HESI MEDSURG Practice Questions

1.4 nursing interventions assessing the client to cough productively?: Deep breathing,
fluid intake increased to 3liters/day,
use humidifier to loosen secretions,
suction airway to stimulate coughing.

2.After kidney surgery, what are the primary assessments the nurse should take?: Respiratory status (
breathing is guarded because of pain);
circulatory status (the kidney is very vesicular,and excessive bleeding can occur);
pain assessment;
urinary assessment( most importantly, assessment of urinary output)

3.After the urinary catheter is removed in the TURD client, what are three priority nursing actions to
be taken?: Continued strict I&O,
continued observation For hematuria,
inform client that nursing and frequency may last for a week

4.And a client with Cirrhosis, It is imperative to prevent further bleeding and observer bleeding
tendencies. List six relevant nursing interventions: Avoid injections, you small needles for IV
insertion's,maintain pressure for five minutes on all venipuncture site, Use electric razor, you soft bristle
toothbrush for mouth care, check stores and emesis for occult blood

5.Bradycardia is defined as a heart rate below___________ BPM, tachycardia is defined as a heart rate
above_________BPM: 60 bpm, 100 bpm

6.Burn depth is a measure of severity, describe the characteristics of superficial partial thickness, deep
partial thickness in both the Chris Burns: Superficial partial-thickness: 1st degree pink or red(sunburn)
slight Edema, pain relieved by cooling
Deep partial thickness 2nd° destruction of epidermis and upper layer of dermis white or red very
Edematous sensitive to touch and cold air, hair does not pull out easily.
Call thickness 3rd° total destruction of dermis and epidermis reddened areas do not Blanche with
pressure not painful inelastic Wuoksi white skin to brown leathery eschar

7.Cite two nursing diagnosis for a client undergoing a hysterectomy for cervical cancer: Altered body
image related to uterine removal. Pain related to post operative incision

8.The client has purchased a three month supply of insulin. What bottle should be refrigerated: All but
the current bottle should be kept in the refrigerator

9.A client In renal failure asks why he is being given antacids. How should the nurse reply?: Calcium
and aluminum antacids bind phosphates and help keep phosphates from being absorbed into the
bloodstream, thereby preventing rising phosphate levels, and must be taken with meals

10.A client with a diagnosis of CVA presents with symptoms of aphasia, write hemiparesis, but no
memory or hearing deficit. In what hemisphere has the client suffered a lesion: Left

11.common symptoms of pneumonia?: Tachycardia

fevers with chills
productive cough
bronchial breath sounds

12.Complications of immobility include the potential for thrombus development. State three nursing
interventions to prevent thrombi: Frequent range of motion exercises, frequent every two hour
position change, and avoidance of positions that decrease Venous return

13.Define cerebrovascular accident: Hey disruption of blood supply to a part of the brain, which results
in sudden loss of brain function

14.Describe an autograft: Use of clients own skin for grafting

15.Describe fluid management and the emergent phase, acute phase, and rehabilitation phase of a
burn client clean it up: Stage one emergent phase replacement of fluid is titrated to urine output
Stage two acute phase maintain patent infusion site in case supplemental IV fluids are needed saline
lock is helpful may use Colloids
Stage III rehabilitation face and no extra fluids are needed but high protein drinks are recommended

16.Describe intermittent claudication: Pain related to Peripheral vascular disease occurring with
exercise an disappearing with rest

17.Describe nursing care for the client who is experiencing phantom pain after amputation: Be aware
that phantom pain is real and will eventually disappear and minister pain medication, phantom pain
response to medication

18.Describe pain management of the burn client: Administer pain medication, especially before
dressing wound, reinforce distraction/relaxation techniques and use a guided imagery

19.Describe post operative residual limb (stump),care, after amputationfor the first 48 hours: Elevate
residual limb first 24 hours, do not elevate residual lamp after 48 hours keep residual limb and extended
position and turn prone three times a day to prevent flexion contracture

20.Describe the method of collecting the trough and a peak blood levels and of anabiotic's: Collection
of trough draw blood 30 minutes before menstruation of anabiotic, Collection of peak draw blood 30
minutes after administration of antibiotics

21.Describe the method of extinguishing each of the following burns, thermal, chemical, and
electrical: Thermal remove clothing, immersed in tepid water. Chemical flush with water or Celine.
Electrical separate client from electrical source

22.Describe the nurses discharge instructions to a client with Venous Peripheral vascular
disease: Keep extremities elevated when sitting,
rest at first sign of pain,
keep extremities warm ( but do not use heating pad),
change positions often,
avoid crossing legs,
where unrestrictive clothing

23.Describe the physical appearance of clients who are cushingoid: Mood face, Obesity in trunk,
buffalo hump and back, muscle atrophy, and thin skin
24.Describe the preoperative nursing care for a client undergoing a laryngectomy?: Involve
family/client in manipulation of tracheostomy equipment before surgery,
plan acceptable communication method,
refer to speech pathologist,
discuss rehabilitation program

25.Describe the priority nursing care for a client who has had radiation implants: Do not permit
pregnant visitors or pregnant caretakers in room, discourage visits by small children, confined client to
room, nurse must wear radiation badge, nurse limits time in room, keep supplies and equipment within
clients reach

26.Describe three nursing interventions to help describe Edema post Mastectomy: Position arm on
operative side on pillow avoid blood pressure measurements injections or venipunctures an operative
arm encourage hand activity in use

27.Develop a teaching plan for a client taking antihypertensive medication: Explain how and when to
take medication,
reason for medication,
necessity of compliance,
need to follow up visits while on medication,
need for certain lab tests,
vital sign parameters while initiating therapy

28.Develop a teaching plan for a client taking nitroglycerin?: Take at first sign of anginal pain.
Take no more than three, five minutes apart.
Call for emergency attention if no relief in 10 minutes.

