HESI Med Surg Review Questions and answers

HESI Med Surg Review Questions and answers A patient had abdominal surgery and states that after coughing it feels like his guts has spilled out. What should the nurse do first? Visualize the abdominal area A patient has been taking Kenalog (corticosteroid) with increase redness... Schedule an appointment A patient hd a BDP. What warrants further intervention? Positive gastro occult emesis A patient who has been taking B12 says he's fatigue. What lab to monitor? CBC A patient with Parkinson is walking. ? Confirm that its effective Whats priority for a patient who is allergic to bananas? Replace latex How to prevent a renal calculi? limit tea and chocolate If a patient is in F-vib what medication to give? Adenosine A nurse is caring for a patient and is unable to palpate a pedal pulse. What should the nurse do next? Obtain a doppler A client with a history of COPD has established a walking program. How do we know that walking is effective? Cardiovascular improvement Post -op A client informs the nurse that he know all about how to breath. How should the nurse respond? .... Order 100 units in 250ml to infuse at 12units/hr 12/100 *250= 30 A client complains of pain in the right calf. What is the nurse's priority? Remain in bed A client just returned after having a TURP and has clot. What should the nurse do? slowly irrigate What's Priority for a client with Multiple Scerolosis and has urinary rention? Self cathetherization The nurse is monitoring drainainge of an abscess. What lab should the nurse monitor? WBCs What intervetion the nurse shoudl implement for a patient with Congestive Heart Failure? Use bedside commode when needing to void What intervention should be done for post op cataract extraction? implement deep breathing A client is discharged on Prednisolone. What should the patient report? Wt gain A client is diagnosed with Pyelinephritis. What is priority? IV antibiotics What is a diet for Osteomalacia? Milk and cereal What should the nurse instruct a client who has Raynuads Syndrome to do at work? Use space heater What to report with a Bronchoscopy? ... What should the nurse expect for a client who has unstable Angina who had a cardiac catheter? Thoro....... What to teach a client with acute glumoronepheritis/ Restrict Sodium What to teach a client with GERD? Wear loose clothing How should a client with COPD breath? Pursed lips A client presents with the s/s of Diabetes type 2 and feeling shaky. What is the nurse priority? Obtain glucose level What should the HCP order for a client with Hypothyroidism who has depression and can not sleep? Request PRN... What should a client with Ulcerative Colitis report? Stool with fatty streaks MRSA intervetions? contact precaution, culture & sensitivity, monitor WBCs CKD lab to report? K 6.5 A client has a positive guaic stool. What lab to review? Platelets Phenochrocytoma with HA Assess the blood pressure Suprapubic prostateomy concern? Urine leakacge Abdominal cramping after surgery .... A client tells the nurse that her biopsy results indicate that the cancer cells are well differentiated How should the nurse respond? Ask HCP A client that has Asthma has bronchocontriction with increase mucus .... Ulcer that is venous... Irregular.... What lab indicate a Diabetic is adhering to regiment? A1c A client has 40% of burns. Which fluid is needed during the acute phase? Latated Ringers A client has a pain of 8 out of 10 on the pain scale ? Administer opioids and non pharmacological interventions What should be included in the teaching for a client with Diabetes Mellitus with an ulcer? Check shoes before putting them on The HCP orders 8200 units and available is 2ml each 1ml. How much to give 0.8 A client with Gullian Barre is not blinking. What intervention to implement? Administer lubericant What is a concern for a client with Diabetes Insipidous? Sodium level 185 What would indicate a sign of dementia in a client with AIDS? A change in writing What should the nurse evaluate with a client that has ORIFSA? Select All Verify. Monitor for manifestations of compartment syndrome What intervention will the nurse implement when caring for a client with a pulmonary infection? Select All Assess breathing, change in level of consciousness, monitor skin color What is needed for a client that has traction applied and need repositioning? A trapeze bar RA diagnosis? .... A client is being seen at the clinic for Tinea Pedia. What question to ask Are you taking the