Med-Surg Evolve HESI Practice Quiz – Flashcards
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A client is admitted for further testing to confirm sarcoidosis. Which diagnostic test provides definitive information that the nurse should report to the HCP?
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Lung Tissue Biopsy (http://en.wikipedia.org/wiki/Sarcoidosis)
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A 58y/o client who has been post-menopausal for 5 years is concerned about the risk for osteoporosis because her mother has the condition. Which information should the nurse offer?
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Calcium loss from bones can be slowed by increasing calcium intake and exercise.
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After the 4th dose of gentamicin (Garamycin) IV, the nurse plans to draw blood samples to determine peak and trough levels. What are the best times to draw these samples?
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5 minute before and 30 minutes after the next dose.
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A client who is HIV positive asked the nurse, ¨How will I know when I have AIDS?¨ How should the nurse respond?
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AIDS is diagnosed when a specific opportunistic infection is found in an otherwise health individual
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During CPR, when attempting to ventilate a client's lungs, the nurse notes that the chest is not moving. Which action should the nurse take FIRST?
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Reposition the head and validate that the head is in the proper position to open the airway.
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Which intervention should the nurse plan to implement when caring for a client who has just undergone a right above-the-knee amputation?
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Place a large tourniquet at the bedside
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When preparing a client who has had a total laryngectomy for discharge, which instruction is most important to include in discharge teaching?
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Tell the client to carry a medical alert card stating that he is a total neck breather.
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When working with a 70y/o obese client with bilateral osteoarthritis (OA) of the hips, what should the nurse recommend that is most beneficial in protecting the client's joints?
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Initiate a weight-reduction diet to achieve a healthy body weight
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A 58y/o client who has no health problems asks the nurse about the Pneumovax vaccine. The response should be based on which information?
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The vaccine is administered once to older adults or persons with a history of chronic illnesses.
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Which information about mammograms is most important to provide a post-menopausal female client?
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Yearly mammograms should be done regardless of previous normal x-rays.
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When providing discharge teaching for a client with osteoporosis, the nurse should reinforce which home care activity?
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Eliminate hazards to home safety
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Physical exams of a comatose clients reveals decorticate posturing. Which statement is accurate regarding the client's status?
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Severe dysfunction of the cerebral cortex has occurred
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A 77y/o female client is admitted to the hospital. She is confused, has no appetite, is N/V, and is complaining of a headache. Her pulse rate is 43 bpm. Which question is priority for the nurse to ask the client/family on admission?
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Does the client take digitalis?
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A client with a completed ischemic stroke has blood pressure of 180/90. Which action should the nurse implement?
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Give antihypertensive medications.
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After checking the urinary drainage system for kinks in the tubing, the nurse determines the postanesthesia client has dark, concentrated urinary output of 54 mL for the last 2 hours. What priority nursing action should be implemented?
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Report the finding to the surgeon.
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Despite several eye surgeries, a 78 y/o client who lives alone has persistent vision problems. The visiting nurse is discussing painting the house with the client. The nurse suggests that the edge of the steps should be painted which color?
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Medium Yellow
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During an interview with a client planning elective surgery, the client asks the nurse, ¨What is the advantage of having a preferred provider org insurance plan?¨ Which response is best?
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Insurance coverage of employees is less expensive to employers.
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The nurse is interviewing a male client with HTN. Which additional medical diagnosis in the client's history presents the greatest risk for developing a CVA?
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DM
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A client with a 16-year history of DM is having renal function tests because of recent fatigue, weakness, and elevated blood urea nitrogen, and serum creatinine levels. Which finding should the nurse conclude as an early symptom of renal insufficiency?
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Nocturia
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What finding should the nurse identify as most significant for a client diagnosis with polycystic kidney disease (PKD)?
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3+ Bacteria in urine
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The nurse is planning care for a client with newly diagnosed DM that requires insulin. Which assessment should the nurse identify before beginning the teaching session?
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Willingness of the client to learn the injection sites
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The nurse is teaching a client with maple syrup urine disease (MSUD), an autosomal recessive disorder, about inheritance pattern. Which information should the nurse provide?
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Both genes of a pair must be abnormal for the disorder to occur.
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A client is admitted to the hospital with a medical diagnosis of pneumococcal pneumonia. The nurse knows that the prognosis for gram-negative pneumonias is very poor because...
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Gram-negative organisms are more resistant to antibiotic therapy.
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A client who was in a MVC was admitted to the hospital and the right knee was placed in a skeletal traction. The nurse has documented the nursing diagnosis in the client's medical record as: Potential for impairment of skin integrity r/t immobility from traction. Which intervention is indicated?
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Provide skin care while maintaining traction
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Which working in the ER, the nurse is exposed to a client with active TB. When should the nurse plan to obtain a tuberculin skin test?
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Within 4-6 weeks after exposure.
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A male client who has never smoked but has COPD for the past 5 years is now being assessed for lung cancer. The nurse knows that he is most likely to develop which type of lunch cancer?
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Adenocarcinoma
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A female client taking oral contraceptives reports to the nurse that she is experience calf pain. What action should the nurse implement?
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Advise the client to notify the HCP for immediate medical attention
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Which description of symptoms is characteristic of a client diagnosed with trigeminal neuralgia (tic douloureux)?
