Hesi Medical Surgical Adult health 1 and II

Question 1 of 60

Hesi Medical Surgical Adult health 1 and II. An older adult client who experienced a cerebrovascular accident (CVA) has difficulty with visual perception and eats only half of the food on the meal tray. The client’s family expresses concern about the client’s nutritional status. How should the nurse respond to the family’s concern?

A Demonstrate the use of visual scanning during meals to the client and family.
B Explain that weight loss will be reversed after the acute phase of the stroke has ended.
C Encourage the family to offer to feed the client when she does not eat her entire meal.
D Suggest that the family bring foods from home that the client enjoys eating.

Question 2 of 60

The nurse is developing a plan of care for a client with type 2 diabetes mellitus (DM). When providing teaching on lowering blood glucose levels and increasing serum high-density lipoprotein (HDL) levels, which instruction should the nurse include?

A Limit calories on days unable to exercise.
B Monthly appointments with the dietitian.
C Monitor blood glucose levels daily.
D Regular exercise with medical approval.

Question 3 of 60 (Case Study Question 1 of 6)

The nurse is performing the morning assessment with the client. Highlight the assessment findings that require follow-up by the nurse.

The client is postoperative below-the-knee amputation right leg day 3. He is sitting up with his left leg and right leg residual limb hanging off the bed. There is client-controlled analgesia (PCA) of morphine on demand in the left hand area; there is no redness at the site with 0.9% sodium chloride infusing at 50 mL an hour. Hesi Medical Surgical Adult health 1 and II

General: Alert, oriented to person, place, and time.
Eyes: Pupils round, reactive to light and accommodation (PERRLA).
Lungs: Lungs clear all lobes.
Heart: Telemetry monitor displaying sinus rhythm (SR).
Abdomen: Abdomen soft, bowel sounds in all 4 quadrants. Denies pain with urination and describes urine as light yellow.
Right leg: Right leg incision is open to air, skin to the area is cool to touch, and edema noted along the incision. Sutures intact, no redness noted, popliteal pulses strong bilaterally and wound drain with approximately 100 mL red drainage present right leg. Reports pain is a 2 on a 0 to 10 scale, right residual limb area.
Left leg: 2+ pedal pulse, loss of hair on the lower leg, skin is dry, scaly, cool to touch, thickened toenails noted, and capillary refill is greater than 4 seconds.

Question 4 of 60 (Case Study Question 2 of 6)

Select the 3 assessment findings that indicate ineffective peripheral tissue perfusion for this client.

A Edema
B Blood pressure
C Capillary refill
D Oxygen saturation
E Pale skin

Question 5 of 60 (Case Study Question 3 of 6)

The client is at risk for ________ and ________. Hesi Medical Surgical Adult health 1 and II

A contractures
B infection
C deep vein thrombosis
D neuroma
E pneumonia Hesi Medical Surgical Adult health 1 and II

Question 6 of 60 (Case Study Question 4 of 6)

Physical therapy is working with client. New prescriptions are received and implemented. For each action, click to indicate whether the actions are indicated or contraindicated for postoperative amputation. Each column must have at least one response option selected.

Action	Indicated	Contraindicated
Collaborative care	X
Strengthening exercises	X
Instructions on equipment	X
Assessment for grieving	X
Conditioning exercises of residual limb	X
Obtaining soft mattress overlay		X

Question 7 of 60 (Case Study Question 5 of 6)

Which item(s) should the nurse teach the client? Select all that apply. Hesi Medical Surgical Adult health 1 and II

A Fine motor skills
B Alternating positions
C Use of equipment
D Therapeutic coping
E Prevention of skin breakdown
F Soaking baths for pain management
G Keeping a positive outlook
H Circular wrapping of the residual limb

Question 8 of 60 (Case Study Question 6 of 6)

For each client activity, click to indicate whether the activity shows positive or negative health promotion postamputation due to extensive peripheral vascular disease. Each row must have one option response selected.

Client Activity	Positive	Negative
Avoids looking at residual limb		X
Asks questions about self care	X
Inquires about blood pressure	X
Requests nurse to perform wound care		X
Turns side to side	X
Executes pull ups on trapeze bar	X

Question 9 of 60

An older adult client with long-term type 2 diabetes mellitus (DM) is seen in the clinic for a routine health assessment. Which assessment(s) would the nurse complete to determine if a patient with type 2 diabetes mellitus (DM) is experiencing long-term complications? Select all that apply.

A. Signs of respiratory tract infection
B. Visual acuity
C. Skin condition of lower extremities
D. Serum creatinine and blood urea nitrogen (BUN)
E. Sensation in feet and legs

Question 11 of 60

A client with a gram-positive bacterial skin infection is receiving daptomycin 500 mg IV every 24 hours. The pharmacy delivers a secondary infusion of 0.9% sodium chloride with daptomycin 500 mg/100 mL to be infused in 30 minutes. How many mL/hour should the nurse program the infusion pump? (Enter the numerical value only.)