prescription Tolfnate What should the nurse do after reading the results of a TB test that read 5mm? Document the findings A client that had a CVA has visual impairment and has not be able to eat all of his food. What should the nurse instruct the family to do? Visual..... Meloma observe for what? Appearance A patient had abdominal surgery and states that after coughing it feels like his guts has spilled out. What should the nurse do first? Visualize the abdominal area A patient has been taking Kenalog (corticosteroid) with increase redness... Schedule an appointment A patient hd a BDP. What warrants further intervention? Positive gastro occult emesis A patient who has been taking B12 says he's fatigue. What lab to monitor? CBC A patient with Parkinson is walking. ? Confirm that its effective Whats priority for a patient who is allergic to bananas? Replace latex How to prevent a renal calculi? limit tea and chocolate If a patient is in F-vib what medication to give? Adenosine A nurse is caring for a patient and is unable to palpate a pedal pulse. What should the nurse do next? Obtain a doppler A client with a history of COPD has established a walking program. How do we know that walking is effective? Cardiovascular improvement Post -op A client informs the nurse that he know all about how to breath. How should the nurse respond? .... Order 100 units in 250ml to infuse at 12units/hr 12/100 *250= 30 A client complains of pain in the right calf. What is the nurse's priority? Remain in bed A client just returned after having a TURP and has clot. What should the nurse do? slowly irrigate What's Priority for a client with Multiple Scerolosis and has urinary rention? Self cathetherization The nurse is monitoring drainainge of an abscess. What lab should the nurse monitor? WBCs What intervetion the nurse shoudl implement for a patient with Congestive Heart Failure? Use bedside commode when needing to void What intervention should be done for post op cataract extraction? implement deep breathing A client is discharged on Prednisolone. What should the patient report? Wt gain A client is diagnosed with Pyelinephritis. What is priority? IV antibiotics What is a diet for Osteomalacia? Milk and cereal What should the nurse instruct a client who has Raynuads Syndrome to do at work? Use space heater What to report with a Bronchoscopy? ... What should the nurse expect for a client who has unstable Angina who had a cardiac catheter? Thoro....... What to teach a client with acute glumoronepheritis/ Restrict Sodium 7:32 AM (6 hours ago) What to teach a client with GERD? Wear loose clothing How should a client with COPD breath? Pursed lips A client presents with the s/s of Diabetes type 2 and feeling shaky. What is the nurse priority? Obtain glucose level What should the HCP order for a client with Hypothyroidism who has depression and can not sleep? Request PRN... What should a client with Ulcerative Colitis report? Stool with fatty streaks MRSA intervetions? contact precaution, culture & sensitivity, monitor WBCs CKD lab to report? K 6.5 A client has a positive guaic stool. What lab to review? Platelets Phenochrocytoma with HA Assess the blood pressure Suprapubic prostateomy concern? Urine leakacge Abdominal cramping after surgery .... A client tells the nurse that her biopsy results indicate that the cancer cells are well differentiated How should the nurse respond? Ask HCP A client that has Asthma has bronchocontriction with increase mucus .... Ulcer that is venous... Irregular.... What lab indicate a Diabetic is adhering to regiment? A1c A client has 40% of burns. Which fluid is needed during the acute phase? Latated Ringers A client has a pain of 8 out of 10 on the pain scale...? Administer opioids and non pharmacological interventions What should be included in the teaching for a client with Diabetes Mellitus with an ulcer? Check shoes before putting them on The HCP orders 8200 units and available is 2ml each 1ml. How much to give 0.8 A client with Gullian Barre is not blinking. What intervention to implement? Administer lubericant What is a concern for a client with Diabetes Insipidous? Sodium level 185 What would indicate a sign of dementia in a client with AIDS? A change in writing What should the nurse evaluate with a client that has ORIFSA? Select All Verify... Monitor for manifestations of compartment syndrome What intervention will the nurse implement when caring for a client with a pulmonary infection? Select All Assess breathing, change in