HESI Med Surg Exam Questions With Complete Solutions
1. A nurse is reviewing the hematologic test results for a patient
in whom the hematocrit (Hct) is reported at a reading of 30%.
Based on this result, the nurse should interpret that the patient
A. is susceptible to bleeding disorders.
B. has fewer red blood cells than normal. C. is experiencing an
inflammatory response.
D. is experiencing an acute hemolytic crisis. Correct Answers
B. has fewer red blood cells than normal.The Hct is the measure
of the volume of red blood cells in whole blood expressed as a
percentage. This test is useful in the diagnosis of anemia,
polycythemia, and abnormal hydration states. Patients who are
susceptible to bleeding disorders likely will have a low platelet
count. The inflammatory response may best be evaluated by
examination of results that include the white blood cell count
with differential analysis. Acute hemolytic crisis develops in
patients receiving blood components in which incompatibility
occurs or in patients with bleeding disorders or conditions that
promote cellular damage, such as damage associated with shock.
1. The arterial blood gas (ABG) readings that indicate
compensated respiratory acidosis are a PaCO2 of
A. 30 mm Hg and bicarbonate level of 24 mEq/L.
B. 30 mm Hg and bicarbonate level of 30 mEq/L.
C. 50 mm Hg and bicarbonate level of 20 mEq/L.
D. 50 mm Hg and bicarbonate level of 30 mEq/L. Correct
Answers D. 50 mm Hg and bicarbonate level of 30 mEq/L. If
compensation is present, carbon dioxide and bicarbonate are
abnormal (or nearly so) in opposite directions (e.g., one is
acidotic and the other alkalotic).
,1. When assessing a patient's nutritional-metabolic pattern
related to hematologic health, the nurse would:
A. Inspect the skin for petechiae.
B. Ask the patient about joint pain.
C. Assess for vitamin C deficiency.
D. Determine if the patient can perform ADLs. Correct
Answers A. Inspect the skin for petechiae. Any changes in the
skin's texture or color should be explored when assessing the
patient's nutritional-metabolic pattern related to hematologic
health. The presences of petechiae or ecchymotic areas could be
indicative of hematologic deficiencies related to poor nutritional
intake or related causes.
10. Anticoagulant therapy is used in the treatment of
thromboembolic disease because anticoagulants can
A. dissolve the thrombi.
B. decrease blood viscosity.
C. prevent absorption of vitamin K.
D. inhibit the synthesis of clotting factors. Correct Answers D.
inhibit the synthesis of clotting factors. Anticoagulant therapy is
based on the premise that the initiation or extension of thrombi
can be prevented by inhibiting the synthesis of clotting factors or
by accelerating their inactivation. The anticoagulants heparin
and warfarin do not induce thrombolysis but effectively prevent
clot extension.
10. During discharge teaching for a 65-year-old patient with
emphysema and pneumonia, which of the following vaccines
should the nurse recommend the patient receive?
A. S. aureus
,B. H. influenzae
C. Pneumococcal
D. Bacille Calmette-Guérin (BCG) Correct Answers C.
Pneumococcal The pneumococcal vaccine is important for
patients with a history of heart or lung disease, recovering from
a severe illness, age 65 or over, or living in a long-term care
facility.
10. If a nurse is caring for an 80-year-old patient with a
temperature of 100.4° F, crackles at the right lung base, pain
with deep inspiration, and dyspnea, which of the following
orders is the nurse's priority? A. Sputum specimen for culture
and sensitivity
B. Codeine 15 mg orally every 6 hours as needed
C. Incentive spirometer every 2 hours while awake
D. Amoxicillin (Amoxil) 500 mg orally 4 times a day Correct
Answers A. Sputum specimen for culture and sensitivity The
patient presents with signs of a respiratory infection. To initiate
the most effective therapy, the health care prescriber must know
the pathogen causing the infection. Therefore, the sputum
specimen is the nurse's priority. If the antibiotic is administered
before the specimen is obtained, the results of the culture might
not be as accurate and could impair the effectiveness of therapy.
After the specimen is obtained, the nurse can administer codeine
for coughing and begin the incentive spirometry to mobilize
secretions and improve the patient's ability to expectorate the
secretions.
10. The blood bank notifies the nurse that the two units of blood
ordered for an anemic patient are ready for pick up. The nurse
, should take which of the following actions to prevent an adverse
effect during this procedure?
A. Immediately pick up both units of blood from the blood bank.
B. Regulate the flow rate so that each unit takes at least 4 hours
to transfuse.
C. Set up the Y-tubing of the blood set with dextrose in water as
the flush solution.
D. Infuse the blood slowly for the first 15 minutes of the
transfusion. Correct Answers D. Infuse the blood slowly for
the first 15 minutes of the transfusion. Because a transfusion
reaction is more likely to occur at the beginning of a transfusion,
the nurse should initially infuse the blood at a rate no faster than
2 ml/min and remain with the patient for the first 15 minutes
after hanging a unit of blood.
11. If a patient has pernicious anemia, the nurse should provide
information regarding
A. frequent bouts of dyspnea.
B. risks relative to dehydration.
C. deficiency of intrinsic factor.
D. lack of any effective treatment for this condition. Correct
Answers C. deficiency of intrinsic factor. Pernicious anemia is
a type of anemia caused by failure of absorption of vitamin B12
(cobalamin). The most common cause is lack of intrinsic factor,
a glucoprotein produced by the parietal cells of the gastric
lining.
11. The nurse evaluates that discharge teaching for a patient
hospitalized with pneumonia has been most effective when the
patient states which of the following measures to prevent a
relapse?
