1 / 34
HESI Med Surg 1 Exam Questions and Answers 2023 (Verified Answers)
- The nurse observes ventricular fibrillation on telemetry and, on entering the
client's bathroom, finds the client unconscious on the floor. Which interven- tion should the nurse implement first?A.Administer an antidysrhythmic medication.B.Start cardiopulmonary resuscitation.C.Defibrillate the client at 200 J.D.Assess the client's pulse oximetry.
ANS : B. Start cardiopulmonary
resuscitation.
Rationale:
Ventricular fibrillation is a life-threatening dysrhythmia, and CPR should be started immediately (B). (A and C) are appropriate, but CPR is the priority action. The client is dying, and (D) does not address the seriousness of this situation.
- / 4
2 / 34
- The nurse assesses a client who has been prescribed furosemide (Lasix)
for cardiac disease. Which electrocardiographic change would be a concern for a client taking a diuretic?A.Tall, spiked T waves B.A prolonged QT interval C.A widening QRS complex D.Presence of a U wave
ANS : D . Presence of a U
wave
Rationale:
A U wave (D) is a positive deflection following the T wave and is often present with hypokalemia (low potassium level). (A, B, and C) are all signs of hyperkalemia.
- A 43-year-old homeless, malnourished female client with a history of alco-
holism is transferred to the ICU. She is placed on telemetry, and the rhythm strip shown is obtained. The nurse palpates a heart rate of 160 beats/min, and the client's blood pressure is 90/54 mm Hg. Based on these findings, which IV medication should the nurse administer?
A. 2 / 4
3 / 34
Amiodarone (Cordarone) B.Magnesium sulfate C.Lidocaine (Xylocaine) D.Procainamide (Pronestyl)
ANS : B. Magnesium sulfate
Rationale:
Because the client has chronic alcoholism, she is likely to have hypomagnesemia.(B) is the recommended drug for torsades de pointes, which is a form of polymorphic ventricular tachycardia (VT) usually associated with a prolonged QT interval that occurs with hypomagnesemia. (A and D) increase the QT interval, which can cause the torsades to worsen. (C) is the antiarrhythmic of choice in most cases of drug-induced monomorphic VT, not torsades.
- When developing a discharge teaching plan for a client after the insertion
of a permanent pacemaker, the nurse writes a goal of "The client will verbalize symptoms of pacemaker failure." Which behavior indicates that the goal has been met?A.The client demonstrates the procedures to change the rate of the pacemaker using a magnet.B.The client carries a card in his wallet stating the type and serial number of the 3 / 4
4 / 34
pacemaker.C.The client tells the nurse that it is important to report redness and tenderness at the insertion site.D.The client states that changes in the pulse and feelings of dizziness are
significant changes. ANS : D .
The client states that changes in the pulse and feelings of dizziness are significant changes.
Rationale:
Changes in pulse rate and/or rhythm may indicate pacer failure. Feelings of dizziness may be caused by a decreased heart rate, leading to decreased cardiac output (D). The rate of a pacemaker is not changed by a client, although the client may
- / 4