level of consciousness, monitor skin color What is needed for a client that has traction applied and need repositioning? A trapeze bar RA diagnosis? .... A client is being seen at the clinic for Tinea Pedia. What question to ask Are you taking the prescription Tolfnate What should the nurse do after reading the results of a TB test that read 5mm? Document the findings A client that had a CVA has visual impairment and has not be able to eat all of his food. What should the nurse instruct the family to do? Visual..... Meloma observe for what? Appearance 2021 Hesi Med Surg V2 1. Pulmonary artery wedge pressure (SWAN GANZ) • Assess/monitor for dysrhythmias 2. Pt w/ dysrhythmias (pg 99) • Calcium of 7.2 (low) 3. LOW Cardiac output • MI 4. Renal Failure (pg 79) • 45% BUN 5. S/S of shock (pg 30) • Hypotension, thready pulse 6. How to check for Carbon monoxide poisoning • Cherry red mouth or tongue 7. Paracentesis • Empty bladder completely before procedure 8. Pt has angina (pg 87) • Pain radiates to Left arm 9. Pt has increased abdominal girth Pos-op surgery • Call MD 10. ARDS (pg 27) • Patient using abdominal muscles to breath 11. Mechanical ventilator- asymmetry • Check for placement 12. Tylenol Over Dose (Bun & Creat. High) • acetylcysteine Mucomyst (an antagonist) 13. Lupus (pg 131-132) • Use a Heavy Sunblock 14. Pancreatitis: Which enzyme increases in 1st 24 hours • Amylase 15. Pancreatitis (pg 118) • NPO to Rest and prevent production of enzymes 16. HIV (pg 53) • The # of T-CELLS decrease and die 17. How to turn a pt w/ enteral feeding and IV • Nurse must HOLD enteral feeding than restart the feeding after 18. Pt w/ Hysterectomy (sx to remove uterus) • Check for Hypo-tension (low BP) and check for increased bleeding 19. Carpal Spasm w/ BP check (pg 121) • Check CALCIUM levels 20. For Dysrhythmias • Administer Epinephrine 21. Know PARKLAND FORMULA • By 8 pm will have 3500 22. Lupus • Exacerbations of Fever 23. Thyroid (pg 121) • T3 secretion / production 24. More than 30% of burns • Give fluid resuscitation 25. Ineffective airway clearance • Thin secretions to remove easily 26. Autonomic dysreflexia (pg 148) • Diaphoretic and headaches 27. Pulmonary contusion due to crushing of chest from an accident • Most common penetrating wound 28. Levothyroxine (Synthroid) (pg 122) • report palpitations and SOB 29. Esophageal varices & portal HTN • Give them stool softeners to prevent straining 30. Pheochromocytoma • Monitor BP 31. Acute Renal Failure Diet (pg 81) • LOW Protein & HIGH CARBS; low Na & K 32. Cholecystitis (pg 119) • Diet; Weight Program 33. Burns: Debridement / hydrotherapy (pg 180 Hesi Hint) • Give Narcotics before 34. Septic Shock (possible negative question – in septic shock, massive vasodilation occurs) • Constriction happens 35. Anaphylactic shock • Constriction of airway 36. Glasgow Coma Scale of 14 (pg 143) • Monitor neuro status every 2 hrs 37. Insulin Protocol (Big scenario that begins with insulin scale) • Increased insulin by 1unit/hr 38. Injury to L4, T1 • Pt c/o urinary retention * 39. Decreased CO • MI * 40. Strip w/ asystole • Begin CPR 41. MATH 7.5 mg/ml 750 ml /100=7.5 42. MATH 15 gtt/min 630ml /(7 hr) 420 min X 10=15 43. MATH 21 gtts/min 20.8 so round to whole number OF 21 (Formula had 400 ML AND I FORGOT THE REST BUT ANSWER IS 21) 44. AV Graft has a bruit (pg 82) • Document the finding; bruit is normal 45. Nurse to administer meds thru Central Triple Lumen Catheter and notices no IV infusing. • Admin 3ml saline or Aspirate for blood return (I chose aspirate but not sure LOOK Up) 46. Lady in the ER diagnosed with MI and states “oh I just Have a little indigestion, I’ll be fine • Deficient knowledge or Ineffective (I chose deficient knowledge but not sure..Look Up) 47. Given a percentage of burns and the calculation is (Know Rules of Nines) (pg 176) • 45% 48. Patient had a thyroidectomy - which indicates a problem (pg 121) • Muscle twitching and jerking 49. Patients BP is 60/40 (something like that) Nurse’s action administer • Vasoconstrictor - a negative inotrope 50. Patient had a mechanical valve replacement. What does nurse teach patient? (pg 106) • It must be replaced every 10 years or Take antibiotics before dental procedures (I chose the underlined one but not 100% sure..LOOK UP) PICS OF CARDIAC STRIPS 51. They will show you a strip and you would document it as • Normal Sinus Rhythm (NSR) 52. A picture of V-FIb What action do you take (pg 100-101) • D-fib 53. This one just shows a pic and asks you what it is (pg 100) • Atrial Flutter 54. Mechanism/action of calcitonin • Moves calcium from the blood circulation into the bone 55. Pt with V-fib pg (100-101) • Start CPR; do not call code 2021 Hesi Med Surg V1 – Mixed with Correct answers and Rationales I memorized from my Hesi Testing Center. 