1. A nurse is reviewing the hematologic test results for a patient
in whom the hematocrit (Hct) is reported at a reading of 30%.
Based on this result, the nurse should interpret that the patient
A. is susceptible to bleeding disorders.
B. has fewer red blood cells than normal. C. is experiencing an
inflammatory response.
D. is experiencing an acute hemolytic crisis. Correct Answers
B. has fewer red blood cells than normal.The Hct is the measure
of the volume of red blood cells in whole blood expressed as a
percentage. This test is useful in the diagnosis of anemia,
polycythemia, and abnormal hydration states. Patients who are
susceptible to bleeding disorders likely will have a low platelet
count. The inflammatory response may best be evaluated by
examination of results that include the white blood cell count
with differential analysis. Acute hemolytic crisis develops in
patients receiving blood components in which incompatibility
occurs or in patients with bleeding disorders or conditions that
promote cellular damage, such as damage associated with shock.
1. The arterial blood gas (ABG) readings that indicate
compensated respiratory acidosis are a PaCO2 of
A. 30 mm Hg and bicarbonate level of 24 mEq/L.
B. 30 mm Hg and bicarbonate level of 30 mEq/L.
C. 50 mm Hg and bicarbonate level of 20 mEq/L.
D. 50 mm Hg and bicarbonate level of 30 mEq/L. Correct
Answers D. 50 mm Hg and bicarbonate level of 30 mEq/L. If
compensation is present, carbon dioxide and bicarbonate are
abnormal (or nearly so) in opposite directions (e.g., one is
acidotic and the other alkalotic).
,1. When assessing a patient's nutritional-metabolic pattern
related to hematologic health, the nurse would:
A. Inspect the skin for petechiae.
B. Ask the patient about joint pain.
C. Assess for vitamin C deficiency.
D. Determine if the patient can perform ADLs. Correct
Answers A. Inspect the skin for petechiae. Any changes in the
skin's texture or color should be explored when assessing the
patient's nutritional-metabolic pattern related to hematologic
health. The presences of petechiae or ecchymotic areas could be
indicative of hematologic deficiencies related to poor nutritional
intake or related causes.
10. Anticoagulant therapy is used in the treatment of
thromboembolic disease because anticoagulants can
A. dissolve the thrombi.
B. decrease blood viscosity.
C. prevent absorption of vitamin K.
D. inhibit the synthesis of clotting factors. Correct Answers D.
inhibit the synthesis of clotting factors. Anticoagulant therapy is
based on the premise that the initiation or extension of thrombi
can be prevented by inhibiting the synthesis of clotting factors or
by accelerating their inactivation. The anticoagulants heparin
and warfarin do not induce thrombolysis but effectively prevent
clot extension.
10. During discharge teaching for a 65-year-old patient with
emphysema and pneumonia, which of the following vaccines
should the nurse recommend the patient receive?
A. S. aureus
,B. H. influenzae
C. Pneumococcal
D. Bacille Calmette-Guérin (BCG) Correct Answers C.
Pneumococcal The pneumococcal vaccine is important for
patients with a history of heart or lung disease, recovering from
a severe illness, age 65 or over, or living in a long-term care
facility.
10. If a nurse is caring for an 80-year-old patient with a
temperature of 100.4° F, crackles at the right lung base, pain
with deep inspiration, and dyspnea, which of the following
orders is the nurse's priority? A. Sputum specimen for culture
and sensitivity
B. Codeine 15 mg orally every 6 hours as needed
C. Incentive spirometer every 2 hours while awake
D. Amoxicillin (Amoxil) 500 mg orally 4 times a day Correct
Answers A. Sputum specimen for culture and sensitivity The
patient presents with signs of a respiratory infection. To initiate
the most effective therapy, the health care prescriber must know
the pathogen causing the infection. Therefore, the sputum
specimen is the nurse's priority. If the antibiotic is administered
before the specimen is obtained, the results of the culture might
not be as accurate and could impair the effectiveness of therapy.
After the specimen is obtained, the nurse can administer codeine
for coughing and begin the incentive spirometry to mobilize
secretions and improve the patient's ability to expectorate the
secretions.
10. The blood bank notifies the nurse that the two units of blood
ordered for an anemic patient are ready for pick up. The nurse
, should take which of the following actions to prevent an adverse
effect during this procedure?
A. Immediately pick up both units of blood from the blood bank.
B. Regulate the flow rate so that each unit takes at least 4 hours
to transfuse.
C. Set up the Y-tubing of the blood set with dextrose in water as
the flush solution.
D. Infuse the blood slowly for the first 15 minutes of the
transfusion. Correct Answers D. Infuse the blood slowly for
the first 15 minutes of the transfusion. Because a transfusion
reaction is more likely to occur at the beginning of a transfusion,
the nurse should initially infuse the blood at a rate no faster than
2 ml/min and remain with the patient for the first 15 minutes
after hanging a unit of blood.
11. If a patient has pernicious anemia, the nurse should provide
information regarding
A. frequent bouts of dyspnea.
B. risks relative to dehydration.
C. deficiency of intrinsic factor.
D. lack of any effective treatment for this condition. Correct
Answers C. deficiency of intrinsic factor. Pernicious anemia is
a type of anemia caused by failure of absorption of vitamin B12
(cobalamin). The most common cause is lack of intrinsic factor,
a glucoprotein produced by the parietal cells of the gastric
lining.
11. The nurse evaluates that discharge teaching for a patient
hospitalized with pneumonia has been most effective when the
patient states which of the following measures to prevent a
relapse?