Answer: 200 mL/hr

Question 12 of 60

Following a transurethral resection of the prostate (TURP), a client is discharged from the hospital with an indwelling urinary catheter. Which instruction is most important for the nurse to include in the discharge teaching plan?

A Drink 3 liters of water each day.
B Clamp the catheter when taking a shower.
C Avoid driving a car for 2 weeks.
D Eliminate all spicy foods from your diet

Question 13 of 60 (1 of 6)

A 57-year-old male presents to the Emergency Department with a history of hypertension, obesity, a 20-year smoking history (quit 5 years ago), and a current prescription for metoprolol succinate. He is seeking treatment for chest pain that began while mowing his lawn two hours prior to admission.

Case Summary

Chief Complaint: Severe chest pain described as pressure and tightness, rated at a 7/10 on the pain scale.
Current Status: The pain has become progressively worse and is unrelieved by rest.
Physical Findings:
- Neurological: The client is alert and oriented but appears agitated.
- Cardiovascular: He exhibits a rapid, regular heart rhythm with a heart rate of 121 beats/minute. His blood pressure is elevated at 162/98 mm Hg.
- Respiratory: His breathing is rapid and shallow at 21 breaths/minute, with an oxygen saturation of 92% on room air.
- Other: His BMI is 32 kg/m², classifying him as obese.

A history is completed by the healthcare provider and a rapid assessment and vital signs are completed by the nurse. Click to highlight the findings that require follow up.

Agitated
Reported chest pain described as pressure and tightness that is unrelieved with rest
Rapid regular rhythm
Rapid and shallow breaths
Reported 7 on a 0 to 10 scale, tightness and pressure in chest

Question 14 of 60 (2 of 6)

The healthcare provider places prescriptions for further diagnostics. Click to indicate if the listed symptoms are consistent with angina, myocardial infarction, or both. Each column must have at least one response option selected. Hesi Medical Surgical Adult health 1 and II

Symptoms	Angina	Myocardial Infarction
Chest pain radiating down arm	X	X
Feelings of fear		X
Pain relieved by nitroglycerin	X
Epigastric distress		X
Pain only relieved by opioids		X
Occurring without cause		X

Question 15 of 60 (3 of 6)

Initial testing is complete, and the nurse is reviewing the results. Choose the most likely options for the information missing from the statement by selecting from the lists of options provided.

The nurse determines that the client has myocardial infarction as evidenced by ST depression on electrocardiogram and normal troponin level.

Question 16 of 60 (4 of 6)

The client was given oxygen, sublingual nitroglycerin, and aspirin. After one dose of nitroglycerin, the client’s pain decreased to a reported 2 on a 0 to 10 scale with squeezing pain. The client was admitted for observation and percutaneous coronary intervention (PCI) to be completed later within the evening. The client asks the nurse to explain why a PCI is being completed.

Drag and drop word choices to complete the sentence.

If healthcare providers see a narrowed heart vessel while performing a percutaneous coronary intervention (PCI), they may perform a balloon angioplasty to compress the plaque against the vessel wall and hold it there with a stent, which will lessen vasospasms and pain.

Question 17 of 60 (5 of 6)

The percutaneous coronary intervention was completed, and the client tolerated the procedure well. The healthcare provider has discontinued the client’s home medication prescription for metoprolol and prescribed the client lisinopril, aspirin, amlodipine, and nitroglycerin.

For each medication, choose the drug classification and medication action.

Medication	Drug Classification	Medication Action
Amlodipine	Calcium channel blocker	Lessens contractility of smooth muscle
Aspirin	Antiplatelet	Inhibits cyclooxygenase and thromboxane $A_{2}$
Lisinopril	Angiotensin-converting enzyme inhibitor	Prevents conversion of angiotensin I to angiotensin II
Nitroglycerin	Nitrate	Enhances oxygen uptake into coronary arteries

Question 18 of 60

The nurse has provided discharge teaching to the client to manage his chest pain at home. Which 2 statements from the client should the nurse recognize as a need for further education?

A I will chew my nitroglycerin tabs as soon as pain begins.
B I will keep my nitroglycerin tablets with me all the time.
C I will wait 5 minutes after taking my nitroglycerin to see if the pain improves.
D I will lie down or sit if I start to feel any chest discomfort.
E I will wear a medication alert bracelet to indicate my history of heart problems.
F I will take the nitroglycerin 1 or 2 more times 10 minutes apart if pain does not get better.
G I will call 911 if there is no improvement in my chest pain after taking nitroglycerin.