29.differentiate between acute renal failure and chronic renal failure?: Acute is often reversible,
abrupt deterioration of kidney function.
Chronic renal failure is irreversible,
slow deterioration of kidney function characterized by increase BUN and creatine,
eventually dialysis is required

30.Differentiate between essential and secondary hypertension: Essential has no known cause,
secondary hypertension develops in response to an identifiable mechanism

31.Differentiate between rheumatoid arthritis and degenerative joint disease in terms of joint
involvement: Rheumatoid arthritis occurs bilaterally. Degenerative joint disease occurs asymmetrically

32.Differentiate between the symptoms of left-sided cardiac failure in right sided cardiac failure: Left
side of failure results in pulmonary congestion due to back up of circulation in the left ventricle. Right
sided failure results in Peripheral congestion due to back up of circulation in the right ventricle.

33.During the oliguric phase of renal failure, protein should be severely restricted, what is the
rationale for this restriction?: Toxic metabolites that accumulate in the blood (urea,creatine) eventually
dialysis is required

34.Following transurethral resection of the prostate gland (TURP), hematuria should subside by what
postoperative day?: Fourth day
35.Four nursing interventions for the care of the blind person and for nursing interventions for the
care of a deaf person: Care of the blind client announce presence clearly, call by name, orient carefully
to surroundings, guide by walking in front of a client with his or her hand on your elbow. Care of the
deaf client reduce distraction before beginning conversation, look at and listen to client, give client for
attention if he or she is a lip reader, face client directly

36.Headache and vomiting or symptoms of mini disorders. What characteristics of the symptoms
would alert the nurse to refer a client to a neurologist: Headache that is more severe upon awakening
and vomiting not associated with nausea or symptoms of brain tumor

37.How do clients experiencing angina describe that pain?: Squeezing,

heavy,
burning,
radiates to left arm or shoulder,
transient or prolonged

38.How does the nurse prevent hypoxia during suctioning?: Deliver 100% of oxygen (hyperinflating)
before and after endotracheal suctioning

39.How do you hyperosmotic osmotic diuretics that are used to treat intercranial pressure act?: Do
you hydrate the brain and reduce cerebral Edema by holding water in the renal tubule's to prevent
reabsorption and by drawing fluid from the extravascular spaces into the plasma

40.How should the head of the bed be positioned for post craniotomy clients with infrarentorial
lesions: Supratentorial-elevated, infratentorial-flat

41.How should the nurse administer pancreatic enzymes: Give with meals or snacks powder forms
should be mixed with fruit juices

42.Identify 5 foot care interventions that should be taught to the client with diabetes: Check feet daily
and report any breaks, sores, or blisters to healthcare provider, where well fitting shoes, never go
barefoot or wear sandals, never personally remove corns or calluses, cut or file nail strength across,
wash feet daily with mild soap and warm water

43.Identify pain relief interventions for clients with arthritis: Warm, moist heat compresses, Baths,
showers, diversionary activities imaging, distractions, self hip gnosis, biofeedback, and medications

44.Identify the categories of drugs commonly used to treat arthritis: NSAIDs nonsteroidal anti-
inflammatory drugs of which salicylates are the cornerstone of treatment, and corticosteroids used
when arthritic symptoms are severe

45.Identify the peak action time of the following types of insulin, rapid acting regular insulin,
intermediate acting, long acting: Rapid acting regular insulin 1-4 hour. Intermediate acting insulin 6 to
12 hour, long acting insulin peakless

46.Identify two nursing interventions for a client with hemodialysis?: Do not take blood pressure or
preform venipuncture on the arm with the AV shunt, fistula, or graft assess site for thrill and bruit

47.Identify two sites that should be assessed for infection and immunosuppressed clients: No cavity
and genital area
48.Identify two types of hearing loss: Conductive transmission of sound an inner ear is blocked and
sensorineural damage to eighth cranial nerve

49.I neighbor calls the neighborhood nurse stating that he was not hard to the floor by his very hyper
active dog. He is wondering what symptoms would indicate the need to visit in emergency room.
What should the nurse tell him to do: Call his healthcare provider now and inform him or her of the fall.
Symptoms needing medical attention would include vertigo, confusion, or any subtle behavioral change,
headache, vomiting, ataxia imbalance, or seizure

50.In your own words describe the Glasgow coma scale: And obstructive assessment of the level of
consciousness based on a score of 3 to 15 with scores of seven or less indicator of coma

51.Is multiple sclerosis thought to occur because of an auto immune process: Yes

52.Is paralysis always a consequence of spinal cord injury: No

53.It's three problems associated with immobility: Venus thrombosis, urinary calculi, skin integrity
problems

54.I want to mission care of the burned clients: Provide a patent airway as into Bashan maybe
necessary. Determine baseline data. Initiate fluid and electrolyte therapy. And minister pain
medications. Determine the depth and extent of burnt. And minister tetanus toxoid. Insert NG tube

55.List five important teaching aspects for clients who are beginning corticosteroid therapy: Any
medication until weening plan has begun by physician; monitor serum potassium, glucose, and sodium
frequency; weigh daily and report gain of more than 5 pounds a week; Monitor blood pressure and
pulse closely; teach symptoms of Cushing's syndrome