HESI MEDI SURG FINAL EXAM WITH REAL
QUESTIONS AND VERIFIED ANSWERS ||
ALREADY GRADED A+|| GUARANTEED PASS ||
LATEST UPDATE 2025
A nurse is preparing to establish oxygen therapy for a patient with COPD, and
the physician's prescription reads "oxygen per nasal cannula at 5 L per minute."
Which of the following actions should the nurse take?
A. Administer the oxygen as prescribed. B. Call the physician and question the
correct flow rate of the oxygen.
C. Establish the oxygen as prescribed and obtain an ABG.
D. Change the delivery device from a nasal cannula to a simple oxygen mask. -
ANSWER-B. Call the physician and question the correct flow rate of the
oxygen. The nurse should call the physician immediately and question the
flow rate for delivery of the oxygen before implementation. Oxygen is used
cautiously in patients with COPD because of longstanding hypoxemia
serving as the respiratory drive mechanism. If high levels of oxygen are
administered, the respiratory drive can be obliterated. Changing the device to
a simple oxygen mask may alter the oxygen concentration being delivered to
the patient and will further enhance the obliteration of the patient's
respiratory drive. Obtaining an ABG sample is not a priority at this time, and
the action does not address the validity of the prescribed oxygen dosing for
the patient.
The resurgence in TB resulting from the emergence of multidrug-resistant
strains of Mycobacterium tuberculosis is primarily the result of A. a lack
of effective means to diagnose TB.
B. poor compliance with drug therapy in patients with TB.
C. the increased population of immunosuppressed individuals with AIDS. D.
indiscriminate use of antitubercular drugs in treatment of other infections. -
, ANSWER-B. poor compliance with drug therapy in patients with TB.
Drugresistant strains of TB have developed because TB patients' compliance
to drug therapy has been poor and there has been general decreased vigilance
in monitoring and follow-up of TB treatment. Antitubercular drugs are
almost exclusively used for TB infections. TB can be effectively diagnosed
with sputum cultures. The incidence of TB is at epidemic proportions in
patients with HIV, but this does not account for drug-resistant strains of TB.
The chronic inflammation of the bronchi characteristic of chronic obstructive
pulmonary disease (COPD) results in
A. collapse of small bronchioles on expiration.
B. permanent, abnormal dilation of the bronchi.
C. hyperplasia of mucus-secreting cells and bronchial edema.
D. destruction of the elastic and muscular structures of the bronchial wall. -
ANSWER-C. hyperplasia of mucus-secreting cells and bronchial edema.
Chronic bronchitis is characterized by chronic inflammation of the bronchial
lining, with edema and increased mucus production. Collapse of small
bronchioles on expiration is common in emphysema, and abnormal dilation
of the bronchi because of destruction of the elastic and muscular structures is
characteristic of bronchiectasis.
In teaching the patient with COPD about the need for physical exercise, the
nurse informs the patient that
A. all patients with COPD should be able to increase walking gradually up
to 20 min/day.
B. a bronchodilator inhaler should be used to relieve exercise-induced
dyspnea immediately after exercise.
C. shortness of breath is expected during exercise but should return to
baseline within 5 minutes after the exercise.
D. monitoring the heart rate before and after exercise is the best way to
determine how much exercise can be tolerated. - ANSWER-C. shortness of
breath is expected during exercise but should return to baseline within 5
minutes after the exercise.Shortness of breath usually increases during exercise,
but the activity is not being overdone if breathing returns to baseline within 5
,minutes after stopping. Bronchodilators can be administered 10 minutes before
exercise but should not be administered for at least 5 minutes after activity to
allow recovery. Patients are encouraged to walk 15 to 20 minutes a day with
gradual increases, but actual patterns will depend on patient tolerance. Dyspnea
most frequently limits exercise and is a better indication of exercise tolerance
than is heart rate in the patient with COPD.
Select all that apply. Which of the following are clinical manifestations of
tension pneumothorax? A. Midline trachea
B. Severe hypertension
C. Progressive cyanosis
D. A loud bruit on affected side
E. Asymmetrical chest wall movement
F. Subcutaneous emphysema in the neck - ANSWER-C,E, F The indicators of
tension pneumothorax are asymmetrical chest wall movement, severe
hypotension, subcutaneous emphysema in the neck and upper chest, and
progressive cyanosis.