Question 19 of 60

A client with a history of asthma reports having episodes of bronchoconstriction and increased mucus production while exercising. Which action should the nurse implement?

A Determine if the client is using an inhaler before exercising.
B Teach client to use pursed lip breathing when episodes occur.
C Assess client for signs and symptoms of upper airway infection.
D Review the client’s routine asthma management prescriptions. Hesi Medical Surgical Adult health 1 and II

Question 20 of 60

The nurse observes that a client with Parkinson’s disease (PD) has a mask like face. Which follow up assessment is most important for the nurse to implement?

A Determine ability to chew and swallow.
B Observe appearance of oral mucosa.
C Note frequency of drooling.
D Assess patterns of speech.

Question 21 of 60

The nurse is obtaining the admission history for a client with suspected peptic ulcer disease (PUD). Which subjective data reported by the client supports this medical diagnosis?

A Frequent use of chewable and liquid antacids for indigestion.
B Severe abdominal cramps and diarrhea after eating spicy foods.
C Upper midabdominal pain described as gnawing and burning.
D Marked loss of weight and appetite over the last 3 or 4 months.

Question 22 of 60

Two hours before a client’s scheduled surgery, the nurse is completing the preoperative checklist. Which information requires immediate action by the nurse?

Reference Range: Potassium [3.5 to 5 mEq/L (3.5 to 5 mmol/L)]

A Preoperative chest x-ray report is not available.
B Client’s pulse oximeter reading is 96%.
C Surgical consent form is not signed.
D Preoperative serum potassium level is 2.8 mEq/L (2.8 mmol/L).

Question 24 of 60

Two days after a nephrectomy, the client reports abdominal pressure and nausea. Which assessment should the nurse implement?

A Measure hourly urine output.
B Palpate the abdomen.
C Auscultate bowels sounds.
D Ambulate client in hallway.

Question 36 of 60

The nurse is teaching a client with cancer about skin care for the portal site receiving external beam radiation. Which client action about skin care indicates a need for further teaching? Hesi Medical Surgical Adult health 1 and II

A Dries the area with patting motions after taking a shower.
B Applies prescribed lotions to the radiation site.
C Washes the radiation site with antibacterial soap and water.
D Wears clothing to cover the radiation site.

Question 37 of 60

A client is to receive progesterone 10 mg IM daily. The medication is labeled “Progesterone 50 mg/mL.” How many mL should the nurse administer? (Enter numerical value only. If rounding is required, round to the nearest tenth.)

0.2

Question 38 of 60

One hour after major abdominal surgery, a client in the post-anesthesia care unit (PACU) has a blood pressure (BP) of 136/80 mm Hg. Fifteen minutes later, it is 114/72 mm Hg. Which action should the nurse take first?

A Review the client’s baseline BP trends.
B Encourage the client to breathe deeply.
C Check the abdominal surgical dressing.
D Increase frequency of BP assessments

Question 39 of 60

While performing a neurovascular assessment distal to a client’s fracture site, the nurse determines that the client’s pulse is present, regular, and full force. Which nursing action should be taken next?

A Observe the color of the extremity.
B Document the neurovascular assessment as normal.
C Notify the healthcare provider of assessment finding.
D Discontinue elevating the client’s affected extremity.

Question 40 of 60

A client with urolithiasis is preparing for discharge after lithotripsy. Which intervention should the nurse include in the client’s postoperative discharge instructions?

A Use incentive spirometer.
B Restrict physical activities.
C Report when hematuria becomes pink tinged.
D Monitor urinary stream for decrease in output.

Question 41 of 60

A client with gouty arthritis reports tenderness and swelling of the right ankle and great toe. The nurse observes the area of inflammation extends above the ankle area. The client receives prescriptions for colchicine and indomethacin. Which instruction should the nurse include in the discharge teaching?

A Substitute natural fruit juices for carbonated drinks.
B Massage joints to relax muscles and decrease pain.
C Limit use of mobility equipment to avoid muscle atrophy.
D Return for periodic liver function studies.

Question 42 of 60

A male client who had abdominal surgery 5 days ago, and hospitalized because of a surgical wound infection, tells the nurse that he feels like his insides just spilled out when he coughed. Which action should the nurse take first? Hesi Medical Surgical Adult health 1 and II

A Visualize the abdominal incision.
B Obtain sterile towels soaked in saline.
C Notify the healthcare provider.
D Assure the client that such feelings occur with wound infections.

Question 43 of 60

Based on the provided case study data for the 68-year-old female with ESRD and hyperkalemia ($5.9 \text{ mEq/L}$), the appropriate nursing actions to implement at this time are:

D Call the healthcare provider to notify changes in vital signs
F Clarify order of lisinopril with the healthcare provider
H Perform a focus cardiovascular assessment
I Perform a 12-lead electrocardiogram (ECG) STAT
J Administer calcium gluconate STAT

Question 44 of 60

A client with chronic syndrome of inappropriate antidiuretic hormone (SIADH) reports to the nurse of being constantly thirsty. Which action should the nurse take?

