Medical Surgical Hesi V2 Exam Qustions And
Answers Verified 100% Correct
While caring for a client with Amyotrophic Lateral Sclerosis (ALS), a
nurse performs a neurological assessment every 4 hours. Which
assessment finding warrants immediate intervention by the nurse?
A. Inappropriate laughter
B. Increasing anxiety
C. Weakened cough effort
D. Asymmetrical weakness - ANSWER -D. Asymmetrical weakness
The nurse is providing preoperative education for a Jewish client
scheduled to receive a xenograft to promote burn healing. Which
information should the nurse provide this client?
A. Grafting icreases the risk for bacterial infections
B. The xenograft is taken from a non-human source.
C. Grafts are later removed by a debriding procedure.
D. As the burn heals, the graft permanently attaches. - ANSWER -B.
The xenograft is taken from a non-human source.
A male client who had colon surgery 3 days ago is anxious and
requesting assistance to reposition. While the nurse is turning him,
the wound dehiscences and ulcerates. The nurse moistens an
,available sterile dressing and places it over the wound. Which
intervention should the nurse implement next?
A. Bring additional sterile dressing supplies to the room.
B. Prepare the client to return to the OR
C. Obtain a sample of the drainage to send to the lab.
D. Auscultate the abdomen for bowel sound activity. - ANSWER -A.
Bring additional sterile dressing supplies to the room.
A client with carcinoma of the lung is complaining of weakness and
has a serum sodium level of 117 mEq/L. Which nursing problem
should the nurse include in this clients plan of care?
A. Altered urinary elimination
B. Impaired gas exchange
C. Fluid volume excess
D. Decreased cardiac output - ANSWER -C. Fluid volume excess
A female client enters the clinic and insists on being seen. She is
weak, nervous, and reports a racing heart beat and recent weight loss
of 15 pounds. After ruling out substance withdrawal, the healthcare
provider suspects hyperthyroidism and admits her for further testing.
Which action should the nurse implement?
A. Begin preparing the client for thyroidectomy procedure.
, B. Space the clients care to provide periods of rest.
C. Assess the client for hyperactive bowel sounds.
D. Provide warm blankets to prevent heat loss. - ANSWER -C. Assess
the client for hyperactive bowel sounds.
The nurse is teaching a client with glomerulonephritis about self care.
Which dietary recommendations should the nurse encourage the
client to follow?
A. Increase intake of high-fiber foods, such as bran cereal
B. Restrict protein intake by limiting meats and other high-protein
foods.
C. Limit oral fluid intake of 500ml per day
D. Increase intake of potassium rich foods such as bananas and
cantaloupe. - ANSWER -B. Restrict protein intake by limiting meats
and other high-protein foods.
An overweight, young adult male who was recently diagnosed with
type 2 diabetes mellitus is admitted for a hernia repair. He tells the
nurse that he is feeling very weak and jittery. Which actions should
the nurse implement? (Select all that apply)
A. Check his fingerstick glucose
B. Assess his skin temperature and moisture
C. Measure his pulse and BP
D. Document anxiety on the surgical checklist.
E. Administer a PRN dose of regular insulin. - ANSWER -A,B,C
Answers Verified 100% Correct
While caring for a client with Amyotrophic Lateral Sclerosis (ALS), a
nurse performs a neurological assessment every 4 hours. Which
assessment finding warrants immediate intervention by the nurse?
A. Inappropriate laughter
B. Increasing anxiety
C. Weakened cough effort
D. Asymmetrical weakness - ANSWER -D. Asymmetrical weakness
The nurse is providing preoperative education for a Jewish client
scheduled to receive a xenograft to promote burn healing. Which
information should the nurse provide this client?
A. Grafting icreases the risk for bacterial infections
B. The xenograft is taken from a non-human source.
C. Grafts are later removed by a debriding procedure.
D. As the burn heals, the graft permanently attaches. - ANSWER -B.
The xenograft is taken from a non-human source.
A male client who had colon surgery 3 days ago is anxious and
requesting assistance to reposition. While the nurse is turning him,
the wound dehiscences and ulcerates. The nurse moistens an
,available sterile dressing and places it over the wound. Which
intervention should the nurse implement next?
A. Bring additional sterile dressing supplies to the room.
B. Prepare the client to return to the OR
C. Obtain a sample of the drainage to send to the lab.
D. Auscultate the abdomen for bowel sound activity. - ANSWER -A.
Bring additional sterile dressing supplies to the room.
A client with carcinoma of the lung is complaining of weakness and
has a serum sodium level of 117 mEq/L. Which nursing problem
should the nurse include in this clients plan of care?
A. Altered urinary elimination
B. Impaired gas exchange
C. Fluid volume excess
D. Decreased cardiac output - ANSWER -C. Fluid volume excess
A female client enters the clinic and insists on being seen. She is
weak, nervous, and reports a racing heart beat and recent weight loss
of 15 pounds. After ruling out substance withdrawal, the healthcare
provider suspects hyperthyroidism and admits her for further testing.
Which action should the nurse implement?
A. Begin preparing the client for thyroidectomy procedure.
, B. Space the clients care to provide periods of rest.
C. Assess the client for hyperactive bowel sounds.
D. Provide warm blankets to prevent heat loss. - ANSWER -C. Assess
the client for hyperactive bowel sounds.
The nurse is teaching a client with glomerulonephritis about self care.
Which dietary recommendations should the nurse encourage the
client to follow?
A. Increase intake of high-fiber foods, such as bran cereal
B. Restrict protein intake by limiting meats and other high-protein
foods.
C. Limit oral fluid intake of 500ml per day
D. Increase intake of potassium rich foods such as bananas and
cantaloupe. - ANSWER -B. Restrict protein intake by limiting meats
and other high-protein foods.
An overweight, young adult male who was recently diagnosed with
type 2 diabetes mellitus is admitted for a hernia repair. He tells the
nurse that he is feeling very weak and jittery. Which actions should
the nurse implement? (Select all that apply)
A. Check his fingerstick glucose
B. Assess his skin temperature and moisture
C. Measure his pulse and BP
D. Document anxiety on the surgical checklist.
E. Administer a PRN dose of regular insulin. - ANSWER -A,B,C
