HESI MED SURG 2 NURSING EXAM 2024 COMPLETE REAL
EXAM QUESTIONS AND WELL ELABORATED ANSWERS
(CORRECT VERIFIED ANSWERS) A NEW UPDATED VERSION |
GUARANTEED SUCCESS
The osmolality of the extracellular fluid is almost entirely due to - ANSWER: Sodium
Dextrose 10% is a _____ solution. It should only be administered _____ - ANSWER:
hyperosmolar; IV
Use only ___ solutions in irrigations & infusions unless there is a specific aim to shift
fluid to intracellular or extracellular spaces. - ANSWER: isotonic, neutral
Common causes of fluid volume deficit. - ANSWER: Vomiting, diarrhea, GI suctioning,
sweating, inadequate fluid intake, massive edema, ascites
Symptoms of fluid volume deficit - ANSWER: Weight loss, decreased skin turgor,
oliguria, dry & sticky mucous membranes, postural hypotension, weak & rapid pulse
Lab findings in fluid volume deficit - ANSWER: Elevated BUN, elevated creatinine,
increased serum osmolarity, elevated hemoglobin, elevated hemocrit
Interventions for fluid volume deficit - ANSWER: Strict I&O, replacement of fluids
isotonically, WATER IS A HYPOTONIC SOLUTION, if IV fluid hydration is needed
isotonic fluids are used
Common causes of fluid volume excess - ANSWER: Heart failure, renal failure,
cirrhosis, liver failure, excessive table salt intake, overhydration, poorly controlled IV
therapy
Symptoms of fluid volume excess - ANSWER: Peripheral edema, increased bounding
pulse, elevated B/P, distended neck & hand veins, dyspnea, attention loss,altered
LOC, confusion
Lab findings in fluid volume excess - ANSWER: Decreased BUN, decreased
hemoglobin, decreased hematocrit, decreased serum osmolarity, decreased urine
osmolality & specific gravity
Interventions for fluid volume excess - ANSWER: Diuretics, Fluid restriction, Strict
I&O, Sodium-restricted diet, weighed daily, Serum potassium monitored
Signs & Symptoms of hyponatremia - ANSWER: Anorexia, weakness, nausea,
vomiting, lethargy, confusion, muscle cramps, seizures
Interventions for hyponatremia - ANSWER: Restrict fluids
,Signs & Symptoms of hypernatremia - ANSWER: Thirst, dry mouth, stick mucous
membranes, hallucinations, lethargy, irritability, seizures
Interventions for hypernatremia - ANSWER: restrict sodium, increase water intake
Signs and symptoms of hypokalemia - ANSWER: fatigue, anorexia, nausea, muscle
weakness, decreased GI mobility, dysrhythmias, paresthesia, flat T waves on ECG
Interventions for hypokalemia - ANSWER: potassium supplements, monitor renal
status, encourage foods high in potassium
Signs and symptoms of hyperkalemia - ANSWER: muscle weakness, bradycardia,
dysrhythmias, flaccid paralysis, intestinal colic, tall T waves on ECG
Interventions for hyperkalemia - ANSWER: Eliminate parenteral potassium from IV
medications and medications, administer insulin with 50% glucose, administer
kayexalate, monitor ECG, administer calcium gluconate to protect heart, IV loop
diuretics, renal dialysis may be required
Signs and symptoms of hypocalcemia - ANSWER: diarrhea, numbness, tingling of
extremities, convulsions, positive trousseau sign, positive Chvostek sign, at risk for
tetany
interventions for hypocalemia - ANSWER: administer calcium supplements
administer calcium IV slowly, increase calcium intake
signs and symptoms of hypercalcemia - ANSWER: muscle weakness, constipation,
anorexia, nausea, polyuria, polydipsia, neurosis, dysrhythmias
Signs and symptoms of hypomagnesemia - ANSWER: Anorexia, distention,
neuromuscular irritability, depression, disorientation
interventions for hypomagnesemia - ANSWER: Administer MgSO4 IV, Encourage
foods high in magnesium
signs and symptoms of hypermagnesemia - ANSWER: flushing, hypotension,
drowsiness, lethargy, hypoactive reflexes, depressed respirations, bradycardia
interventions for hypermagnesemia - ANSWER: avoid magnesium-based antacids &
laxatives, restrict dietary intake of foods high in magnesium
Signs & Symptoms of Hypophosphatemia - ANSWER: Paresthesias, muscle weakness,
muscle pain, mental changes, cardiomyopathy, respiratory failure
interventions for hypophosphatemia - ANSWER: correct underlying cause, administer
oral replacement of phosphates with vitamin D
