Med Surg HESI 2023 V2
GRADED A 55 QUESTIONS
AND ANSWERS
1. A female client who was involved in a motor vehicle collision is admitted with a
fractured left femur which is immobilized using a fracture traction splint in preparation for an
open reduction internal fixation (ORIF). The nurse determines that her distal pulses are
diminished in the left foot. Which interventions should the nurse implement? (Select all that
apply.)
A. Offer ice chips and oral clear liquids
B. Verify pedal pulses using a doppler pulse device
C. Monitor left leg for pain, pallor, paresthesia, paralysis, pressure
D. Evaluate the application of the splint to the left leg
E. Administer oral antispasmodics and narcotic analgesics: - B. Verify pedal pulses using a
doppler pulse device
C. Monitor left leg for pain, pallor, paresthesia, paralysis, pressure
D. Evaluate the application of the splint to the left leg
2. 28. A male client with Herpes zoster (shingles) on his thorax tells the nurse that he is having
difficulty sleeping. What is the probable etiology of this problem?
A. Pain
B. Nocturia
C. Dyspnea
D. Frequent cough - A. Pain
3. 29. When planning care for a client newly diagnosed with open angle glaucoma, the nurse
identifies a priority nursing diagnosis of, "visual sensory/perceptual alterations." This diagnosis
is based on which etiology?
A. Limited eye movement
B. Decreased peripheral vision C. Blurred distance vision
D. Photosensitivity - B. Decreased peripheral vision
4. 30. A client who is newly diagnosed with emphysema is being prepared for discharge. Which
instruction is best for the nurse to provide the client to assist them with dyspnea self-
management?
A. Allow additional time to complete physical activities to reduce oxygen demand
B. Practice inhaling through the nose and exhaling slowly through pursed lips
C. Use a humidifier to increase home air quality humidity between 30-50%
D. Strengthen abdominal muscles by alternating leg raises during exhalation - B. Practice
inhaling through the nose and exhaling slowly through pursed lips
5. 31. A client with cancer is receiving chemotherapy with a known vesicant. The client's IV
has been in place for 72 hours. The nurse determines that a new IV site cannot be obtained, and
leaves the present IV in place. What is the greatest clinical risk related to this situation?
A. Impaired skin integrity
B. Fluid volume excess
C. Acute pain and anxiety
, D. Peripheral neurovascular dysfunction - A. Impaired skin integrity
GRADED A 55 QUESTIONS
AND ANSWERS
1. A female client who was involved in a motor vehicle collision is admitted with a
fractured left femur which is immobilized using a fracture traction splint in preparation for an
open reduction internal fixation (ORIF). The nurse determines that her distal pulses are
diminished in the left foot. Which interventions should the nurse implement? (Select all that
apply.)
A. Offer ice chips and oral clear liquids
B. Verify pedal pulses using a doppler pulse device
C. Monitor left leg for pain, pallor, paresthesia, paralysis, pressure
D. Evaluate the application of the splint to the left leg
E. Administer oral antispasmodics and narcotic analgesics: - B. Verify pedal pulses using a
doppler pulse device
C. Monitor left leg for pain, pallor, paresthesia, paralysis, pressure
D. Evaluate the application of the splint to the left leg
2. 28. A male client with Herpes zoster (shingles) on his thorax tells the nurse that he is having
difficulty sleeping. What is the probable etiology of this problem?
A. Pain
B. Nocturia
C. Dyspnea
D. Frequent cough - A. Pain
3. 29. When planning care for a client newly diagnosed with open angle glaucoma, the nurse
identifies a priority nursing diagnosis of, "visual sensory/perceptual alterations." This diagnosis
is based on which etiology?
A. Limited eye movement
B. Decreased peripheral vision C. Blurred distance vision
D. Photosensitivity - B. Decreased peripheral vision
4. 30. A client who is newly diagnosed with emphysema is being prepared for discharge. Which
instruction is best for the nurse to provide the client to assist them with dyspnea self-
management?
A. Allow additional time to complete physical activities to reduce oxygen demand
B. Practice inhaling through the nose and exhaling slowly through pursed lips
C. Use a humidifier to increase home air quality humidity between 30-50%
D. Strengthen abdominal muscles by alternating leg raises during exhalation - B. Practice
inhaling through the nose and exhaling slowly through pursed lips
5. 31. A client with cancer is receiving chemotherapy with a known vesicant. The client's IV
has been in place for 72 hours. The nurse determines that a new IV site cannot be obtained, and
leaves the present IV in place. What is the greatest clinical risk related to this situation?
A. Impaired skin integrity
B. Fluid volume excess
C. Acute pain and anxiety
, D. Peripheral neurovascular dysfunction - A. Impaired skin integrity
