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HESI Med Surg 1 Final Exam Study Guide Questions and Answers 2023 (Verified Answers)
- Four days after abdominal surgery a client has not passed flatus and
there are no bowel sounds. Paralytic ileus is suspected. What does the nurse conclude is the most likely cause of the ileus ANS Impaired neural functioning
Paralytic ileus occurs when neurologic impulses are diminished as a result of anesthesia, infection, or surgery. Interference in blood supply will result in necrosis of the bowel. Perforation of the bowel will result in pain and peritonitis. Obstruction of the bowel initially will cause increased peristalsis and bowel sounds.
- A nurse is caring for a client with cirrhosis of the liver. Which laboratory test
should the nurse monitor that, when abnormal, might identify a client who may benefit from neomycin enemas ANS Ammonia level
Increased ammonia levels indicate that the liver is unable to detoxify protein by-prod- ucts. Neomycin reduces the amount of ammonia-forming bacteria in the intestines.Culture and sensitivity testing is unnecessary; cirrhosis is an inflammatory, not infectious, process. Increased white blood cell count may indicate infection; however, this will have no relationship to the need for neomycin enemas. ALT, also called serum glutamic-pyruvic transaminase (SGPT), assesses for liver disease but has no relationship to the need for neomycin enemas. 1 / 3
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- Name the characteristics that support chronic persistent stage of Lyme
disease: Arthritis
Chronic fatigue
R: Systemic infectious disease caused by Spirochete Borrelia Burgdorferi.
4. symptoms of Prodomal stage w/inhalation of anthrax.: Fatigue
Mild chest pain dry cough
R:The manifestations include low-grade fever; fatigue; mild chest pain; and a dry, harsh cough. Inhalation anthrax is a two-stage illness, prodromal and fulminant. The prodromal stage is the early stage and is difficult to distinguish from influenza or pneumonia. A special feature of inhalation anthrax is that it is not accompanied by upper respiratory manifestations of sore throat or rhinitis.
- Which are examples of a type IV hypersensitivity reaction ANS Sarcoidosis
and poison ivy
In type IV hypersensitivity, the inflammation is caused by a reaction of sensitized T cells with the antigen and the resultant activation of macrophages due to lymphokine release. Myasthenia gravis is an example of a type II or cytotoxic hypersensitivity 2 / 3
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reaction. Rheumatoid arthritis and systemic lupus erythematosus are examples of type III immune complex-mediated reactions.
- A client was diagnosed with ulcerative colitis. Two months after the diag-
nosis, the client is readmitted for an exacerbation of the illness. The client is weak, thin, and irritable. The client states, "I am now ready for surgery to create an ileostomy." Which nursing intervention will best meet the client's priority need ANS Replace the Pt's fluid and electrolytes R:Fluid and electrolyte replacement is a life-saving strategy; it must be done before surgery is performed. Helping the client regain former body weight is not the priority at this time. The client is neither physically nor cognitively ready to learn the psychomotor skill of how to manage an ileostomy. The client is not demonstrating a readiness for contact with other persons with ileostomies at this time
- A nurse discovers the condition depicted in the image upon assessment of
a client. Which organism may lead to this condition ANS Human herpes virus- 8
The client in the image has Kaposi's sarcoma (KS). The risk for KS appears to be related to co-infection with human herpes virus-8. KS is the most common acquired immune deficiency syndrome-related malignancy. Cytomegalovirus may lead to retinitis, encephalitis, pneumonitis, adrenalitis, hepatitis, and disseminated infection. Varicella-zoster virus causes chicken pox and shingles. Human papilloma virus causes multiple types of malignancies such as cervical and anal cancer.
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