EVOLVE ELSEVIER HESI MED SURG FINAL

EVOLVE ELSEVIER HESI MED SURG FINAL

ACTUAL EXAM WITH 100+ REAL QUESTIONS

AND VERIFIED CORRECT ANSW ERS ALREADY

GRADED A+ |GUARANTEED SUCCESS |HESI

MED SURG LATEST UPDATE 2024-2025 | [BRAND

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Based on the clinical manifestations of Cushing syndrome, which nursing intervention would be appropriate for a client who is newly diagnosed with Cushing syndrome?

• Monitor blood glucose levels daily.
• Increase intake of fluids high in potassium.
• Encourage adequate rest between activities.
• Offer the client a sodium-enriched menu. - ANSWER- A. Monitor Blood

Glucose Levels

Cushing syndrome results from a hypersecretion of glucocorticoids in the adrenal cortex. Clients with Cushing syndrome often develop diabetes mellitus. Monitoring of serum glucose levels assesses for increased blood glucose levels so that treatment can begin early. A common finding in Cushing syndrome is generalized edema. Although potassium is needed, it is generally obtained from food intake, not by offering potassium-enhanced fluids. Fatigue is usually not an overwhelming 1 / 4

factor in Cushing syndrome, so an emphasis on the need for rest is not indicated A low-calorie, low-carbohydrate, low-sodium diet is not recommended.

When assigning clients on a medical-surgical floor to an RN and a PN, the charge nurse should assign which client to the PN.

• A young adult with bacterial meningitis with recent seizures
• An older adult client with pneumonia and viral meningitis
• A female client in isolation with meningococcal meningitis
• A male client 1 day postoperative after drainage of a brain abscess - ANSWER-
• An older adult client with pneumonia and viral meningitis

Rationale:

The most stable client is option B. Options A, C, and D are all at high risk for increased intracranial pressure and require the expertise of the RN for assessment and management of care.

In assessing a client diagnosed with primary aldosteronism, the nurse expects the laboratory test results to indicate a decreased serum level of which substance?

• Sodium
• Phosphate
• Potassium
• Glucose - ANSWER- C. Potassium

Rationale:

Clients with primary aldosteronism exhibit a profound decline in serum levels of potassium; and hypokalemia; hypertension is the most prominent and universal sign. The serum sodium level is normal or elevated, depending on the amount of water resorbed with the sodium. Option B is influenced by the parathyroid hormone (PTH). Option D is not affected by primary aldosteronism.

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A client on telemetry has a pattern of uncontrolled atrial fibrillation with a rapid ventricular response. Based on this finding, the nurse anticipates assisting the physician with which treatment?

• Administer lidocaine, 75 mg intravenous push.
• Perform synchronized cardioversion.
• Defibrillate the client as soon as possible.
• Administer atropine, 0.4 mg intravenous push. - ANSWER- B. Perform

synchronized cardioversion.

Rationale:

With uncontrolled atrial fibrillation, the treatment of choice is synchronized cardioversion to convert the cardiac rhythm back to normal sinus rhythm. Option A is a medication used for ventricular dysrhythmias. Option C is not for a client with atrial fibrillation; it is reserved for clients with life-threatening dysrhythmias, such as ventricular fibrillation and unstable ventricular tachycardia. Option D is the drug of choice in symptomatic sinus bradycardia, not atrial fibrillation.

A client with hypertension has been receiving ramipril (Altace), 5 mg PO, daily for

• weeks and is scheduled to receive a dose at 0900. At 0830, the client's blood

pressure is 120/70 mm Hg. Which action should the nurse take?

• Administer the prescribed dose at the scheduled time.
• Hold the dose and contact the health care provider.
• Hold the dose and recheck the blood pressure in 1 hour.
• Check the health care provider's prescription to clarify the dose. - ANSWER-
• Administer the prescribed dose at the scheduled time

Rationale:

The client's blood pressure is within normal limits, indicating that the ramipril, an antihypertensive, is having the desired effect and should be administered. Options B and C would be appropriate if the client's blood pressure was excessively low 3 / 4

(<100 mm Hg systolic) or if the client were exhibiting signs of hypotension such as dizziness. This prescribed dose is within the normal dosage range, as defined by the manufacturer; therefore, option D is not necessary.

Which consideration is most important when the nurse is assigning a room for a client being admitted with progressive systemic sclerosis (scleroderma)?

• Provide a room that can be kept warm.
• Make sure that the room can be kept dark.
• Keep the client close to the nursing unit.

Select a room that is visible from the nurses' desk. - ANSWER- Provide a room that can be kept warm.

Rationale:

Abnormal blood flow in response to cold (Raynaud phenomenon) is precipitated in clients with scleroderma. Option B is not a significant factor. Stress can also precipitate the severe pain of the Raynaud phenomenon, so a quiet environment is preferred to option C, which is often very noisy. Option D is not necessary.

The nurse is assessing a male client with acute pancreatitis. Which finding requires the most immediate intervention by the nurse?

• The client's amylase level is three times higher than the normal level.

While the nurse is taking the client's blood pressure, he has a carpal spasm.

• On a 1 to 10 scale, the client tells the nurse that his epigastric pain is at 7.

The client states that he will continue to drink alcohol after going home. - ANSWER- While the nurse is taking the client's blood pressure, he has a carpal spasm.

Rationale:

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