HESI Med Surg QUESTION &
ANSWER LATEST UPDATE
2022/2023
Anadultclientwhoishospitalizedaftersurgeryreportssuddenonsetofchestpainanddyspnea.Theclient
appears anxious, restless, and mildly cyanotic. The nurse should further assess the client
forwhichcondition?
Pulmonary
embolism.Heartfailur
e.
Tuberculosis.
Bronchitis.
Pulmonaryembolism.
Post-surgical clients are at an increased risk for deep vein thrombosis (DVT), which may result
inpulmonary embolism if the clot breaks off and travels to the lungs. Signs and symptoms
ofpulmonary embolism include chest pain, dyspnea, anxiety, restlessness, and - in severe cases
-cyanosis.
Jarvis,PhysicalExaminationandHealthAssessment,7thed.,p.493
Which information should the nurse obtain when performing an initial assessment of a client
whopresentstotheemergencydepartmentwithapainfulankleinjury?(Selectallthatapply.)
Quality of the pain.Signs
of inflammation.Ankle
range of
motion.Musclestrengtht
esting.
Visibledeformitiesofthejoint.
Quality of the
pain.Signs of
inflammation.Ankleran
geofmotion.
Visibledeformitiesofthejoint.
Initialassessmentofajointinjuryisperformedtodeterminetheextentofthedamage.Thenurse'sinitial
,assessment of a painful ankle injury should include pain quality, the presence of
deformities,evidenceof inflammation,andrangeof motion.
JarvisPhysicalExaminationandHealthAssessment,7thed.p.586-8
Whichdescriptionofpainisconsistentwithadiagnosisofrheumatoidarthritis?Jointp
ainisworseinthemorningandinvolves symmetricjoints.
,Jointpainis betterinthe morningandworsensthroughouttheday.
Jointpainisconsistentthroughoutthedayandisrelievedbypainmedication.Jointpai
nisworseduring thedayand involvesunilateraljoints.
Jointpainisworseinthemorningandinvolvessymmetricjoints.
Rheumatoid arthritis (RA) is an autoimmune disease that causes joint pain and swelling. RA
ischaracterizedby painthat isworse whenarisingandinvolves symmetricjoints.
Jarvis.(2016),PhysicalExaminationandHealthAssessment,7thEd.,Chapter22;p.586
Which physical assessment finding should the nurse anticipate in a client with long-
termgastroesophagealrefluxdisease (GERD)?
Hoarseness.D
ry
mouth.Mouth
ulcers.Weight
loss.Hoarsene
ss.
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
irritationofthe refluxofgastricsecretions.
Ignatavicius, (2016). Medical-surgical nursing: Patient-centered collaborative care, eight edition.,
Ch.49,p.1111.
Aclientpresentswithchronicvenousinsufficiency.Whichassessmentfindingshouldthenurseanticipate?
Bilateral lower leg stasis
dermatitis.Clubbingoffingersand
toes.
Intermittent
claudication.Peripheral
cyanosis.
Bilaterallowerlegstasisdermatitis.
Clients who suffer from chroninc venous insufficiency often develop statsis dermatitis in the
lowerextremities. Statis dermatitis appear as brownish-red discoloration on the lower extremities
at theankles which can develop into stasis ulcers due to the pooling of the venous blood flow back
to theheart.
Ignatavicius, (2013). Medical-surgical nursing: Patient-centered collaborative care, 7th ed.., Ch. 33,
p.803.
A client has been hospitalized with a femur fracture and is being treated with traction. Which
actionbythe nurse is thepriority whencaring forthis client?
Assess neurovascular
status.Change the client's
position.Inspect the traction
equipment.Review pain
medication
orders.Assessneurovascularstat
us.
Theuseoftractionforlongbonefracturesreducesthepotentialfordamagetothesurroundingtissues.Report
sofincreasedpainmay indicatecirculatory compromiseortissue 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.
Which statement made by a client with chronic pancreatitis indicates that further education
isneeded?
Iwillcutbackonsmokingcigarettesdaily.Iwill
avoiddrinkingcaffeinatedbeverages.
Iwillrestfrequentlyandavoidvigorousexercise.Iwil
leatabland,low-fat,high-proteindiet.