, signs and symptoms of hyperphosphatemia - ANSWER: short term: tetany
symptoms, long term: phosphorus precipition in nonosseous sites
interventions for hyperphosphatemia - ANSWER: administer albumin hydroxide with
meals to bind phosphorus, dialysis may be required if renal failure is the underlying
cause
Respiratory acidosis ABG - ANSWER: Low pH, High PCO2
Respiratory alkalosis ABG - ANSWER: High pH, Low PCO2
Metabolic acidosis ABG - ANSWER: Low pH, Low HCO3
Metabolic alkalosis ABG - ANSWER: High pH, High HCO3
Interventions for prevenion of post-op urinary retention - ANSWER: Monitor
hydration status and encourage oral intake if allowed, offer bedpan or assist to
commode
inventions for prevention of post-op pulmonary problems - ANSWER: assist patient
to turn, cough & deep breathe q2h, keep patient hydrated, enable early ambulation,
provide early incentive spirometer
interventions for prevention of post-op wound healing problems - ANSWER: teach
splinting of incision when lient coughs, monitor for signs of infection, malnutrition &
dehydration, provide high protein diet
interventions for prevention of post-op UTIs - ANSWER: oral fluid intake, emptying
bladder q4-6h, monitor I&O, Avoid catheterization
interventions for prevention of post-op thrombophebitis - ANSWER: leg exercises
q8h, early ambulation, apply anti embolism stocking or SCDS, avoid pressure and
crossing of the legs, low dose heparin may be used prophylactically
interventions for prevention of post-op decreased gastrointestinal peristalsis -
ANSWER: NG tubing to decompress GI tract, limit use of narcotic analgesics,
encourage early ambulation
Assessment of Pneumonia - ANSWER: Tachypnea, fever with chills, productive cough
with pain, rapid bounding pulse, bronchial breath sounds and crackles, elevated WBC
count, ABG indication of hypoxemia, a drop in O2 saturation
Interventions for patients with pneumonia - ANSWER: Assess sputum, assist patient
to cough, suction airway, humidify the air, teach deep breathing exercises, provide
fluids up to 3L/day unless contraindicated, assess lung sounds before and after
EXAM QUESTIONS AND WELL ELABORATED ANSWERS
(CORRECT VERIFIED ANSWERS) A NEW UPDATED VERSION |
GUARANTEED SUCCESS
The osmolality of the extracellular fluid is almost entirely due to - ANSWER: Sodium
Dextrose 10% is a _____ solution. It should only be administered _____ - ANSWER:
hyperosmolar; IV
Use only ___ solutions in irrigations & infusions unless there is a specific aim to shift
fluid to intracellular or extracellular spaces. - ANSWER: isotonic, neutral
Common causes of fluid volume deficit. - ANSWER: Vomiting, diarrhea, GI suctioning,
sweating, inadequate fluid intake, massive edema, ascites
Symptoms of fluid volume deficit - ANSWER: Weight loss, decreased skin turgor,
oliguria, dry & sticky mucous membranes, postural hypotension, weak & rapid pulse
Lab findings in fluid volume deficit - ANSWER: Elevated BUN, elevated creatinine,
increased serum osmolarity, elevated hemoglobin, elevated hemocrit
Interventions for fluid volume deficit - ANSWER: Strict I&O, replacement of fluids
isotonically, WATER IS A HYPOTONIC SOLUTION, if IV fluid hydration is needed
isotonic fluids are used
Common causes of fluid volume excess - ANSWER: Heart failure, renal failure,
cirrhosis, liver failure, excessive table salt intake, overhydration, poorly controlled IV
therapy
Symptoms of fluid volume excess - ANSWER: Peripheral edema, increased bounding
pulse, elevated B/P, distended neck & hand veins, dyspnea, attention loss,altered
LOC, confusion
Lab findings in fluid volume excess - ANSWER: Decreased BUN, decreased
hemoglobin, decreased hematocrit, decreased serum osmolarity, decreased urine
osmolality & specific gravity
Interventions for fluid volume excess - ANSWER: Diuretics, Fluid restriction, Strict
I&O, Sodium-restricted diet, weighed daily, Serum potassium monitored
Signs & Symptoms of hyponatremia - ANSWER: Anorexia, weakness, nausea,
vomiting, lethargy, confusion, muscle cramps, seizures
Interventions for hyponatremia - ANSWER: Restrict fluids
,Signs & Symptoms of hypernatremia - ANSWER: Thirst, dry mouth, stick mucous
