NGN HESI MED SURG Exam Questions and Answers with Rationales Graded A+ | Latest update 2024/2025 GRADED A+.

NGN HESI MED SURG Exam Questions and Answers with Rationales Graded A+ Latest update 2024/2025 GRADED A+. A client is being discharged following radioactive seed implantation for prostate cancer. What is the mostimportant information that the nurse should provide to this client’s family? A. Follow exposure precautions. B. Encourage regular meals. C. Collect all urine. D. Avoid touching the client. Rationale: Clients being treated for prostate cancer with radioactive seed implants should be instructed regarding the amount oftime and distance needed to prevent excessive exposure that would pose a hazard to others. Option B is a good suggestion to promote adequate nutrition but is not as important as option A. Option C is unnecessary. Contact with the client is permitted but should be brief to limit radiation exposure.  In assessing a client with an arteriovenous (AV) shunt who is scheduled for dialysis today, the nurse notes theabsence of a thrill or bruit at the shunt site. What action should the nurse take? A. Advise the client that the shunt is intact and ready for dialysis asscheduled. B. Encourage the client to keep the shunt site elevated above the level ofthe heart. NUR NGN HESI MED SURG Exam Questions and Answers with Rationales Graded A+Latest update 2023/2024 GRADED A+ C. Notify the health care provider of the findings immediately. D. Flush the site at least once with a heparinized saline solution. Rationale: Absence of a thrill or bruit indicates that the shunt may be obstructed. The nurse should notify the health care provider so that intervention can be initiated to restore function of the shunt. Option A is incorrect. Option B will notresolve the obstruction. An AV shunt is internal and cannot be flushed without access using special needles.  The nurse is concerned about infection for a client after an esophagogastrostomy for esophageal cancer. Whichactions should the nurse include in the client’s plan of care? (Select all that apply.) A. Frequent oral care every 2 hours while awake. B. Use incentive spirometer every 2 hours. C. Empty contents from NG tube every 8 hours. D. Ambulate within 1 hour of return from the PACU. E. Limit visitors until postoperative day 2. Rationale: One hour post op is too soon to ambulate for this client. Visitors help support the patient and are encouraged to visit.Oral care is necessary as the client will be NPO. To decrease the risk of infection post operatively, implement routine pulmonary exercises. The client will have an NG tube in place, likely to intermittent suction, to decompressthe stomach post surgery.  The nurse notes that the client’s drainage has decreased from 50 to 5 mL/hr 12 hours after chest tube insertion forhemothorax. What is the best initial action for the nurse to take? A. Document this expected decrease in drainage. B. Clamp the chest tube while assessing for air leaks. C. Milk the tube to remove any excessive blood clot buildup. D. Assess for kinks or dependent loops in the tubing. Rationale: The least invasive nursing action should be performed first to determine why the drainage has diminished. Option Ais completed after assessing for any problems causing the decrease in drainage. Option B is no longer considered standard protocol because the increase in pressure may be harmful to the client. Option C is an appropriate nursing action after the tube has been assessed for kinks or dependent loops.  A client on telemetry has a pattern of uncontrolled atrial fibrillation with a rapid ventricular response. Based onthis finding, the nurse anticipates assisting the physician with which treatment? A. Administer lidocaine, 75 mg intravenous push. B. Perform synchronized cardioversion. C. Defibrillate the client as soon as possible. D. Administer atropine, 0.4 mg intravenous push. Rationale: With uncontrolled atrial fibrillation, the treatment of choice is synchronized cardioversion to convert the cardiac rhythm back to normal sinus rhythm. Option A is a medication used for ventricular dysrhythmias. Option C is not fora client with atrial fibrillation; it is reserved for clients with life-threatening dysrhythmias, such as ventricular fibrillation and unstable ventricular tachycardia. Option D is the drug of choice in symptomatic sinus bradycardia, not atrial fibrillation.  A practical nurse (PN) tells the charge nurse in a long-term facility that she does not want to be assigned to one particular resident. She reports that the male client keeps insisting that she is his daughter and begs her to stay in hisroom. What is the best managerial decision? A. Notify the family that the resident will have to be discharged if hisbehavior does not improve. B. Notify administration of the PN’s insubordination and need forcounseling about her statements. C. Ask the PN what she has done to encourage the resident to believethat she is his daughter. D. Reassign the PN until the resident can be assessed more completelyfor reality orientation. Rationale: Temporary reassignment is the best option until the resident can be examined and his medications reviewed. He mayhave worsening cerebral dysfunction from an infection or electrolyte imbalance. Option A is not the best option because the family cannot control the resident’s actions. The administration may need to know about the situation, but not as a case of insubordination. Implying that the PN is somehow creating the situation is inappropriate until a further evaluation has been conducted.  Client census is often used to determine staffing needs. Which method of obtaining census determination for aparticular unit provides the best formula for determining long-range staffing patterns? A. Midnight census B. Oncoming shift census C. Average daily census D. Hourly census Rationale: An average daily census is determined by trend data and takes into account seasonal and daily fluctuations, so it is the best method for determining staffing needs. Options A and B provide data at a certain point in time, and that datacould change quickly. It is unrealistic to expect to obtain an hourly census, and such data would only provide information about a certain point in time.  The nurse is counseling a healthy 30-year-old female client regarding osteoporosis prevention. Which activitywould be most beneficial in achieving the client’s goal of osteoporosis prevention? A. Cross-country skiing B. Scuba diving C. Horseback riding D. Kayaking Rationale: Weight-bearing exercise is an important measure to reduce the risk of osteoporosis. Of the activities listed, cross-country skiing includes the most weight-bearing, whereas options B, C, and D involve less.  Which condition should the nurse anticipate as a potential problem in a female client with a neurogenic bladder? A. Stress incontinence B. Infection C. Painless gross hematuria D. Peritonitis Rationale: Infection is the major complication resulting from stasis of urine and subsequent catheterization. Option A is the involuntary loss of urine through an intact urethra as a result of a sudden increase in intra-abdominal pressure. Option C is the most common symptom of bladder cancer. Option D is the most common and serious complication of peritoneal dialysis.  The nurse is assessing a 75-year-old client for symptoms of hyperglycemia. Which symptom of hyperglycemia isan older adult most likely to exhibit? A. Polyuria B. Polydipsia C. Weight loss D. Infection Rationale: Signs and symptoms of hyperglycemia in older adults may include fatigue, infection, and evidence of neuropathy(e.g., sensory changes). The nurse needs to remember that classic signs and symptoms of hyperglycemia, such as options A, B, and C and polyphagia, may be absent in older adults.  Which abnormal laboratory finding indicates that a client with diabetes needs further evaluation for diabeticnephropathy? A. Hypokalemia B. Microalbuminuria C. Elevated serum lipid levels D. Ketonuria Rationale: Microalbuminuria is the earliest sign of diabetic nephropathy and indicates the need for follow-up evaluation. Hyperkalemia, not option A, is associated with endstage renal disease caused by diabetic nephropathy. Option Cmay be elevated in end-stage renal disease. Option D may signal the onset of diabetic ketoacidosis (DKA).