2024 LATEST EXAM FOR HESI Med Surg

An adult client who is hospitalized after surgery reports sudden onset of chest pain and dyspnea. The client appears anxious, restless, and mildly cyanotic. The nurse should further assess the client for which condition? Pulmonary embolism. Heart failure. Tuberculosis. Bronchitis. Pulmonary embolism. Post-surgical clients are at an increased risk for deep vein thrombosis (DVT), which may result in pulmonary embolism if the clot breaks off and travels to the lungs. Signs and symptoms of pulmonary embolism include chest pain, dyspnea, anxiety, restlessness, and - in severe cases - cyanosis. Jarvis, Physical Examination and Health Assessment, 7th ed., p.493 Which information should the nurse obtain when performing an initial assessment of a client who presents to the emergency department with a painful ankle injury? (Select all that apply.) Quality of the pain. Signs of inflammation. Ankle range of motion. Muscle strength testing. Visible deformities of the joint. Quality of the pain. Signs of inflammation. Ankle range of motion. Visible deformities of the joint. Initial assessment of a joint injury is performed to determine the extent of the damage. The nurse's initial assessment of a painful ankle injury should include pain quality, the presence of deformities, evidence of inflammation, and range of motion. Jarvis Physical Examination and Health Assessment, 7th ed. p. 586-8 Which description of pain is consistent with a diagnosis of rheumatoid arthritis? Joint pain is worse in the morning and involves symmetric joints. Joint pain is better in the morning and worsens throughout the day. Joint pain is consistent throughout the day and is relieved by pain medication. Joint pain is worse during the day and involves unilateral joints. Joint pain is worse in the morning and involves symmetric joints. Rheumatoid arthritis (RA) is an autoimmune disease that causes joint pain and swelling. RA is characterized by pain that is worse when arising and involves symmetric joints. Jarvis. (2016), Physical Examination and Health Assessment, 7th Ed., Chapter 22; p. 586 Which physical assessment finding should the nurse anticipate in a client with long-term gastroesophagealreflux disease (GERD)? Hoarseness. Dry mouth. Mouth ulcers. Weight loss. Hoarseness. 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 irritation of the reflux of gastric secretions. Ignatavicius, (2016). Medical-surgical nursing: Patient-centered collaborative care, eight edition., Ch. 49, p. 1111. A client presents with chronic venous insufficiency. Which assessment finding should the nurse anticipate? Bilateral lower leg stasis dermatitis. Clubbing of fingers and toes. Intermittent claudication. Peripheral cyanosis. Bilateral lower leg stasis dermatitis. Clients who suffer from chroninc venous insufficiency often develop statsis dermatitis in the lower extremities. Statis dermatitis appear as brownish-red discoloration on the lower extremities at the ankles which can develop into stasis ulcers due to the pooling of the venous blood flow back to the heart. 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 action by the nurse is the priority when caring for this client? Assess neurovascular status. Change the client's position. Inspect the traction equipment. Review pain medication orders. Assess neurovascular status. The use of traction for long bone fractures reduces the potential for damage to the surrounding tissues. Reports of increased pain may indicate circulatory compromise or tissue 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 is needed? I will cut back on smoking cigarettes daily. I will avoid drinking caffeinated beverages. I will rest frequently and avoid vigorous exercise. I will eat a bland, low-fat, high-protein diet. I will cut back on smoking cigarettes daily. To prevent exacerbations of chronic pancreatitis, clients should be instructed to avoid nicotine entirely. 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-centered collaborative care, 8th ed., Ch. 59, pp. 1084-98. The nurse is teaching a female client who uses a contraceptive diaphragm about reducing the risk for toxic shock syndrome (TSS). Which information should the nurse include? (Select all that apply.) Remove the diaphragm immediately after intercourse. Wash the diaphragm with an alcohol solution. Use the diaphragm to prevent conception during the menstrual cycle. Do not leave the diaphragm in place longer than 8 hours after intercourse. Replace the old diaphragm every 3 months. Do not leave the diaphragm in place longer than 8 hours after intercourse. Replace the old diaphragm every 3 months. The diaphragm needs to remain against the cervix for 6 to 8 hours to prevent pregnancy but should not remain for longer than 8 hours to avoid the risk of toxic shock syndrome. The diaphragm should be replaced every 3 months to maintain integrity. A male client who smokes two packs of cigarettes a day states he understands that smoking cigarettes is contributing to the difficulty that he and his wife are having in getting pregnant and wants to know if other factors could be contributing to their difficulty. What information is best for the nurse to provide? (Select all that apply.) Marijuana cigarettes do not affect sperm count. Alcohol consumption can cause erectile dysfunction. Low testosterone levels affect sperm production. Cessation of smoking improves general health and fertility. Obesity has no effect on sperm production. Alcohol consumption can cause erectile dysfunction. Low testosterone levels affect sperm production. Cessation of smoking improves general health and fertility. Use of tobacco, alcohol, and marijuana may affect sperm counts. Sperm count is also negatively affected by low testerone levels and obesity. 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 finding should the RN report as early signs of hypovolemic shock? Faint pedal pulses. Decrease in blood pressure.