A Withhold the next diuretic dose until contacting the healthcare provider.
B Provide the client with additional oral fluids of her preference.
C Encourage the client to use hard candy frequently to help relieve thirst.
D Measure the client’s capillary glucose reading at regular intervals.

Question 48 of 60

A client with pernicious anemia takes supplemental folate and self-administers monthly vitamin B12 injections. The client reports feeling increasingly fatigued. Which laboratory value should the nurse review?

A Complete blood count.
B Serum electrolytes.
C Liver enzymes.
D Platelet count.

Question 49 of 60

When explaining dietary guidelines to a client with acute glomerulonephritis (AGN), which instruction should the nurse include in the dietary teaching?

A Eat high-potassium foods.
B Restrict sodium intake.
C Avoid foods high in carbohydrates.
D Select a protein-rich food daily.

Question 50 of 60

Which group of foods is best for the nurse to recommend for clients with a strong family history of colon and rectal cancers?

A Oatmeal, raisins, and fruit with skin.
B Lean beef, salads, and baked potatoes.
C Potatoes, low-fat breads, and applesauce.
D Chicken, rice, and wheat products.

Question 51 of 60

A client with edema receives a prescription for a one time dose of furosemide 20 mg IV. The medication is available in a 10 mg/mL vial. How many mL should the nurse administer? (Enter numerical value only.) Hesi Medical Surgical Adult health 1 and II

Question 52 of 60

Which findings during the admission assessment should the nurse document that are related to a client diagnosed with Cushing’s syndrome?

A Central type obesity, with thin extremities.
B Husky voice and troubled by hoarseness.
C Visible swelling of the neck, with no pain.
D Warm, soft, moist, salmon colored skin.

Question 53 of 60

Based on the provided case study data for the 35-year-old female legal secretary, here is the completion of the diagram:

Potential Condition:
- Rheumatoid arthritis
Actions to Take:
- Educate on disease process and management
- Consult dietician for nutrition and weight loss
Parameters to Monitor:
- Pain
- Physical mobility

Question 54 of 60

A client with cholelithiasis is admitted with jaundice due to obstruction of the common bile duct. Which finding is most important for the nurse to report to the healthcare provider?

A Radiating, sharp pain in right shoulder.
B Distended, hard, and rigid abdomen.
C Clay colored stool.
D Bile stained emesis.

Question 55 of 60

The nurse is administering the second unit of whole blood to an older adult client who was admitted yesterday with gastrointestinal (GI) bleeding. Which parameters should the nurse monitor that indicate fluid overload?

A Thready pulse, hypotension, and chest or back pain.
B Chills, fever, and tachycardia.
C Urticaria, itching, and wheezing.
D Bounding pulse, hypertension, and distended neck veins.

Question 56 of 60

The parent of an adolescent tells the clinic nurse, “My child has athlete’s feet. I have been applying triple antibiotic ointment for two days, but there has been no improvement.” Which instruction should the nurse provide?

A Applying too much ointment can deter its effectiveness. Apply a thin layer to prevent maceration.
B Continue using the ointment for a full week, even after the symptoms disappear.
C Stop using the ointment and encourage complete drying of feet and wearing clean socks.

Question 57 of 60

When caring for a client with a cervical spinal cord injury, which intervention is the most important for the nurse to implement?

A Assess the extremity reflexes.
B Logroll to change positions.
C Obtain hourly neurological assessments.
D Immobilize the head in anatomical alignment.

Question 58 of 60

A client with eczema is applying 10% urea cream onto the affected skin areas. Which finding reflects the expected therapeutic response?

A Hydration of affected dry skin areas.
B Reduced pain in eczematous areas.
C Decreased weeping of ulcerations in affected areas.
D Healing with a return to normal skin appearance.

Question 59 of 60

A client arrives to the emergency department (ED) following a motor vehicle collision. The nurse observes the client experiencing increasing dyspnea and notes absent breath sounds on the left side. Which procedure should the nurse prepare the client for?

A Bronchoscopy.
B Chest tube insertion.
C Pulmonary function test.
D Endotracheal intubation.

Question 60 of 60

Which client has the highest risk for developing skin cancer?

A A 70-year-old fair-skinned client who works as a secretary.
B A 65-year-old fair-skinned client who is a construction worker.
C A 25-year-old dark-skinned client whose mother had skin cancer.
D A 16-year-old dark-skinned client who tans in tanning beds once a week.

Hesi Medical Surgical Adult health 1 and II

Isaura K

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