HESI MED SURG 2 NURSING EXAM 2024 COMPLETE REAL
EXAM QUESTIONS AND WELL ELABORATED ANSWERS
(CORRECT VERIFIED ANSWERS) A NEW UPDATED VERSION |
GUARANTEED SUCCESS
When caring for a client with a percutaneous endoscopic gastrostomy (PEG) tube,
what protocols should the nurse implement for intermittent feedings? (Select all that
apply.)
Select all that apply
Assessing residual amounts once a day.
Keeping the head of the bed elevated 30 degrees.
Changing the enteral-feeding bag every 24 hours.
Checking the placement of the tube by means of gastric aspiration.
Flushing the tube with 50 ml of normal saline solution after each feeding.
Submit - ANSWER: ------Keeping the head of the bed elevated 30 degrees. -------
Changing the enteral-feeding bag every 24 hours. -------Checking the placement of
the tube by means of gastric aspiration. -------Flushing the tube with 50 ml of normal
saline solution after each feeding.
The nurse is teaching a client about precautions for a new prescription for lovastatin
(Mevacor). Which symptom should the nurse instruct the client to report to the
healthcare provider immediately?
Terrible nightmares.
Increased nocturia.
Severe muscle pain.
Visual disturbances. - ANSWER: Severe muscle pain.
The nurse obtains a client's history that includes right mastectomy and radiation
therapy for cancer of the breast 10 years ago. Which current health problem should
the nurse consider is a consequence of the radiation therapy?
Asthma.
Myocardial infarction.
Chronic esophagitis with gastroesophageal reflux.
Pathologic fracture of two ribs on the right chest. - ANSWER: Pathologic fracture of
two ribs on the right chest.
Which findings are within expected parameters of a normal urinalysis for an older
adult? (Select all that apply.)
Select all that apply
pH 6.
Nitrate small.
Protein small.
Sugar negative.
Bilirubin negative.
,Specific gravity 1.015. - ANSWER: pH 6. ----------------- Nitrate small --------- Protein
small --------- Sugar negative.
Bilirubin negative.
Specific gravity 1.015.
A client with acute appendicitis is experiencing anxiety and loss of sleep about
missing final examination week at college. Which outcome is most important for the
nurse to include in the plan of care?
Sleeping six to eight hours.
Achieve a sense of control.
Utilize problem solving skills.
Increased focus of attention. - ANSWER: Achieve a sense of control.
The nurse is preparing an adult client for an upper gastrointestinal (UGI) series.
Which information should the nurse include in the teaching plan?
The xray procedure may last for several hours.
A nasogastric tube (NGT) is inserted to instill the barium.
Enemas are given to empty the bowel after the procedure.
Nothing by mouth is allowed for 6 to 8 hours before the study.
Submit - ANSWER: Nothing by mouth is allowed for 6 to 8 hours before the study.
An older female client is admitted with atrophic vaginitis and perineal cutaneous
candidiasis. What is the priority nursing diagnosis for this client?
Risk for injury.
Impaired comfort.
Disturbed body image.
Ineffective health maintenance. - ANSWER: Impaired comfort.
Which action should the nurse implement on the scheduled day of surgery for a
client with type 1 diabetes mellitus (DM)?
Obtain a prescription for an adjusted dose of insulin.
Administer an oral anti-diabetic agent.
Give an insulin dose using parameters of a sliding scale.
Withhold insulin while the client is NPO. - ANSWER: Obtain a prescription for an
adjusted dose of insulin.
A client with a history of hypertension, myocardial infarction, and heart failure is
admitted to the surgical intensive care unit after coronary artery bypass surgery graft
(CABG). The nurse determines the client's serum potassium level is 4.5 mEq/L. What
action should the nurse implement?
Notify the healthcare provider.
Decrease the IV solution flow rate.
Document the finding as the only action.
Administer potassium replacement as prescribed. - ANSWER: Document the finding
as the only action.
, The nurse assesses a long-term resident of a nursing home and finds the client has a
fungal infection (candidiasis) beneath both breasts. To prevent nosocomial infection,
which protocol should the nurse review with the rest of the staff?