1. Guaiac Occult Test. What lab is most important? Platelet Count 2. Patient had BDP 3 months ago with dehydration. What would warrant the nurse immediate intervention? Positive Gastro Occult 3. A patient with Parkinson’s. “Freezes.” Pretends there is a crack on the floor and Carefully lifts leg and steps over. Confirm that this is the correct and effective technique. 4. Patient had Atrial Fibrillation and then AED was used. One minute later, Patient sudden goes in to ventricular Tachycardia. What should the nurse do? Administer Adenosine over 1-2 seconds IV 5. Heart failure acute exacerbation. How to Reduce Cardiac Workload? Bedside Commode 6. External Fixation Device- What should the nurse do first? Assess for peripheral pulse at the foot 7. COPD patient is experience shortness of breath. Pursed Lip Breathing 8. Client with CVA (stroke). Has only eaten half of their food. Family is concern about nutrition. What should the nurse tell the family? Demonstrate the use of Visual Scanning. 9. A male client with asthma has bronchoconstriction and mucous production due to exercising. What should the nurse do? Determine if the client is using an inhaler before exercising. 10. A client with liver abscess and drainage of abscess. Which lab value? White blood Cell Count 11. Suprapubic prostatectomy. Three-way catheter. Which assessment? Urine Leaking meatus 12. A client with ulcerative colitis. UAP report what finding? Stool with fatty streaks 13. Flank pain and acute pyelonephritis. Priority nursing action. Administer IV antibiotics. 14. Long-standing pulmonary infection. Assess for hypoxia. Select All That Apply. Breathing patterns, Check mentation, color of skin and nailbeds 15. Traction applied, but client is frustrated because client keeps calling nurse for help with repositioning. Use a trapeze bar. 16. Multiple Sclerosis and urinary retention. Self-Catheterization 17. Client works as a data desk job with Raynaud’s syndrome. What to do to prevent wrist injury? Space Heater 18. C.K.D. Lab to report. Potassium 6.5 19. Client withy Gullian Barre is not blinking. Administer Lubricant 20. Taking prednisone PO 5mg. What symptom? Rapid Weight Gain. 21. Succinylcholine. High Temperature. Ice Pack axillary 22. The nurse drops a sterile package of supplies on the floor in the operating room (OR) suite. The … impervious wrapper. Which action should the nurse implement? Open contents to sterile field package intact. 23. Client with Acute Glomerulonephritis. Restrict Sodium. 24. Client ask about biopsy results from cancer cells well differentiated. What response? Ask Healthcare provider to gather more information. 25. Right cataract and lens implant. Which intervention should the nurse first? Provide an eye shield to be worn while sleeping. 26. The unlicensed assistive personnel (UAP) reports to the nurse that a client who was admitted with abdominal pain has just had a large black tarry stool. What intervention should the nurse implement first? - Test the stool for occult blood. 27. Which action is most important for the nurse to implement to reduce the risk for deep vein thrombosis in a postoperative client? -Advise the client to perform leg exercises regularly. 28. The nurse is preparing a client for a bronchoscopy. While obtaining consent, the client complains of thirst and admits to drinking a small amount of orange juice two hours ago. What action should the nurse take? -Delay procedure for 6 hours. 29. A client uses triamcinolone (kenalog), a corticosteroid ointment, to manage pruritis caused by a chronic skin rash. The client calls the clinic nurse to report increased erythema with purulent exudate at the site. What action should the nurse implement? -Schedule an appointment for the client to the healthcare provider. 30. The nurse learns in change of shift report that the x-ray report for a newly admitted client indicates consolidation in the left lower lung. What action should the nurse take? -Administer a PRN dose of a bronchodilator. 31. The nurse is monitoring the glucose q4h of an adult woman admitted with DKA. Two hours after receiving 10 units of regular insulin for glucose of 255, the client is perspiring and complaining of shakiness. What intervention should the nurse implement? -Check Capillary glucose level. 