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HESI RN MEDICAL SURGICAL EXAM 2024 LATEST/ RN
MED SURG HESI TEST BANK/ REAL EXAM QUESTIONS
AND VERIFIED ANSWERS WITH RATIONALES (100%
CORRECT ANSWERS) GRADED A+
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. - Correct Answer - B)
Increase intake of soluble fiber to 10 to 25 grams per day.
Rationale: To reduce risk factors associated with coronary heart disease, the daily intake of soluble fiber (B) should be increased to between 10 and 25 gm. Cholesterol intake (A) should be limited to 180 mg/day or less. Intake of plant stanols and sterols is recommended at 2 g/day (C). Saturated fat (D) intake should be limited to 7% of total daily calories.
A splint is prescribed for nighttime use by a client with rheumatoid arthritis. Which statement by the nurse provides the most accurate explanation for use of the splints?
- Prevention of deformities.
- Avoidance of joint trauma.
- Relief of joint inflammation.
- Improvement in joint strength. - Correct Answer - A) Prevention of deformities. 1 / 4
pg. 2 Rationale: Splints may be used at night by clients with rheumatoid arthritis to prevent deformities (A) caused by muscle spasms and contractures. Splints are not used for (B).(C) is usually treated with medications, particularly those classified as non-steroidal antiinflammatory drugs (NSAIDs). For (D), a prescribed exercise program is indicated.
A 32-year-old female client complains of severe abdominal pain each month before her menstrual period, painful intercourse, and painful defecation. Which additional history should the nurse obtain that is consistent with the client's complaints?
- Frequent urinary tract infections.
- Inability to get pregnant.
- Premenstrual syndrome.
- Chronic use of laxatives. - Correct Answer - B) Inability to get pregnant.
Rationale: Dysmenorrhea, dyspareunia, and difficulty or painful defecation are common symptoms of endometriosis, which is the abnormal displacement of endometrial tissue in the dependent areas of the pelvic peritoneum. A history of infertility (B) is another common finding associated with endometriosis. Although (A, C, and D) are common, nonspecific gynecological complaints, the most common complaints of the client with endometriosis are pain and infertility.
A client with a 16-year history of diabetes mellitus is having renal function tests because of recent fatigue, weakness, elevated blood urea nitrogen, and serum creatinine levels.Which finding should the nurse conclude as an early symptom of renal insufficiency?
- Dyspnea.
- Nocturia.
- Confusion.
- Stomatitis. - Correct Answer - B) Nocturia.
Rationale: As the glomerular filtration rate decreases in early renal insufficiency, metabolic waste products, including urea, creatinine, and other substances, such phenols, hormones, electrolytes, accumulate in the blood. In the early stage of renal insufficiency, polyuria results from the inability of the kidneys to concentrate urine and contribute to nocturia (B). (A, C, and D) are more common in the later stages of renal failure. 2 / 4
pg. 3 A client with heart disease is on a continuous telemetry monitor and has developed sinus bradycardia. In determining the possible cause of the bradycardia, the nurse assesses the client's medication record. Which medication is most likely the cause of the bradycardia?
- Propanolol (Inderal).
- Captopril (Capoten).
- Furosemide (Lasix).
- Dobutamine (Dobutrex). - Correct Answer - A) Propanolol (Inderal).
Rationale: Inderal (A) is a beta adrenergic blocking agent, which causes decreased heart rate and decreased contractility. Neither (B), an ACE inhibitor, nor (C), a loop diuretic, causes bradycardia. (D) is a sympathomimetic, direct acting cardiac stimulant, which would increase the heart rate.
A client has been taking oral corticosteroids for the past five days because of seasonal allergies. Which assessment finding is of most concern to the nurse?
- White blood count of 10,000 mm3.
- Serum glucose of 115 mg/dl.
- Purulent sputum.
- Excessive hunger. - Correct Answer - C) Purulent sputum.
Rationale: Steroids cause immunosuppression, and a purulent sputum (C) is an
indication of infection, so this symptom is of greatest concern. Oral steroids may increase (A) and often cause (D). (B) may remain normal, borderline, or increase while taking oral steroids.
A female client receiving IV vasopressin (Pitressin) for esophageal varice rupture reports to the nurse that she feels substernal tightness and pressure across her chest.Which PRN protocol should the nurse initiate?
- Start an IV nitroglycerin infusion. 3 / 4
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- Nasogastric lavage with cool saline.
- Increase the vasopressin infusion.
- Prepare for endotracheal intubation. - Correct Answer - A) Start an IV nitroglycerin
infusion.
Rationale: Vasopressin is used to promote vasoconstriction, thereby reducing bleeding.Vasoconstriction of the coronary arteries can lead to angina and myocardial infarction, and should be counteracted by IV nitroglycerin per prescribed protocol (A). (B) will not resolve the cardiac problem. (C) will worsen the problem. Endotracheal intubation may be needed if respiratory distress occurs (D).
The nurse hears short, high-pitched sounds just before the end of inspiration in the right and left lower lobes when auscultating a client's lungs. How should this finding be recorded?
- Inspiratory wheezes in both lungs.
- Crackles in the right and left lower lobes.
- Abnormal lung sounds in the bases of both lungs.
- Pleural friction rub in the right and left lower lobes. - Correct Answer - B) Crackles in
the right and left lower lobes.
Rationale: Fine crackles (B) are short, high-pitched sounds heard just before the end of inspiration that are the result of rapid equalization of pressure when collapsed alveoli or terminal bronchioles suddenly snap open. Wheezing (A) is a continuous high-pitched squeaking or musical sound caused by rapid vibration of bronchial walls that are first evident on expiration and may be audible. Although (C) describes an adventitious lung sound, this documentation is vague. (D) is a creaking or grating sound from roughened, inflamed surfaces of the pleura rubbing together heard during inspiration, expiration, and with no change during coughing.
A client asks the nurse about the purpose of beginning chemotherapy (CT) because the tumor is still very small. Which information supports the explanation that the nurse should provide?
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