Follow contact isolation procedures.
Wash hands after caring for the client.
Wear gloves when providing personal care.
Restrict pregnant staff or visitors into the room.
Submit - ANSWER: Wash hands after caring for the client.
Which finding should the nurse identify as an indication of carbon monoxide
poisoning in a client who experienced a burn injury during a house fire?
Pulse oximetry reading of 80%.
Expiratory stridor and nasal flaring.
Cherry red color to the mucous membranes.
Presence of carbonaceous particles in sputum. - ANSWER: cherry red color to the
mucous membrane
The nurse is caring for a client with human immunodeficiency virus (HIV) infection
who develops Mycobacterium avium complex (MAC). What is the most significant
desired outcome for this client?
Free from injury of drug side effects.
Return to pre-illness weight.
Adequate oxygenation.
Maintenance of intact perineal skin. - ANSWER: return to pre-illness weight
A client who is receiving the sixth unit of packed red blood cell transfusion is
demonstrating signs and symptoms of a febrile, nonhemolytic reaction. What
assessment finding is most important for the nurse to identify?
Increased anxiety since the transfusion began.
Drowsiness after receiving diphenhydramine (Benadryl).
Complaints of feeling cold.
Flushed skin and headache. - ANSWER: Flushed skin and headache.
In planning care for a client with an acute stroke resulting in right-sided hemiplegia,
which positioning should the nurse should use to maintain optimal functioning?
Mid-Fowler's with knees supported.
Supine with trochanter rolls to the hips.
Sim's position alternated with right lateral position q2 hours.
Left lateral, supine, brief periods on the right side, and prone. - ANSWER: Left lateral,
supine, brief periods on the right side, and prone.
A Korean-American client, who speaks very little English, is being discharged
following surgery. Which nurse should the nurse manager assign to provide the
discharge instructions for the client?
A graduate registered nurse (RN) with three weeks of experience.
The registered nurse (RN) case-manager for the unit with 1 year's experience.
A "floating" registered nurse (RN) with five years of nursing experience.
EXAM QUESTIONS AND WELL ELABORATED ANSWERS
(CORRECT VERIFIED ANSWERS) A NEW UPDATED VERSION |
GUARANTEED SUCCESS
When caring for a client with a percutaneous endoscopic gastrostomy (PEG) tube,
what protocols should the nurse implement for intermittent feedings? (Select all that
apply.)
Select all that apply
Assessing residual amounts once a day.
Keeping the head of the bed elevated 30 degrees.
Changing the enteral-feeding bag every 24 hours.
Checking the placement of the tube by means of gastric aspiration.
Flushing the tube with 50 ml of normal saline solution after each feeding.
Submit - ANSWER: ------Keeping the head of the bed elevated 30 degrees. -------
Changing the enteral-feeding bag every 24 hours. -------Checking the placement of
the tube by means of gastric aspiration. -------Flushing the tube with 50 ml of normal
saline solution after each feeding.
The nurse is teaching a client about precautions for a new prescription for lovastatin
(Mevacor). Which symptom should the nurse instruct the client to report to the
healthcare provider immediately?
Terrible nightmares.
Increased nocturia.
Severe muscle pain.
Visual disturbances. - ANSWER: Severe muscle pain.
The nurse obtains a client's history that includes right mastectomy and radiation
therapy for cancer of the breast 10 years ago. Which current health problem should
the nurse consider is a consequence of the radiation therapy?
Asthma.
Myocardial infarction.
Chronic esophagitis with gastroesophageal reflux.
Pathologic fracture of two ribs on the right chest. - ANSWER: Pathologic fracture of
two ribs on the right chest.
Which findings are within expected parameters of a normal urinalysis for an older
adult? (Select all that apply.)
Select all that apply
pH 6.
Nitrate small.
Protein small.
Sugar negative.
Bilirubin negative.
,Specific gravity 1.015. - ANSWER: pH 6. ----------------- Nitrate small --------- Protein
small --------- Sugar negative.
Bilirubin negative.
