HESI PN MED SURGE PROCTORED EXAM
VERSION 6
A nurse is caring for a client following a bone marrow biopsy. What information should the nurse include in the discharge education?• Teach the client to report excessive bleeding and evidence of infection to the provider.• Teach the client to check the biopsy site daily. Keep the dressing clean, dry, and intact.• If sutures are in place, remind the client to return in 7-10 days to have them removed.
What dietary education should the nurse provide to a client diagnosed with a hiatal hernia?• Avoid eating immediately prior to going to bed.• Avoid foods and beverages that decrease LES pressure (fatty and fried foods, chocolate, coffee, peppermint, spicy foods, tomatoes, citrus fruits, and alcohol).
A nurse is caring for a client with chronic gastritis. Provide three (3) dietary recommendations the nurse should include in client education?• Assist the client in identifying foods that are triggers.• Provide small, frequent meals and encourage the client to eat slowly.• Advise the client to avoid alcohol, caffeine, and foods that can cause gastric irritation.
A nurse is caring for a client who has been admitted with renal calculi. List three (3) interventions the nurse will take in the management of renal calculi.• Strain all urine to check for passage of the calculus and save the calculus for laboratory analysis.• Encourage increased oral intake to 3L/day unless contraindicated.• Encourage ambulation to promote passage of calculus.
Define the following types of urinary incontinence: Stress, urge, overflow, reflex, functional, total.• Stress: loss of small amounts of urine from increased abdominal pressure without bladder muscle contraction with laughing, sneezing, or lifting.• Urge: inability to stop urine flow long enough to reach the bathroom due to an overactive detrusor muscle with increased bladder pressure.• Overflow: urinary retention from bladder overdistention and frequent loss of small amounts of urine due to obstruction of the urinary outlet or an impaired detrusor muscle.• Reflex: involuntary loss of moderate amount of urine usually without warning due to hyperreflexia of the detrusor muscle, usually from spinal cord dysfunction. 1 / 2
• Functional: loss of urine due to factors that interfere with responding to the need to urinate, such as cognitive, mobility, and environmental barriers.• Total: unpredictable, involuntary loss of urine that generally does not respond to treatment.
A nurse is caring for a client with pneumonia. What are three (3) physical assessment findings that are noted with the development of pneumonia?• Pleuritic chest pain (sharp) • Sputum production (yellow-tinged) • Dull percussion over areas of consolidation • Decreased oxygen saturation levels A nurse is caring for a client scheduled for a liver biopsy. What nursing actions should be taken before, during and after this procedure?• Inform client that biopsy through venous route reduces the risk of hemorrhage.• Position the client to the right side for 1-2 hours to ensure hemostasis.• Monitor for hemorrhage (coagulation studies, frank bleeding).A nurse is caring for a client with colorectal cancer who is scheduled for a colectomy. What preoperative and post-operative education should be provided to this client?
• Preoperative:
- Educate the client regarding preoperative diet (clear liquids several days prior to
- Instruct the client to complete bowel prep with cathartics.
- Inform client of the administration of antibiotics (neomycin, metronidazole) to
surgery).
eradicate intestinal flora.
• Post-operative:
- Teach client regarding turning and deep breathing.
- Educate the client regarding the care of the incision, activity limits, and ostomy care,
- Provide information regarding management of postoperative complications,
if applicable.
including incontinence or sexual dysfunction (most likely to occur with AP resection).
A nurse is caring for a client with Cushing’s disease. Would the nurse expect this client’s plasma cortisol levels to be increased or decreased?
INCREASED
A client is diagnosed with Addisonian Crisis. List the lab values that will be affected by this disease process.
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