Select all that apply. During initial assessment, a nurse should record which of
the following manifestations of respiratory distress?
A. Tachypnea
B. Nasal flaring
C. Thready pulse
D. Panting or grunting
E. Use of intercostal muscles
F. An inspiratory-to-expiratory ratio of 1:2 - ANSWER-AD Manifestations of
respiratory distress include tachypnea, grunting and panting on respiration,
central cyanosis, use of accessory muscles, and flaring nares.
The nurse assesses a patient with shortness of breath for evidence of
longstanding hypoxemia by inspecting:
, A. Chest excursion
B. Spinal curvatures
C. The respiratory pattern
D. The fingernail and its base - ANSWER-D. The fingernail and its base
Clubbing, a sign of long-standing hypoxemia, is evidenced by an increase in
the angle between the base of the nail and the fingernail to 180 degrees or
more, usually accompanied by an increase in the depth, bulk, and sponginess
of the end of the finger.
Respiratory acidosis is at highest risk in a patient with
A. hypokalemia.
B. pulmonary fibrosis.
C. salicylate overdose.
D. COPD. – ANSWER-D. COPD. Chronic respiratory acidosis is most
commonly caused by COPD. Pulmonary fibrosis, hypokalemia, and
salicylate overdose do not predispose a patient to respiratory acidosis.
Hypokalemia can lead to cardiac dysrhythmias. Salicylate overdose results in
central nervous system changes, and pulmonary fibrosis can result in
respiratory arrest.
Select all that apply.
Atelectasis can be caused by A.
long-term smoking.
B. inadequate surfactant.
C. localized airway obstruction.
D. an increase in lung expansion.
E. an increase in elastic recoil. - ANSWER-BCE The collapse of lung tissue has
several causes, including reduced lung expansion, localized airway
obstruction, inadequate surfactant, and an increase in elastic recoil. Smoking,
although harmful, does not in itself cause atelectasis.
QUESTIONS AND VERIFIED ANSWERS ||
ALREADY GRADED A+|| GUARANTEED PASS ||
LATEST UPDATE 2025
A nurse is preparing to establish oxygen therapy for a patient with COPD, and
the physician's prescription reads "oxygen per nasal cannula at 5 L per minute."
Which of the following actions should the nurse take?
A. Administer the oxygen as prescribed. B. Call the physician and question the
correct flow rate of the oxygen.
C. Establish the oxygen as prescribed and obtain an ABG.
D. Change the delivery device from a nasal cannula to a simple oxygen mask. -
ANSWER-B. Call the physician and question the correct flow rate of the
oxygen. The nurse should call the physician immediately and question the
flow rate for delivery of the oxygen before implementation. Oxygen is used
cautiously in patients with COPD because of longstanding hypoxemia
serving as the respiratory drive mechanism. If high levels of oxygen are
administered, the respiratory drive can be obliterated. Changing the device to
a simple oxygen mask may alter the oxygen concentration being delivered to
the patient and will further enhance the obliteration of the patient's
respiratory drive. Obtaining an ABG sample is not a priority at this time, and
the action does not address the validity of the prescribed oxygen dosing for
the patient.
The resurgence in TB resulting from the emergence of multidrug-resistant
strains of Mycobacterium tuberculosis is primarily the result of A. a lack
of effective means to diagnose TB.
B. poor compliance with drug therapy in patients with TB.
C. the increased population of immunosuppressed individuals with AIDS. D.
indiscriminate use of antitubercular drugs in treatment of other infections. -
, ANSWER-B. poor compliance with drug therapy in patients with TB.
Drugresistant strains of TB have developed because TB patients' compliance
to drug therapy has been poor and there has been general decreased vigilance
in monitoring and follow-up of TB treatment. Antitubercular drugs are
almost exclusively used for TB infections. TB can be effectively diagnosed
with sputum cultures. The incidence of TB is at epidemic proportions in
patients with HIV, but this does not account for drug-resistant strains of TB.