Specific gravity 1.015.
A client with acute appendicitis is experiencing anxiety and loss of sleep about
missing final examination week at college. Which outcome is most important for the
nurse to include in the plan of care?
Sleeping six to eight hours.
Achieve a sense of control.
Utilize problem solving skills.
Increased focus of attention. - ANSWER: Achieve a sense of control.
The nurse is preparing an adult client for an upper gastrointestinal (UGI) series.
Which information should the nurse include in the teaching plan?
The xray procedure may last for several hours.
A nasogastric tube (NGT) is inserted to instill the barium.
Enemas are given to empty the bowel after the procedure.
Nothing by mouth is allowed for 6 to 8 hours before the study.
Submit - ANSWER: Nothing by mouth is allowed for 6 to 8 hours before the study.
An older female client is admitted with atrophic vaginitis and perineal cutaneous
candidiasis. What is the priority nursing diagnosis for this client?
Risk for injury.
Impaired comfort.
Disturbed body image.
Ineffective health maintenance. - ANSWER: Impaired comfort.
Which action should the nurse implement on the scheduled day of surgery for a
client with type 1 diabetes mellitus (DM)?
Obtain a prescription for an adjusted dose of insulin.
Administer an oral anti-diabetic agent.
Give an insulin dose using parameters of a sliding scale.
Withhold insulin while the client is NPO. - ANSWER: Obtain a prescription for an
adjusted dose of insulin.
A client with a history of hypertension, myocardial infarction, and heart failure is
admitted to the surgical intensive care unit after coronary artery bypass surgery graft
(CABG). The nurse determines the client's serum potassium level is 4.5 mEq/L. What
action should the nurse implement?
Notify the healthcare provider.
Decrease the IV solution flow rate.
Document the finding as the only action.
Administer potassium replacement as prescribed. - ANSWER: Document the finding
as the only action.
, The nurse assesses a long-term resident of a nursing home and finds the client has a
fungal infection (candidiasis) beneath both breasts. To prevent nosocomial infection,
which protocol should the nurse review with the rest of the staff?
Follow contact isolation procedures.
Wash hands after caring for the client.
Wear gloves when providing personal care.
Restrict pregnant staff or visitors into the room.
Submit - ANSWER: Wash hands after caring for the client.
Which finding should the nurse identify as an indication of carbon monoxide
poisoning in a client who experienced a burn injury during a house fire?
Pulse oximetry reading of 80%.
Expiratory stridor and nasal flaring.
Cherry red color to the mucous membranes.
Presence of carbonaceous particles in sputum. - ANSWER: cherry red color to the
mucous membrane
The nurse is caring for a client with human immunodeficiency virus (HIV) infection
who develops Mycobacterium avium complex (MAC). What is the most significant
desired outcome for this client?
Free from injury of drug side effects.
Return to pre-illness weight.
Adequate oxygenation.
Maintenance of intact perineal skin. - ANSWER: return to pre-illness weight
A client who is receiving the sixth unit of packed red blood cell transfusion is
demonstrating signs and symptoms of a febrile, nonhemolytic reaction. What
assessment finding is most important for the nurse to identify?
Increased anxiety since the transfusion began.
Drowsiness after receiving diphenhydramine (Benadryl).
Complaints of feeling cold.
Flushed skin and headache. - ANSWER: Flushed skin and headache.
In planning care for a client with an acute stroke resulting in right-sided hemiplegia,
which positioning should the nurse should use to maintain optimal functioning?
Mid-Fowler's with knees supported.
Supine with trochanter rolls to the hips.
Sim's position alternated with right lateral position q2 hours.
Left lateral, supine, brief periods on the right side, and prone. - ANSWER: Left lateral,
supine, brief periods on the right side, and prone.
A Korean-American client, who speaks very little English, is being discharged
following surgery. Which nurse should the nurse manager assign to provide the
discharge instructions for the client?
A graduate registered nurse (RN) with three weeks of experience.
The registered nurse (RN) case-manager for the unit with 1 year's experience.
A "floating" registered nurse (RN) with five years of nursing experience.