Iwillcutbackonsmokingcigarettesdaily.
To prevent exacerbations of chronic pancreatitis, clients should be instructed to avoid
nicotineentirely. 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-centeredcollaborativecare,8thed., Ch.59,pp.1084-98.
Thenurseisteachingafemaleclientwhousesacontraceptivediaphragmaboutreducingtheriskfortoxic
shock syndrome (TSS). Which information should the nurse include? (Select all that
apply.)Removethediaphragm immediatelyafterintercourse.
Washthediaphragmwithanalcoholsolution.
Usethediaphragmtopreventconceptionduringthemenstrualcycle.
Donotleavethediaphragminplacelongerthan8hoursafterintercourse.Replacethe
olddiaphragmevery 3months.
Donotleavethediaphragminplacelongerthan8hoursafterintercourse.Replacethe
olddiaphragmevery 3months.
The diaphragm needs to remain against the cervix for 6 to 8 hours to prevent pregnancy but
shouldnot remain for longer than 8 hours to avoid the risk of toxic shock syndrome. The diaphragm
shouldbereplacedevery 3monthstomaintainintegrity.
A male client who smokes two packs of cigarettes a day states he understands that
smokingcigarettes is contributing to the difficulty that he and his wife are having in getting pregnant
andwantstoknowifotherfactorscouldbecontributingtotheirdifficulty.Whatinformationisbestforthenur
se to provide? (Select allthatapply.)
Marijuana cigarettes do not affect sperm
count.Alcoholconsumptioncancauseerectiledysfunctio
n.Lowtestosteronelevelsaffectspermproduction.
Cessation of smoking improves general health and
fertility.Obesityhasno effectonspermproduction.
Alcoholconsumptioncancauseerectiledysfunction.Low
testosteronelevelsaffectspermproduction.
Cessationofsmokingimprovesgeneralhealthandfertility.
Use of tobacco, alcohol, and marijuana may affect sperm counts. Sperm count is also
negativelyaffectedby low testerone levels andobesity.
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
findingshouldtheRNreport asearlysigns ofhypovolemicshock?
Faint
pedalpulses.Decreaseinblo
odpressure.
ANSWER LATEST UPDATE
2022/2023
Anadultclientwhoishospitalizedaftersurgeryreportssuddenonsetofchestpainanddyspnea.Theclient
appears anxious, restless, and mildly cyanotic. The nurse should further assess the client
forwhichcondition?
Pulmonary
embolism.Heartfailur
e.
Tuberculosis.
Bronchitis.
Pulmonaryembolism.
Post-surgical clients are at an increased risk for deep vein thrombosis (DVT), which may result
inpulmonary embolism if the clot breaks off and travels to the lungs. Signs and symptoms
ofpulmonary embolism include chest pain, dyspnea, anxiety, restlessness, and - in severe cases
-cyanosis.
Jarvis,PhysicalExaminationandHealthAssessment,7thed.,p.493
Which information should the nurse obtain when performing an initial assessment of a client
whopresentstotheemergencydepartmentwithapainfulankleinjury?(Selectallthatapply.)
Quality of the pain.Signs
of inflammation.Ankle
range of
motion.Musclestrengtht
esting.
Visibledeformitiesofthejoint.
Quality of the
pain.Signs of
inflammation.Ankleran
geofmotion.
Visibledeformitiesofthejoint.
Initialassessmentofajointinjuryisperformedtodeterminetheextentofthedamage.Thenurse'sinitial
,assessment of a painful ankle injury should include pain quality, the presence of
deformities,evidenceof inflammation,andrangeof motion.
JarvisPhysicalExaminationandHealthAssessment,7thed.p.586-8
Whichdescriptionofpainisconsistentwithadiagnosisofrheumatoidarthritis?Jointp
ainisworseinthemorningandinvolves symmetricjoints.
,Jointpainis betterinthe morningandworsensthroughouttheday.
Jointpainisconsistentthroughoutthedayandisrelievedbypainmedication.Jointpai
nisworseduring thedayand involvesunilateraljoints.
Jointpainisworseinthemorningandinvolvessymmetricjoints.
Rheumatoid arthritis (RA) is an autoimmune disease that causes joint pain and swelling. RA
ischaracterizedby painthat isworse whenarisingandinvolves symmetricjoints.