The chronic inflammation of the bronchi characteristic of chronic obstructive
pulmonary disease (COPD) results in
A. collapse of small bronchioles on expiration.
B. permanent, abnormal dilation of the bronchi.
C. hyperplasia of mucus-secreting cells and bronchial edema.
D. destruction of the elastic and muscular structures of the bronchial wall. -
ANSWER-C. hyperplasia of mucus-secreting cells and bronchial edema.
Chronic bronchitis is characterized by chronic inflammation of the bronchial
lining, with edema and increased mucus production. Collapse of small
bronchioles on expiration is common in emphysema, and abnormal dilation
of the bronchi because of destruction of the elastic and muscular structures is
characteristic of bronchiectasis.
In teaching the patient with COPD about the need for physical exercise, the
nurse informs the patient that
A. all patients with COPD should be able to increase walking gradually up
to 20 min/day.
B. a bronchodilator inhaler should be used to relieve exercise-induced
dyspnea immediately after exercise.
C. shortness of breath is expected during exercise but should return to
baseline within 5 minutes after the exercise.
D. monitoring the heart rate before and after exercise is the best way to
determine how much exercise can be tolerated. - ANSWER-C. shortness of
breath is expected during exercise but should return to baseline within 5
minutes after the exercise.Shortness of breath usually increases during exercise,
but the activity is not being overdone if breathing returns to baseline within 5
,minutes after stopping. Bronchodilators can be administered 10 minutes before
exercise but should not be administered for at least 5 minutes after activity to
allow recovery. Patients are encouraged to walk 15 to 20 minutes a day with
gradual increases, but actual patterns will depend on patient tolerance. Dyspnea
most frequently limits exercise and is a better indication of exercise tolerance
than is heart rate in the patient with COPD.
Select all that apply. Which of the following are clinical manifestations of
tension pneumothorax? A. Midline trachea
B. Severe hypertension
C. Progressive cyanosis
D. A loud bruit on affected side
E. Asymmetrical chest wall movement
F. Subcutaneous emphysema in the neck - ANSWER-C,E, F The indicators of
tension pneumothorax are asymmetrical chest wall movement, severe
hypotension, subcutaneous emphysema in the neck and upper chest, and
progressive cyanosis.
Select all that apply. During initial assessment, a nurse should record which of
the following manifestations of respiratory distress?
A. Tachypnea
B. Nasal flaring
C. Thready pulse
D. Panting or grunting
E. Use of intercostal muscles
F. An inspiratory-to-expiratory ratio of 1:2 - ANSWER-AD Manifestations of
respiratory distress include tachypnea, grunting and panting on respiration,
central cyanosis, use of accessory muscles, and flaring nares.
The nurse assesses a patient with shortness of breath for evidence of
longstanding hypoxemia by inspecting:
, A. Chest excursion
B. Spinal curvatures
C. The respiratory pattern
D. The fingernail and its base - ANSWER-D. The fingernail and its base
Clubbing, a sign of long-standing hypoxemia, is evidenced by an increase in
the angle between the base of the nail and the fingernail to 180 degrees or
more, usually accompanied by an increase in the depth, bulk, and sponginess
of the end of the finger.
Respiratory acidosis is at highest risk in a patient with
A. hypokalemia.
B. pulmonary fibrosis.
C. salicylate overdose.
D. COPD. – ANSWER-D. COPD. Chronic respiratory acidosis is most
commonly caused by COPD. Pulmonary fibrosis, hypokalemia, and
salicylate overdose do not predispose a patient to respiratory acidosis.
Hypokalemia can lead to cardiac dysrhythmias. Salicylate overdose results in
central nervous system changes, and pulmonary fibrosis can result in
respiratory arrest.
Select all that apply.
Atelectasis can be caused by A.
long-term smoking.
B. inadequate surfactant.
C. localized airway obstruction.
D. an increase in lung expansion.
E. an increase in elastic recoil. - ANSWER-BCE The collapse of lung tissue has
several causes, including reduced lung expansion, localized airway
obstruction, inadequate surfactant, and an increase in elastic recoil. Smoking,
although harmful, does not in itself cause atelectasis.
