HESI Med Surg Exit Exam V1 | 160 Questions With Correct Answers | Latest Update 2023/2024 (GRADED)

A 10-year-old child with meningitis is suspected of having diabetes insipidus. In evaluating the child's laboratory values, which finding is indicative of diabetes insipidus? a. Decreased urine specific gravity. b. Elevated urine glucose. c. Decreased serum potassium. d. Increased serum sodium. 26. A client with myelogenous leukemia is receiving an autologous bone marrow transplantation (BMT). What is the priority intervention that the nurse should implement when the bone marrow is repopulating? a. Administer sargramostim (Leukine, Prokine). b. Infuse PRBC and platelet transfusions. c. Give parental prophylactic antibiotics. d. Maintain a protective isolation environment. 27. A 38-year-old male client collapsed at his outside construction job in Texas in July. His admitting vital signs to ICU are, BP 82/70, heart rate 140 beats/minute, urine output 10 ml/hr, skin cool to the touch. Pulmonary artery (PA) pressures are, PAWP 1, PAP 8/2, RAP -1, SVR 1600. What nursing action has the highest priority? a. Apply a hypothermia unit to stabilize core temperature. b. Increase the client's IV fluid rate to 200 ml/hr. c. Call the hospital chaplain to counsel the family. d. Draw blood cultures x 3 to detect infection. 28. A client who has Type 1 diabetes and is at 10-weeks gestation comes to the prenatal clinic complaining of a headache, nausea, sweating, feeling shaky, and being tired all the time. What action should the nurse take first? a. Check the blood glucose level. b. Draw blood for a Hemoglobin A1C. c. Assess urine for ketone levels. d. Provide the client with a protein snack. 29. A client in labor states, "I think my water just broke!" The nurse notes that the umbilical cord is on the perineum. What action should the nurse perform first? a. Administer oxygen via face mask. c. Notify the operating room team. b. Place the client in Trendelenburg. c. Administer a fluid bolus of 500 ml. 30. The nurse is planning care for a non-potty-trained child with nephrotic syndrome. Which intervention provides the best means of determining fluid retention? a. Weigh the child daily. b. Observe the lower extremities for pitting edema. c. Measure the child's abdominal girth weekly. d. Weigh the child's wet diapers. 31. The mother of a 9-month-old who was diagnosed with respiratory syncytial virus (RSV) yesterday calls the clinic to inquire if it will be all right to take her infant to the first birthday party of a friend's child the following day. What response should the nurse provide this mother? a. The child can be around other children but should wear a mask at all times. b. The child will no longer be contagious, no need to take any further precautions. c. Make sure there are no children under the age of 6 months around the infected child. d. Do not expose other children. RSV is very contagious even without direct oral contact. 32. A client from a nursing home is admitted with urinary sepsis and has a singlelumen, peripherally-inserted central catheter (PICC). Four medications are prescribed for 9:00 a.m. and the nurse is running behind schedule. Which medication should the nurse administer first? a. Piperacillin/tazobactam (Zosyn) in 100 ml D5W, IV over 30 minutes q8 hours. b. Vancomycin (Vancocin) 1 gm in 250 ml D5W, IV over 90 minutes q12 hours. c. Pantoprazole (Protonix) 40 mg PO daily d. Enoxaparin (Lovenox) 40 mg subq q24 hours. 33. Which action should the nurse implement to reduce the risk of vesicant extravasation in the client who is receiving intravenous chemotherapy? a. Administer an antiemetic before starting the chemotherapy. b. Instruct the client to drink plenty of fluids during the treatment. c. Keep the head of the bed elevated until the treatment is completed. d. Monitor the client's intravenous site hourly during the treatment. 34. An elderly male client reports to the clinic nurse that he is experiencing increasing nocturia with difficulty initiating his urine stream. He reports a weak urine flow and frequent dribbling after voiding. Which nursing action should be implemented? a. Obtain a urine specimen for culture and sensitivity. b. Encourage the client to schedule a digital rectal exam. c. Advise the client to maintain a voiding diary for one week. d. Instruct the client in effective techniques to cleanse the glans penis. 35. The nurse is performing an admission physical assessment of a newborn who is small for gestational age (SGA). Which finding should the nurse report immediately to the pediatric healthcare provider? a. Heel stick glucose of 65 mg/dl. b. Head circumference of 35 cm (14 inches). c. Widened, tense, bulging fontanel. d. High-pitched shrill cry. 36. Which client's laboratory value requires immediate intervention by a nurse? a. A client with GI bleeding who is receiving a blood transfusion and has a hemoglobin of 7 grams. b. A client with pancreatitis who has a fasting glucose of 190 mg/dl today and had 160 mg/dl yesterday. c. A client with hepatitis who is jaundiced and has a bilirubin level that is 4 times the normal value. d. A client with cancer who has an absolute count of neutrophils 500 today and had 2,000 yesterday. 37. In planning the turning schedule for a bedfast client, it is most important for the nurse to consider what assessment finding? a. 4+ pitting edema of both lower extremities. b. A Braden risk assessment scale rating score of ten. c. Warm, dry skin with a fever of 100° F. d. Hypoactive bowel sounds with infrequent bowel movements. 