32. The chest x-ray for a client who is admitted for pneumonia shows pleural effusion with decreased air flow in the entire left upper lobe. What breath sounds that verify the x-ray findings should the nurse document after auscultation of the left upper lobe? -Diminished breath sounds 33. Which food is most important for the nurse to encourage a male patient with osteomalacia to include in his daily diet? - Fortified milk and cereals. 34. An older adult woman is seen in the clinic 3 months following her diagnosis of type 2 diabetes mellitus (DM). She tells the nurse that she has had a difficult time keeping her blood sugar in control. The nurse reviews the client's current finger-stick and daily log of blood glucose levels. Which intervention is most important for the nurse to implement? -Review the client’s glycosylated hemoglobin (A1c) level. 35. The nurse is taking a client's blood pressure and observes carpal spasm after the sphygmomanometer cuff is inflated. What action should the nurse implement next? -Assess the client’s recent serum calcium level. 36. A male client is recovering from an episode of urinary tract calculi. During discharge teaching, the client asks about the dietary restriction he should follow. In discussing fluid intake, the nurse should include which type of fluid limitation? -Tea and hot chocolate. 37. During preoperative teaching for a male client scheduled for repair of an inguinal hernia, the client tells the nurse that he has had several surgeries and understands the need to perform coughing and deep breathing exercises after surgery. How should the nurse respond? -Ask for demonstration of these exercises. 38. A pt suffered an electrical injury with the entrance site on the left hand and the exit site on the left foot is admitted to the burn unit. Which intervention is most important for the nurse to include in this pt's plan of care? - Continuous cardiac monitoring. 39. After 3 days of persistent epigastric pain, a female pt presents to the clinic. She has been taking oral antacids w/o relief. Her vital signs are HR 122 beats/min, respirations 16 breaths/min, O2 96% and BP 116/70. The nurse obtains a 12-lead ECG. Which assessment finding is most critical? -ST elevation in three leads 40. A male client with an external fixation device for a fractured left femur is complaining of left foot pain. Which intervention should the nurse implement first? - Administer PRN pain medication. 41. Two days following abdominal surgery a client begins to complain of cramping abdominal pain, and the nurse's inspection of the abdomen indicates slight distention. Which action should the nurse implement first? -Auscultate abdomen quadrants 42. A fair-skinned female client who is an avid runner is diagnosed with malignant melanoma, which is located on the lateral surface of the lower leg. After wide margin resection, the nurse provides discharge teaching. it is most important for the nurse to emphasize the need to observe for changes in which characteristic? -Appearance of any moles. 43. Math question: Order of 8,200 units. Each 1mL of solution contains 10,000 units of alfa. How many mL? (If Rounding is necessary, then round to the nearest tenth). Simply, divide 8200 and 10,000, which equals = 0.82mL after calculation. THEN ROUND TO THE NEAREST TENTH, and final answer is 0.8mL 44. What instruction should the nurse include in the discharge teaching plan of a client who had a cataract extraction today? Light housekeeping is permitted, but avoid heavy lifting. 45. When a nurse is caring for a client with acute hypothyroidism, which serum laboratory value requires immediate intervention? Serum sodium 122 mEq/L. 46. A potential donor of corneal tissue for the eye bank has just died. The nurse enters the room prescribed antibiotic eye drops. What action should the nurse take next? Secure eye shields over the closed after instilling the eyedrops. 47. 3 months following her diagnosis of type II diabetes…had a difficult time keeping her blood sugar is centered. The nurse reviews that..blood glucose levels. Which interventions in most important for the nurse to implement? Review the client’s glycosylated hemoglobin (A1c) level. 48. I forgot the question, but the answer was Prepare Discharging patient. 49. Retinal Tear. What to do to avoid risk of retina damage? 50. 2-year old boy is having health assessment. Which further assessment by nurse? “He refuses to feed, but I make him eat meats”