HESI Med Surg 1 Final Exam Questions and

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HESI Med Surg 1 Final Exam Questions and Answers 2023 (Verified Answers)

• The nurse is assessing a client's laboratory values following administration

of chemotherapy. Which lab value leads the nurse to suspect that the client is experiencing tumor lysis syndrome (TLS)?

• Serum PTT of 10 seconds.
• Serum calcium of 5 mg/dL.
• Oxygen saturation of 90%.
• Hemoglobin of 10 g/dL ANS B - Tumor lysis syndrome (TLS) results in

hyperkalemia, hypocalcemia, hyperuricemia, and hyperphosphatemia. A serum calcium level of 5, which is low, is an indicator of possible tumor lysis syndrome.

• Which description of symptoms is characteristic of a client diagnosed with

trigeminal neuralgia (tic douloureux)?

• Tinnitus, vertigo, and hearing difficulties.
• Sudden, stabbing, severe pain over the lip and chin.
• Facial weakness and paralysis.
• Difficulty in chewing, talking, and swallowing. ANS B - Trigeminal neuralgia is

char- acterized by paroxysms of pain, similar to an electric shock, in the area innervated by one or more branches of the trigeminal nerve (5th cranial). Women are 1 / 4

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more often afflicted with this condition and generally occurs in clients over the age of 50 years old.

• Which discharge instruction is most important for a client after a kidney

transplant?

• Weigh weekly.
• Report symptoms of secondary Candidiasis.
• Use daily reminders to take immunosuppressants.
• Stop cigarette smoking. ANS C - After a renal transplantation, acute rejection

is a high risk for several months. The organ recipient will have to take immunosuppres- sive therapy for the rest of their lives, such as corticosteroids and azathioprine, to prevent organ transplant rejection. Discharge instructions include measures such as daily reminders to ensure the client takes these medications regularly to prevent organ rejection from occurring.

• The nurse is providing dietary instructions to a 68-year-old client who is at

high risk for development of coronary heart disease (CHD). Which information should the nurse include?

• Limit dietary selection of cholesterol to 300 mg per day.
• Increase intake of soluble fiber to 10 to 25 grams per day.
• Decrease plant stanols and sterols to less than 2 grams/day.
• Ensure saturated fat is less than 30% of total caloric intake. ANS B - To

reduce risk factors associated with coronary heart disease, the daily intake of soluble fiber 2 / 4

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should be increased to between 10 and 25 grams per day. According to the American Heart Association, soluble fibers helps reduce LDL cholesterol levels.

• Two days postoperative, a male client reports aching pain in his left leg. The

nurse assesses redness and warmth on the lower left calf. Which intervention would be most helpful to this client?

• Apply sequential compression devices (SCDs) bilaterally.
• Assess for a positive Homan's sign in each leg.
• Pad all bony prominences on the affected leg.
• Advise the client to remain in bed with the leg elevated. ANS D - For a

client exhibiting symptoms of deep vein thrombosis (DVT), a complication of immobility, the initial care includes bedrest and elevation of the extremity.

• A middle-aged male client with diabetes continues to eat an abundance of

foods that are high in sugar and fat. According to the Health Belief Model, which event is most likely to increase the client's willingness to become compliant with the prescribed diet?

• He visits his diabetic brother who just had surgery to amputate an infected

foot.

• He is provided with the most current information about the dangers of

untreated diabetes.

• He comments on the community service announcements about preventing

complications associated with diabetes.

• His wife expresses a sincere willingness to prepare meals that are within

his prescribed diet. ANS A - The loss of a limb due to diabetes by a family 3 / 4

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member should be the strongest event or "cue to action" and is most likely to increase the client's perceived seriousness of the disease.

• A 58-year-old client who has been post-menopausal for five years is con-

cerned about the risk for osteoporosis because her mother has the condition.Which information should the nurse offer?

• Osteoporosis is a progressive genetic disease with no effective treatment.
• Calcium loss from bones can be slowed by increasing calcium intake and

exercise.

• Estrogen replacement therapy should be started to prevent the progression

osteoporosis.

• Low-dose corticosteroid treatment effectively halts the course of osteo-

porosis. ANS B - Post-menopausal females are at risk for osteoporosis due to the cessation of estrogen secretion, but a regimen including calcium, vitamin D, and weight-bearing exercise can help prevent further bone loss.

• The nurse notes that the only ECG for a 55-year-old male client scheduled

for surgery in two hours is dated two years ago. The client reports that he has

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