38. The healthcare provider prescribes naproxen (Naprosyn) 500 mg PO twice a day for a client with osteoarthritis. During a follow-up visit one month later, the client tells the nurse, "The pills don't seem to be working. They are not helping the pain at all." Which factor should influence the nurse's response? a. Noncompliance is probably affecting optimum medication effectiveness. b. Drug dosage is inadequate and needs to be increased to four times a day. c. The drug needs 4 to 6 weeks to reach therapeutic levels in the bloodstream. d. NSAID response is variable and another NSAID may be more effective. 39. A nurse is interested in studying the incidence of infant death in a particular city and wants to compare that city's rate to the state's rate. What state resource is most likely to provide this information? a. Disease registry. b. Department of Health. c. Bureau of Vital Statistics. d. Census data. 40. A 60-year-old male client is admitted to the hospital with the complaint of right knee pain for the past week. His right knee and calf are warm and edematous. He has a history of diabetes and arthritis. Which neurological assessment action should the nurse perform for this client? a. Glasgow coma scale. b. Pulses, paresthesia, paralysis distal to the right knee. c. Pulses, paresthesia, paralysis proximal to the right knee. d. Optic nerve using an ophthalmoscope. 41. A highly successful businessman presents to the community mental health center complaining of sleeplessness and anxiety over his financial status. What action should the nurse take to assist this client in diminishing his anxiety? a. Encourage him to initiate daily rituals. b. Reinforce the reality of his financial situation. c. Direct him to drink a glass of red wine at bedtime. d. Teach him to limit sugar and caffeine intake. 42. What physical assessment data should the nurse consider a normal finding for a primigravida client who is 12 hours postpartum? a. Soft, spongy fundus. b. Saturating two perineal pads per hour. c. Pulse rate of 56 BPM. d. Unilateral lower leg pain. 43. The nurse plans to educate a client about the purpose for taking the prescribed antipsychotic medication clozapine (Clozaril). Which statement should the nurse provide? a. "It will help you function better in the community." b. "The medication will help you think more clearly." c. "You will be able to cope with your symptoms." d. "It will improve your grooming and hygiene." 44. A male client is admitted to the neurological unit. He has just sustained a C-5 spinal cord injury. Which assessment finding of this client warrants immediate intervention by the nurse? a. Is unable to feel sensation in the arms and hands. b. Has flaccid upper and lower extremities. c. Blood pressure is 110/70 and the apical pulse is 68. d. Respirations are shallow, labored, and 14 breaths/minute. 45. A male infant born at 30-weeks gestation at an outlying hospital is being prepared for transport to a Level IV neonatal facility. His respirations are 90/min, and his heart rate is 150 beats per minute. Which drug is the transport team most likely to administer to this infant? a. Ampicillin (Omnipen) 25 mg/kg slow IV push. b. Gentamicin sulfate (Garamycin) 2.5 mg/kg IV. c. Digoxin (Lanoxin) 20 micrograms/kg IV. d. Beractant (Survanta) 100 mg/kg per endotracheal tube. 46. Because the census is currently low in the Obstetrics (OB) unit, one of the nurses is sent to work on a medical-surgical unit for the day, or until the OB unit becomes busy. Which client assessment is best for the charge nurse to assign to the OB nurse? a. An adult who had a colon resection yesterday and has an IV. b. An older adult who has a fever of unknown origin. c. A woman who had an acute brain attack (stroke, CVA) 6 hours ago. d. A teenager with a femoral fracture who is in traction. 47. A primipara at 38-weeks gestation is admitted to labor and delivery for a biophysical profile (BPP). The nurse should prepare the client for what procedures? a. Chorionic villi sampling under ultrasound. b. Amniocentesis and fetal monitoring. c. Ultrasonography and nonstress test. d. Oxytocin challenge test and fetal heart rates. 48. A male client who is in the day room becomes increasingly angry and aggressive when he is denied a day-pass. Which action should the nurse implement? a. Tell him he can have a day pass if he calms down. b. Put the client's behavior on extinction. c. Decrease the volume on the television set. d. Instruct the client to sit down and be quiet. 49. A client is discussing feelings related to a recent loss with the nurse. The nurse remains silent when the client says, "I don't know how I will go on." What is the most likely reason for the nurse's behavior? a. The nurse is stating disapproval of the statement. b. The nurse is respecting the client's loss. c. Silence is reflecting the client's sadness. d. Silence allows the client to reflect on what was said. 50. An unlicensed assistive personnel (UAP) reports to the charge nurse that a client who delivered a 7-pound infant 12 hours ago is complaining of a severe headache. The client's blood pressure is 110/70, respiratory rate is 18 breaths/minute, heart rate is 74 beats/minute, and temperature is 98.6º F. The client's fundus is firm and one fingerbreadth above the umbilicus. What action should the charge nurse implement first? a. Notify the healthcare provider of the assessment findings. b. Determine if the client received anesthesia during delivery. c. Assign a practical nurse (PN) to reassess the client's vital signs. d. Obtain a STAT hemoglobin and hematocrit. 51. In developing a care plan for a client that has a chest tube due to a hemothorax, the nurse should recognize that which intervention is essential? a. Keep the arm and shoulder of the affected side immobile at all times. b. Ensure that there is no fluctuation in the water-seal chamber. c. Encourage the client to breathe deeply and cough at frequent intervals. d. Maintain the Pleuravac® sligh