Jarvis.(2016),PhysicalExaminationandHealthAssessment,7thEd.,Chapter22;p.586
Which physical assessment finding should the nurse anticipate in a client with long-
termgastroesophagealrefluxdisease (GERD)?
Hoarseness.D
ry
mouth.Mouth
ulcers.Weight
loss.Hoarsene
ss.
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
irritationofthe refluxofgastricsecretions.
Ignatavicius, (2016). Medical-surgical nursing: Patient-centered collaborative care, eight edition.,
Ch.49,p.1111.
Aclientpresentswithchronicvenousinsufficiency.Whichassessmentfindingshouldthenurseanticipate?
Bilateral lower leg stasis
dermatitis.Clubbingoffingersand
toes.
Intermittent
claudication.Peripheral
cyanosis.
Bilaterallowerlegstasisdermatitis.
Clients who suffer from chroninc venous insufficiency often develop statsis dermatitis in the
lowerextremities. Statis dermatitis appear as brownish-red discoloration on the lower extremities
at theankles which can develop into stasis ulcers due to the pooling of the venous blood flow back
to theheart.
Ignatavicius, (2013). Medical-surgical nursing: Patient-centered collaborative care, 7th ed.., Ch. 33,
p.803.
A client has been hospitalized with a femur fracture and is being treated with traction. Which
actionbythe nurse is thepriority whencaring forthis client?
Assess neurovascular
status.Change the client's
position.Inspect the traction
equipment.Review pain
medication
orders.Assessneurovascularstat
us.
Theuseoftractionforlongbonefracturesreducesthepotentialfordamagetothesurroundingtissues.Report
sofincreasedpainmay indicatecirculatory compromiseortissue 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.
Which statement made by a client with chronic pancreatitis indicates that further education
isneeded?
Iwillcutbackonsmokingcigarettesdaily.Iwill
avoiddrinkingcaffeinatedbeverages.
Iwillrestfrequentlyandavoidvigorousexercise.Iwil
leatabland,low-fat,high-proteindiet.
Iwillcutbackonsmokingcigarettesdaily.
To prevent exacerbations of chronic pancreatitis, clients should be instructed to avoid
nicotineentirely. 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-centeredcollaborativecare,8thed., Ch.59,pp.1084-98.
Thenurseisteachingafemaleclientwhousesacontraceptivediaphragmaboutreducingtheriskfortoxic
shock syndrome (TSS). Which information should the nurse include? (Select all that
apply.)Removethediaphragm immediatelyafterintercourse.
Washthediaphragmwithanalcoholsolution.
Usethediaphragmtopreventconceptionduringthemenstrualcycle.
Donotleavethediaphragminplacelongerthan8hoursafterintercourse.Replacethe
olddiaphragmevery 3months.
Donotleavethediaphragminplacelongerthan8hoursafterintercourse.Replacethe
olddiaphragmevery 3months.
The diaphragm needs to remain against the cervix for 6 to 8 hours to prevent pregnancy but
shouldnot remain for longer than 8 hours to avoid the risk of toxic shock syndrome. The diaphragm
shouldbereplacedevery 3monthstomaintainintegrity.
A male client who smokes two packs of cigarettes a day states he understands that
smokingcigarettes is contributing to the difficulty that he and his wife are having in getting pregnant
andwantstoknowifotherfactorscouldbecontributingtotheirdifficulty.Whatinformationisbestforthenur
se to provide? (Select allthatapply.)
Marijuana cigarettes do not affect sperm
count.Alcoholconsumptioncancauseerectiledysfunctio
n.Lowtestosteronelevelsaffectspermproduction.
Cessation of smoking improves general health and
fertility.Obesityhasno effectonspermproduction.
Alcoholconsumptioncancauseerectiledysfunction.Low
testosteronelevelsaffectspermproduction.
Cessationofsmokingimprovesgeneralhealthandfertility.
Use of tobacco, alcohol, and marijuana may affect sperm counts. Sperm count is also
negativelyaffectedby low testerone levels andobesity.
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
findingshouldtheRNreport asearlysigns ofhypovolemicshock?
Faint
pedalpulses.Decreaseinblo
odpressure.
