MED SURG HESI 40 VERSIONS 1000 PLUS QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES|
(BEST DOCUMENT FOR HESI MED SURG) UPDATE
Which cytokine stimulates the liver to produce fibrinogen and protein C? - ANSWER:
Interleukin-6 stimulates the liver to produce fibrinogen and protein C. Interleukin-1
stimulates the production of prostaglandins. Thrombopoietin increases the growth
and differentiation of platelets. Tumor necrosis factor stimulates delayed
hypersensitivity reactions and allergies.
Test-Taking Tip: Identify option components as correct or incorrect. This may help
you identify a wrong answer.
Which type of allergic skin condition in a client is associated with immunological
irregularity, asthma, and allergic rhinitis? - ANSWER: Atopic dermatitis is an allergic
skin condition that is a genetically influenced, chronic, relapsing disease. It is
associated with immunologic irregularity involving inflammatory mediators
associated with allergic rhinitis and asthma. Urticaria is an allergic skin condition that
results in a local increase in permeability of capillaries, causing erythema and edema
in the upper dermis. Psoriasis is an autoimmune chronic dermatitis but not an
allergic skin condition. Acne vulgaris is an inflammatory disorder of sebaceous
glands.
A client with a history of emphysema develops a respiratory infection and is
admitted to the hospital in acute respiratory distress. The client's arterial blood
studies indicate pH 7.30, PO2 60 mm Hg, PCO2 55 mm Hg, and HCO3 23 mEq/L (23
mmol/L). How should the nurse interpret these findings? - ANSWER: The client is
experiencing respiratory acidosis. The pH is less than the norm of 7.35 to 7.45,
indicating acidosis. The PO2 is less than the norm of 80 to 100 mm Hg. The PCO2 is
increased more than the norm of 35 to 45 mm Hg. The HCO3 is within the norm of
21 to 28 mEq/L (21 to 28 mmol/L). These results indicate a respiratory etiology. The
client's carbon dioxide level is increased (hypercapnia), not decreased. These values
are unrelated to hyperkalemia; a serum potassium level of more than 5 mEq/L (5
mmol/L) indicates hyperkalemia. These values are unrelated to anemia; decreased
levels of red blood cells (RBCs), hemoglobin, and hematocrit are related to anemia.
A client who is admitted to the hospital and requires a colon resection states, "I want
to be a do not resuscitate (DNR)." The nurse questions the client's understanding of
a DNR order. Which response by the client best indicates to the nurse an
understanding of a DNR order?
My doctor will know what to do."
2
"My family can make the decisions for me."
Correct3
"If something happens to me, I do not want CPR."
,4
"If I have a heart attack, I do not want any medication - ANSWER: The statement, "If
something happens to me, I do not want CPR," specifically states that if cardiac or
respiratory arrest occurs, the client would rather die peacefully and does not want
cardiorespiratory resuscitation. If a DNR order is signed by the client,
cardiopulmonary resuscitation will not be instituted. The response, "My doctor will
know what to do," reflects an advance directive (e.g., durable power of attorney for
health care), wherein a client gives power to another person (agent, surrogate, or
proxy) to make healthcare decisions on the client's behalf. The response, "My family
can make the decisions for me," reflects an advance directive (e.g., durable power of
attorney for health care), wherein a client gives power to another person (agent,
surrogate, or proxy) to make healthcare decisions on the client's behalf. The
response, "If I have a heart attack, I do not want any medication," reflects an
advance directive (e.g., living will), wherein the client directs treatment in
accordance with personal wishes.
A client recovering from hepatitis A asks the nurse about returning to work. Which is
the best response by the nurse?
1 "As soon as you're feeling less tired, you may go back to work."
2 "Unfortunately, few people fully recover from hepatitis in less than six months."
3 "Gradually increase your activities because relapses may occur in those who return
to full activity too soon."
4 "You cannot return to work for six months because the virus will still be in your
stools, and you still are communicable." - ANSWER: Ans: 3
Relapses are common; they occur after too early ambulation and too much physical
activity. Fatigue is a cardinal symptom; if the client tires at rest, a return to work
must be delayed. The client does not stay contagious for six months.
After a subtotal gastrectomy, a client has a nasogastric (NG) tube to continuous low
suction. Three hours after the surgery, the client complains of nausea and abdominal
pain. The client's abdomen appears distended. What should the nurse do first?
