Fortis Med Surg 2 HESI| Medical Surgical Practice Exam
(Latest 2024/2025) Questions Answered With Detailed
Verified Answers
Laryngectomy Pre-Op - ANSWERPatient teaching should provided on procedure,
good oral hygiene, speech changes after surgery, and use of communication devices
such as alphabet boards, writing materials, and other useful methods of
communication.
Laryngectomy Post-Op - ANSWERAirway management is the most important
intervention. Keep patient in a Semi-Fowler's position to help decrease edema and
prevent tension on the suture line. Suctioning will be frequent via tracheotomy tube.
Maintain adequate fluid intake. Humidifier will help keep secretions moist,
encourage coughing and deep breathing. Give pain medication as needed for pain
control. Monitor vital signs because of risk for hemorrhages.
Laryngectomy Post-Op Focus - ANSWERAirway management, wound care, nutrition,
communication, and psycho-social issues related to body image changes.
NURSE ALERT - ANSWERA Patent airway, and decrease in level of consciousnesses
are a number one priority.
Nurse Alert - ANSWERDiscontinue suctioning a trach if the heart rate decreases 20
beats a minute from baseline or increases 40 beats a minute from baseline.
Nurse Alert - ANSWERAfter surgery and anesthesia assess patient's cough and gag
reflex and sedation to help determine patient's airway status.
NURSE ALERT - ANSWERIf patient does not have gag reflex do not give anything by
mouth.
Ventilation - ANSWERmovement of air
End Tital CO2 monitoring - ANSWERnon invasive technique ventilation vital sign
PaCO2 normal range - ANSWER35-45
cough reflex - ANSWERclears airway
gag reflex - ANSWERprotects airway from irritants
Atelectasis - ANSWERcollapse of alveoli
VQ scan - ANSWERassess ventilation and perfusion. It is used to determine if there is
a Pulmonary Embolism also known as P.E.
, Thoracentesis - ANSWERremoval of fluid by puncturing the chest wall
Bronchoscopy - ANSWERthe visual examination of the bronchi using a bronchoscope.
completed under anesthesia to biopsy or assess what type of treatment will be
needed.
Pulmonary function test - ANSWERvolume and airflow test
NURSING ALERT - ANSWERPost-op Bronchoscopy: if there is Pink colored sputum.
this is NOT NORMAL!
Nursing Alert - ANSWERNothing by mouth if patient is having respiratory distress due
to risk for aspiration.
Pulmonary Embolism Emergency Care - ANSWERAdminister supplemental oxygen via
nasal cannula or mask. In some cases, endotracheal intubation and mechanical
ventilation is necessary to maintain adequate oxygenation. Coughing and deep
breathing, incentive spirometry to prevent atelectasis. IV fluids followed by vaso
pressure if shock present. Administration of anticoagulant such as heparin, lovenox.
Assess ABGs, ECG, VQ scan, D dimer level, Troponin level, BNP level, and Pulmonary
angiography.
Sickle cell Emergency Care - ANSWERAdminister O2 to treat hypoxia and to control
sickling of blood. Assess respiratory status, Rest, DVT prophylaxis agents,
Administration of fluid and electrolytes to help maintain renal function. Administer
opioids, analgesics, NSAIDS to help control pain. Patient may need transfusion
therapy as well. Teach patient to drink plenty of fluids to avoid dehydration and
ways to prevent infections. Pneumonia, flu, and hepatitis vaccines should be
administered.
Stroke Emergency Care - ANSWERAssess ABC's.
Call Stroke Alert (look at the time)
Document Signs observed
Establish IV access x 2
Supplemental oxygen >95%
Check glucose and sodium level.
Monitor for a spike in temperature.
CT scan to be completed within 30 minutes to rule out hemorrhagic stroke. If no
hemorrhagic stroke indicated TPA should be administered within 3 to 4.5 hours of
onset of symptoms. Along with Aspirin 325mg.
seizure medications and precautions implemented.
Head of bed elevated at least 30 degrees.
