the client to report to the health care provider? a. Moon facies b. Gastric irritation c. Abdominal striae d. Rapid weight gain 21. The nurse is caring for a client in the post anesthesia care unit (PACU) who underwent a thoracotomy two hours ago. The nurse observesthe following vital signs: heart rate 140 breaths/minute, respirations 26 breaths/minute, and blood pressure 140/90 mmHG. Which intervention is most important for the nurse to implement? a. Medicate for pain and monitor vital signs according to protocol b. Administer intravenous fluid bolus as prescribed by the healthcare provider c. Apply oxygen at 10 L via non-rebreather mask and monitor pulse oximeter d. Encourage the client to splint the incision with a pillow to cough and deep breathe. 22. A client with lung cancer who wears a subcutaneous morphine sulfate patch for pain is short of breath and is difficult to arouse. When performing a head to toe assessment, the nurse discovers four analgesic patches on the client’s body. Which intervention should the nurse implement first? a. Remove all of the morphine patches b. Administer a narcotic antagonist c. Measure the clients blood pressure d. Apply oxygen per face mask 23. The nurse assess a client who is newly diagnosed with hyperthyroidism and observes that the clients eyeballs are protuberant, causing a wide-eyed appearance and eye discomfort. Based on this finding, which action should the nurse include in the clients plan of care? a. Assess for signs of increased ICP b. Prepared to administer intravenouslevothyroxine c. Obtain a prescription for artificial tear drops d. Review the clients serum electrolyte value 24. A client with Cushing’ssyndrome isrecovering from an elective laparoscopic procedure. Which assessment finding warrants immediate intervention by the nurse? a. Purple marks on skin of the abdomen b. Pitting ankle edema c. Quartersize blood spot on dressing d. Irregular apical pulse 25. Four days following an abdominal aortic aneurysm repair, the client is exhibiting edema of both lower extremities and pedal pulses are not palpable. Which action should the nurse implement first? a. Wrap the feet with warmed blankets b. Elevate extremities on pillows c. Assess pulses with a vascular doppler This study source was downloaded by from CourseH on :44:41 GMT -05:00 d. Evaluate edema for pitting 26. A client with a history of asthma and bronchitis arrives at the clinic with shortness of breath, productive cough with thickened, tenacious mucous, and the inability to walk up a flight of stairs without experiencing breathlessness. Which action is most important for the nurse to instruct the client about self-care? a. Call the clinic if undesirable side effects of medication occur b. Increase the daily intake of oral fluids to liquefy secretions c. Teach anxiety reduction methodsfor feelings ofsuffocation d. Avoid crowded enclosed areas to reduce pathogen exposure 27. A client tellsthe clinic nurse about experiencing burning on urination, and assessment reveals that the client had sexual intercourse four days ago with a person who was casually met. Which action should the nurse implement? a. Observe the perineal area for chancroid like lesion b. Obtain a specimen of urethral drainage for culture c. Assess for perineal itching, erythema, and excoriation d. Identify all sexual partners in the last 4 days 28. A client is hospitalized with heart failure (HF). Which intervention should the nurse implement to improve ventilation and reduce venous return? a. Place the client in high fowler position b. Perform passive range of motion exercises c. Increase the clients activity level d. Administer oxygen per nasal cannula 29. During spring break, a young adult presents to the urgent care clinic and reports a stiff neck, a fever for the past 6 hours and a headache. Which intervention is most important for the nurse to implement first? a. Draw blood cultures b. Administer an antipyretic c. Prepare for a lumbar puncture d. Initiate isolation precautions 30. The nurse is providing teaching to a client with type 2 diabetes mellitus and peripheral neuropathy. Which information should the nurse provide? a. Aching feet may be soaked in lukewarm water for one hour or more b. Family members can help with regular foot exams c. Heat pads are useful if on the lowest setting d. Shoes should be worn outside the house, but it is fine to be barefoot inside 31. The nurse is planning care for an older adult client who experienced a cerebrovascular accident several weeks ago. The client has expressive aphasia and often becomes frustrated with the nursing staff. Which intervention should the nurse implement? a. Encourage clients use of picture charts b. Ask the client simple questions c. Speak slowly to the client d. Teach the client use of basic sign language 32. Which client has the highest risk for developing skin cancer? a. a 25 year old dark skinned client whose mother had skin cancer This study source was downloaded by from CourseH on :44:41 GMT -05:00 b. a 70 year old fair skinned client who works as a secretary c. a 65 year old fair skinned client who is a construction worker d. a 16 year old dark skinned client who tans in tanning beds once a week 33. The nurse is preparing a client for surgery who was admitted to the emergency center following a motor vehicle collision. The client has an open fracture of the femur and is bleeding moderately from the bone protrusion site. During the preoperative assessment, the nurse determines that client currently receives heparin sodium 5,000 units subcutaneously daily. What is the priority nursing action? a. Notify the health care provider of the clients medication history b. Have the client sign the surgical and transfusion permits c. Observe the heparin injection sites for signs of bruising d. Ensure that the potential for bleeding is explain to the client. 34. What food is most important for the nurse to encourage a client with osteomalacia to include in a daily diet? a. Citrus fruits and juices b. Green leafy vegetables c. Fortified milk and cereals d. Red meats and eggs 35. While caring for a client with a full thickness burn covering 40% of the body, the nurse observes purulent drainage at the wound. Before reporting thisfinding to the healthcare provider, the nurse should review which of the client’s laboratory values? a. White blood cell (WBC) count b. Blood pH level c. Platelet count d. Hematocrit 36. A client with gout arthritis repo