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Sudden, stabbing, severe pain over the lip and chin. (Trigeminal neuralgia is characterized by paroxysms of pain, similar to an electric shock, in the area innervated by one or more branches of the trigeminal nerve.)
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A client who is fully awake after a gastroscopy asks the nurse for something to drink. After confirming that liquids are allowed, which assessment action should the nurse consider a priority?
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Check gag and swallow reflexes
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In assessing a client diagnosed with primary hyperaldosteronism, the nurse expects the lab test results to indicate a decreased serum level of which substance?
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Clients with primary aldosteronism exhibit a profound decline in the serum levels of potassium (hypokalemia)
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During a lung assessment, the nurse places a stethoscope on a client's chest and instruct him to say 99 each time. WHat should be the correct interpretation if the nurse hears the words 99 spoken very clearly?
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May indicate pneumonia (Whisper pectoriloquy demonstrates hyperresonance. Normally, the spoken word is not well heard)
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When teaching diaphragmatic breathing to a client with COPD, which information should the nurse provide regarding technique?
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Place a small book on the abd and make it rise while inhaling
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Dysrhythmias are a concern for any client, however, the presence of one is more serious in the elderly because...
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elderly persons are intolerant of decreased cardiac output which may result in dizziness and falls.
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The nurse notes that the only ECG for a 55 y/o male client scheduled for surgery in 2 house is dated 2 years ago. The client reports that he has a hx of heart trouble but has no problems at present. Hospital protocol requires that those over 50 have a recent ECG prior to surgery. What nursing action is best to implement?
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Call for an ECG to be performed immediately.
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The nurse is preparing a teaching plan for a client newly diagnosis with Type 1 DM. Which S/S should the nurse describe when teaching the client about hypoglycemia?
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Sweating, trembling, tachycardia
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Which client should the nurse recognize as most likely to experience sleep apnea?
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Obese older male with a short, thick neck.
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Which intervention should the nurse implement for a female client diagnosed with pelvic relaxation disorder?
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Encourage Kegel exercises 10 times daily
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The nurse is teaching a female client who uses contraceptive diaphragm about reducing the risk for toxic shock syndrome (TSS). Which information should the nurse include?
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Do not leave it in place longer that 8 hours Contact HCP if you experience a sudden onset of fever greater than 101F
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An 81 y/o male client has emphysema. He lives at home with his cat and manages self-care with no difficulty. When making home visit, you notice that his tongue is somewhat cracked and his eyeballs are sunken into his head. What intervention is indicated?
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Help the client determine ways to increase his fluid intake.
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The HCP prescribes aluminum an magnesium hydroxide (Maalox) for a client with CRF who is complaining of indigestion. What intervention is indicated?
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Question order
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In assessing a client who smokes and has emphysema, which finding should the nurse expect?
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Normal skin color (pink puffer)
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A client has a staging procedure for cancer of the breast and asks the nurse which type of breast cancer has the poorest prognosis. Which information should the nurse offer?
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Inflammatory with peau d'orange
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The nurse is assessing a client's lab values following administration of chemo. Which lab value leads the nurse to suspect the client is experiencing tumor lysis syndrome (TLS)?
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Serum calcium of 5 mg/dl TLS results in hyperkalemia, hypocalcemia, hyperuricemia, and hyperphosphatemia. A serum calcium level of 5 mg, which is low, is an indicator of possible tumor lysis syndrome.
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The nurse working in a post-op surgical clinic is assessing a woman who had a left radical mastectomy for breast cancer. Which factor puts the client at greatest risk for developing lymphedema?
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She sustained an insect bite to her left arm yesterday.
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The nurse assesses a client with advanced cirrhosis of the liver for signs of hepatic encephalopathy (HE). Which finding should the nurse consider an indication of progressive HE?
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Difficulty in handwriting Hepatic encephalopathy The earliest symptoms of hepatic encephalopathy include minor mental changes and motor disturbances. The client appears slightly confused and unkempt and has alterations in mood and sleep patterns. The client tends to sleep during the day and have restlessness and insomnia at night. As hepatic encephalopathy progresses, the client may become difficult to awaken and completely disoriented with respect to time and place. With further progression, the client lapses into frank coma and may have seizures. Simple tasks, such as handwriting, become difficult.
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A client experiencing uncontrolled a-fib is admitted to the tele unit. Which initial med should the nurse anticipate administering to the client?
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Digoxin (Lanoxin) is administered for uncontrolled, symptomatic atrial fibrillation resulting in a decreased cardiac output. Digoxin slows the rate of conduction by prolonging the refractory period of the AV node, thus slowing the ventricular response, decreasing the heart rate, and affecting cardiac output
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A male client receives a local anesthetic during surgery. During the post-op assessment, the nurse notices the client is slurring his speech. Which action should the nurse take?
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Evaluate BP, pulse, and resp status
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The nurse knows that lab values sometimes vary for the older client. Which data should the nurse expect to find when reviewing lab values of an 80 y/o male?
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Increased protein in urine, slightly increased serum glucose level
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The nurse is teaching a female client about the best time to plan sex in order to conceive. What should the nurse say?
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The nurse is taking a history of a newly diagnosed Type 2
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what instructions should the nurse give a client who is diagnosed with fibrocystic changes of the breast?
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