1
Instill 30 mL of air into the NG tube
2
Administer the prescribed pain medication
3
Inform the client that abdominal pain is common with NG tubes
4
Notify the surgeon of the absence of bowel sounds - ANSWER: Abdominal distention,
nausea, and abdominal pain can be signs of nasogastric tube blockage. Instilling 30
mL of air may reestablish patency. Although opioids usually are prescribed
postoperatively, they tend to decrease peristalsis and may increase abdominal
distention and nausea. It is not common for NG tubes to cause abdominal pain.
There will be no stools for several days. Bowel sounds are not expected for several
days after stomach or intestinal surgery.
, Test-Taking Tip: After choosing an answer, go back and reread the question stem
along with your chosen answer. Does it fit correctly? The choice that grammatically
fits the stem and contains the correct information is the best choice.
A client had a cholecystectomy and asks whether there will be any dietary
restrictions after the client's discharge. The nurse evaluates that the dietary teaching
is understood when the client makes what comment to a family member?
1
"I should avoid fatty foods for the rest of my life."
2
"I should not eat those foods that upset me before I had surgery."
3
"I need to eat a high-protein diet for several months, and I should follow a sodium
restriction diet."
Correct4
"I need to eat smaller amounts of food at a time, and they should contain low to
moderate fats." - ANSWER: The response is individual, but ultimately most people
can eat anything they want. Eating small, more frequent, and moderate- to low-fat
amounts of food allows the readily available bile to mix with the food bolus and
prevent gas, bloating, diarrhea, or undigested foods. Fats may have to be gradually
reintroduced, but most people tolerate them after this surgery. Foods that caused
gastric distress before surgery usually are tolerated after surgery. Increased protein
is needed only until healing has occurred. Sodium restriction is not necessary.
A client with early-stage cancer of the esophagus is treated with laser therapy.
Which type of food should the nurse instruct the client to select when oral intake is
permitted?
1
Cold
Correct2
Liquid
3
Low in protein
4
Low in calories - ANSWER: Liquid foods are less irritating to the esophageal mucosa.
Cold food is not as "easy" as liquids. High-protein foods are desirable because they
promote tissue repair. High-calorie foods are desirable for maintaining weight,
promoting anabolism, and preventing negative nitrogen balance.
A client with a history of ulcerative colitis has a large portion of the large intestine
removed, and an ileostomy is created. For which potential life-threatening
complication should the nurse assess the client after this surgery?
1
Infection caused by the excretion of feces
2
Injury caused by exposed intestinal mucosa
3
AND CORRECT DETAILED ANSWERS WITH RATIONALES|
(BEST DOCUMENT FOR HESI MED SURG) UPDATE
Which cytokine stimulates the liver to produce fibrinogen and protein C? - ANSWER:
Interleukin-6 stimulates the liver to produce fibrinogen and protein C. Interleukin-1
stimulates the production of prostaglandins. Thrombopoietin increases the growth
and differentiation of platelets. Tumor necrosis factor stimulates delayed
hypersensitivity reactions and allergies.
Test-Taking Tip: Identify option components as correct or incorrect. This may help
you identify a wrong answer.
Which type of allergic skin condition in a client is associated with immunological
irregularity, asthma, and allergic rhinitis? - ANSWER: Atopic dermatitis is an allergic
skin condition that is a genetically influenced, chronic, relapsing disease. It is
associated with immunologic irregularity involving inflammatory mediators
associated with allergic rhinitis and asthma. Urticaria is an allergic skin condition that
results in a local increase in permeability of capillaries, causing erythema and edema
in the upper dermis. Psoriasis is an autoimmune chronic dermatitis but not an
allergic skin condition. Acne vulgaris is an inflammatory disorder of sebaceous
glands.
A client with a history of emphysema develops a respiratory infection and is
admitted to the hospital in acute respiratory distress. The client's arterial blood
studies indicate pH 7.30, PO2 60 mm Hg, PCO2 55 mm Hg, and HCO3 23 mEq/L (23
mmol/L). How should the nurse interpret these findings? - ANSWER: The client is
experiencing respiratory acidosis. The pH is less than the norm of 7.35 to 7.45,
indicating acidosis. The PO2 is less than the norm of 80 to 100 mm Hg. The PCO2 is
increased more than the norm of 35 to 45 mm Hg. The HCO3 is within the norm of
21 to 28 mEq/L (21 to 28 mmol/L). These results indicate a respiratory etiology. The
client's carbon dioxide level is increased (hypercapnia), not decreased. These values
are unrelated to hyperkalemia; a serum potassium level of more than 5 mEq/L (5
mmol/L) indicates hyperkalemia. These values are unrelated to anemia; decreased
levels of red blood cells (RBCs), hemoglobin, and hematocrit are related to anemia.