membranes, hallucinations, lethargy, irritability, seizures
Interventions for hypernatremia - ANSWER: restrict sodium, increase water intake
Signs and symptoms of hypokalemia - ANSWER: fatigue, anorexia, nausea, muscle
weakness, decreased GI mobility, dysrhythmias, paresthesia, flat T waves on ECG
Interventions for hypokalemia - ANSWER: potassium supplements, monitor renal
status, encourage foods high in potassium
Signs and symptoms of hyperkalemia - ANSWER: muscle weakness, bradycardia,
dysrhythmias, flaccid paralysis, intestinal colic, tall T waves on ECG
Interventions for hyperkalemia - ANSWER: Eliminate parenteral potassium from IV
medications and medications, administer insulin with 50% glucose, administer
kayexalate, monitor ECG, administer calcium gluconate to protect heart, IV loop
diuretics, renal dialysis may be required
Signs and symptoms of hypocalcemia - ANSWER: diarrhea, numbness, tingling of
extremities, convulsions, positive trousseau sign, positive Chvostek sign, at risk for
tetany
interventions for hypocalemia - ANSWER: administer calcium supplements
administer calcium IV slowly, increase calcium intake
signs and symptoms of hypercalcemia - ANSWER: muscle weakness, constipation,
anorexia, nausea, polyuria, polydipsia, neurosis, dysrhythmias
Signs and symptoms of hypomagnesemia - ANSWER: Anorexia, distention,
neuromuscular irritability, depression, disorientation
interventions for hypomagnesemia - ANSWER: Administer MgSO4 IV, Encourage
foods high in magnesium
signs and symptoms of hypermagnesemia - ANSWER: flushing, hypotension,
drowsiness, lethargy, hypoactive reflexes, depressed respirations, bradycardia
interventions for hypermagnesemia - ANSWER: avoid magnesium-based antacids &
laxatives, restrict dietary intake of foods high in magnesium
Signs & Symptoms of Hypophosphatemia - ANSWER: Paresthesias, muscle weakness,
muscle pain, mental changes, cardiomyopathy, respiratory failure
interventions for hypophosphatemia - ANSWER: correct underlying cause, administer
oral replacement of phosphates with vitamin D
, signs and symptoms of hyperphosphatemia - ANSWER: short term: tetany
symptoms, long term: phosphorus precipition in nonosseous sites
interventions for hyperphosphatemia - ANSWER: administer albumin hydroxide with
meals to bind phosphorus, dialysis may be required if renal failure is the underlying
cause
Respiratory acidosis ABG - ANSWER: Low pH, High PCO2
Respiratory alkalosis ABG - ANSWER: High pH, Low PCO2
Metabolic acidosis ABG - ANSWER: Low pH, Low HCO3
Metabolic alkalosis ABG - ANSWER: High pH, High HCO3
Interventions for prevenion of post-op urinary retention - ANSWER: Monitor
hydration status and encourage oral intake if allowed, offer bedpan or assist to
commode
inventions for prevention of post-op pulmonary problems - ANSWER: assist patient
to turn, cough & deep breathe q2h, keep patient hydrated, enable early ambulation,
provide early incentive spirometer
interventions for prevention of post-op wound healing problems - ANSWER: teach
splinting of incision when lient coughs, monitor for signs of infection, malnutrition &
dehydration, provide high protein diet
interventions for prevention of post-op UTIs - ANSWER: oral fluid intake, emptying
bladder q4-6h, monitor I&O, Avoid catheterization
interventions for prevention of post-op thrombophebitis - ANSWER: leg exercises
q8h, early ambulation, apply anti embolism stocking or SCDS, avoid pressure and
crossing of the legs, low dose heparin may be used prophylactically
interventions for prevention of post-op decreased gastrointestinal peristalsis -
ANSWER: NG tubing to decompress GI tract, limit use of narcotic analgesics,
encourage early ambulation
Assessment of Pneumonia - ANSWER: Tachypnea, fever with chills, productive cough
with pain, rapid bounding pulse, bronchial breath sounds and crackles, elevated WBC
count, ABG indication of hypoxemia, a drop in O2 saturation
Interventions for patients with pneumonia - ANSWER: Assess sputum, assist patient
to cough, suction airway, humidify the air, teach deep breathing exercises, provide
fluids up to 3L/day unless contraindicated, assess lung sounds before and after