Maintain Systolic BP <160 (Nimodipine)
(Latest 2024/2025) Questions Answered With Detailed
Verified Answers
Laryngectomy Pre-Op - ANSWERPatient teaching should provided on procedure,
good oral hygiene, speech changes after surgery, and use of communication devices
such as alphabet boards, writing materials, and other useful methods of
communication.
Laryngectomy Post-Op - ANSWERAirway management is the most important
intervention. Keep patient in a Semi-Fowler's position to help decrease edema and
prevent tension on the suture line. Suctioning will be frequent via tracheotomy tube.
Maintain adequate fluid intake. Humidifier will help keep secretions moist,
encourage coughing and deep breathing. Give pain medication as needed for pain
control. Monitor vital signs because of risk for hemorrhages.
Laryngectomy Post-Op Focus - ANSWERAirway management, wound care, nutrition,
communication, and psycho-social issues related to body image changes.
NURSE ALERT - ANSWERA Patent airway, and decrease in level of consciousnesses
are a number one priority.
Nurse Alert - ANSWERDiscontinue suctioning a trach if the heart rate decreases 20
beats a minute from baseline or increases 40 beats a minute from baseline.
Nurse Alert - ANSWERAfter surgery and anesthesia assess patient's cough and gag
reflex and sedation to help determine patient's airway status.
NURSE ALERT - ANSWERIf patient does not have gag reflex do not give anything by
mouth.
Ventilation - ANSWERmovement of air
End Tital CO2 monitoring - ANSWERnon invasive technique ventilation vital sign
PaCO2 normal range - ANSWER35-45
cough reflex - ANSWERclears airway
gag reflex - ANSWERprotects airway from irritants
Atelectasis - ANSWERcollapse of alveoli
VQ scan - ANSWERassess ventilation and perfusion. It is used to determine if there is
a Pulmonary Embolism also known as P.E.
, Thoracentesis - ANSWERremoval of fluid by puncturing the chest wall
Bronchoscopy - ANSWERthe visual examination of the bronchi using a bronchoscope.
completed under anesthesia to biopsy or assess what type of treatment will be
needed.
Pulmonary function test - ANSWERvolume and airflow test
NURSING ALERT - ANSWERPost-op Bronchoscopy: if there is Pink colored sputum.
this is NOT NORMAL!
Nursing Alert - ANSWERNothing by mouth if patient is having respiratory distress due
to risk for aspiration.
Pulmonary Embolism Emergency Care - ANSWERAdminister supplemental oxygen via
nasal cannula or mask. In some cases, endotracheal intubation and mechanical
ventilation is necessary to maintain adequate oxygenation. Coughing and deep
breathing, incentive spirometry to prevent atelectasis. IV fluids followed by vaso
pressure if shock present. Administration of anticoagulant such as heparin, lovenox.
Assess ABGs, ECG, VQ scan, D dimer level, Troponin level, BNP level, and Pulmonary
angiography.
Sickle cell Emergency Care - ANSWERAdminister O2 to treat hypoxia and to control
sickling of blood. Assess respiratory status, Rest, DVT prophylaxis agents,
Administration of fluid and electrolytes to help maintain renal function. Administer
opioids, analgesics, NSAIDS to help control pain. Patient may need transfusion
therapy as well. Teach patient to drink plenty of fluids to avoid dehydration and
ways to prevent infections. Pneumonia, flu, and hepatitis vaccines should be
administered.
Stroke Emergency Care - ANSWERAssess ABC's.
Call Stroke Alert (look at the time)
Document Signs observed
Establish IV access x 2
Supplemental oxygen >95%
Check glucose and sodium level.
Monitor for a spike in temperature.
CT scan to be completed within 30 minutes to rule out hemorrhagic stroke. If no
hemorrhagic stroke indicated TPA should be administered within 3 to 4.5 hours of
onset of symptoms. Along with Aspirin 325mg.
seizure medications and precautions implemented.
Head of bed elevated at least 30 degrees.
Maintain Systolic BP <160 (Nimodipine)