A client who is admitted to the hospital and requires a colon resection states, "I want
to be a do not resuscitate (DNR)." The nurse questions the client's understanding of
a DNR order. Which response by the client best indicates to the nurse an
understanding of a DNR order?
My doctor will know what to do."
2
"My family can make the decisions for me."
Correct3
"If something happens to me, I do not want CPR."
,4
"If I have a heart attack, I do not want any medication - ANSWER: The statement, "If
something happens to me, I do not want CPR," specifically states that if cardiac or
respiratory arrest occurs, the client would rather die peacefully and does not want
cardiorespiratory resuscitation. If a DNR order is signed by the client,
cardiopulmonary resuscitation will not be instituted. The response, "My doctor will
know what to do," reflects an advance directive (e.g., durable power of attorney for
health care), wherein a client gives power to another person (agent, surrogate, or
proxy) to make healthcare decisions on the client's behalf. The response, "My family
can make the decisions for me," reflects an advance directive (e.g., durable power of
attorney for health care), wherein a client gives power to another person (agent,
surrogate, or proxy) to make healthcare decisions on the client's behalf. The
response, "If I have a heart attack, I do not want any medication," reflects an
advance directive (e.g., living will), wherein the client directs treatment in
accordance with personal wishes.
A client recovering from hepatitis A asks the nurse about returning to work. Which is
the best response by the nurse?
1 "As soon as you're feeling less tired, you may go back to work."
2 "Unfortunately, few people fully recover from hepatitis in less than six months."
3 "Gradually increase your activities because relapses may occur in those who return
to full activity too soon."
4 "You cannot return to work for six months because the virus will still be in your
stools, and you still are communicable." - ANSWER: Ans: 3
Relapses are common; they occur after too early ambulation and too much physical
activity. Fatigue is a cardinal symptom; if the client tires at rest, a return to work
must be delayed. The client does not stay contagious for six months.
After a subtotal gastrectomy, a client has a nasogastric (NG) tube to continuous low
suction. Three hours after the surgery, the client complains of nausea and abdominal
pain. The client's abdomen appears distended. What should the nurse do first?
1
Instill 30 mL of air into the NG tube
2
Administer the prescribed pain medication
3
Inform the client that abdominal pain is common with NG tubes
4
Notify the surgeon of the absence of bowel sounds - ANSWER: Abdominal distention,
nausea, and abdominal pain can be signs of nasogastric tube blockage. Instilling 30
mL of air may reestablish patency. Although opioids usually are prescribed
postoperatively, they tend to decrease peristalsis and may increase abdominal
distention and nausea. It is not common for NG tubes to cause abdominal pain.
There will be no stools for several days. Bowel sounds are not expected for several
days after stomach or intestinal surgery.
, Test-Taking Tip: After choosing an answer, go back and reread the question stem
along with your chosen answer. Does it fit correctly? The choice that grammatically
fits the stem and contains the correct information is the best choice.
A client had a cholecystectomy and asks whether there will be any dietary
restrictions after the client's discharge. The nurse evaluates that the dietary teaching
is understood when the client makes what comment to a family member?
1
"I should avoid fatty foods for the rest of my life."
2
"I should not eat those foods that upset me before I had surgery."
3
"I need to eat a high-protein diet for several months, and I should follow a sodium
restriction diet."
Correct4
"I need to eat smaller amounts of food at a time, and they should contain low to
moderate fats." - ANSWER: The response is individual, but ultimately most people
can eat anything they want. Eating small, more frequent, and moderate- to low-fat
amounts of food allows the readily available bile to mix with the food bolus and
prevent gas, bloating, diarrhea, or undigested foods. Fats may have to be gradually
reintroduced, but most people tolerate them after this surgery. Foods that caused
gastric distress before surgery usually are tolerated after surgery. Increased protein
is needed only until healing has occurred. Sodium restriction is not necessary.
A client with early-stage cancer of the esophagus is treated with laser therapy.
Which type of food should the nurse instruct the client to select when oral intake is
permitted?
1
Cold
Correct2
Liquid
3
Low in protein
4
Low in calories - ANSWER: Liquid foods are less irritating to the esophageal mucosa.
Cold food is not as "easy" as liquids. High-protein foods are desirable because they
promote tissue repair. High-calorie foods are desirable for maintaining weight,
promoting anabolism, and preventing negative nitrogen balance.
A client with a history of ulcerative colitis has a large portion of the large intestine
removed, and an ileostomy is created. For which potential life-threatening
complication should the nurse assess the client after this surgery?
1
Infection caused by the excretion of feces
2
Injury caused by exposed intestinal mucosa
3
