NURS MISCMED SURG 2019 hesi A&B.docx

MED SURG

What instruction should the nurse include in the discharge teaching plan of a client who had a cataract extraction today?  

a.                  Sexual activities may be resumed upon return home

b.                  Light housekeeping is permitted but avoid heavy lifting

c.                  Use a metal eye shield on operative eye during the day

d.                 Administer eye ointment before applying eye drops 

ANS:B  

3 of 55 

A male adult comes to the urgent care clinic 5 days after being diagnose with influenza. He is short of breath, febrile, and coughing green colored sputum. Which intervention should the nurse implement first?

a.                  Obtain a sputum sample for culture

b.                  Check his oxygen saturation level

c.                  Administer an oral antipyretic

d.                 Auscultate bilateral lung sound  

ANS:A  

4 0f 55 

An elder male client tells the nurse that he is loosing sleep because he has to get up several times at night to go to the bathroom that he has trouble starting his urinary stream and that he does not feel like his bladder is ever completely empty. Which intervention should the nurse implement?  

a.                  collect a urine specimen for culture analysis

b.                  obtain a fingerstick blood glucose level

c.                  palpate the bladder above the symphysis pubis

d.                 review the client fluid intake   

ANS: C  

5 of 55

An adult client is admitted with diabetic ketoacidosis (DKA) and a urinary tract infection (UTI) Prescriptions for intravenous antibiotics and insulin infusion are initiated. Which serum laboratory value warrants the most immediate intervention by the nurse?  

a.                  blood ph of 7.30

b.                  glucose of 350 mg /dl

c.                  white blood cell count of 15000mm

d.                 potassium of 2.5 meq/l  

ANS: D

 6 of 55 

A client with sickle cell anemia develops a fever during the last hour of administration of a unit of packed red blood cell. When notifying the healthcare provider what information should the nurse provide first using the SBAR communication process? 

a.                  explain specific reason for urgent notification

b.                  preface the report by stating the clients name and admitting diagnosis

c.                  communicate the pre-transfusion temperatures

d.                 optain prn prescription for acetaminophen for fever 101f 

ANS: A

7 of 55 

An adult male client is admitted for pneumocystis carinil pneumonia (PCP) secondary to aids. While hospitalize he receives IV pentamidine isethionate therapy. In preparing this client for discharge what important aspect regarding his medication therapy should the nurse explain? 

a.                  AZT therapy must be stopped when IV aerosol pentamine is being used.

b.                  IV pentamine will be given until oral pentamine can be tolerated 

c.                  It will be necessary to continue prophylactic doses of IV or aerosol  pentamine every month

d.                 Iv pentamine may offer protection to others aids related conditions such as kaposis sarcoma 

ANS:C 

8 of 55 

A client subjective data includes dysuria, urgency, and urinary frequency. What action should the nurse implement next? 

a)      a.collect a clean catch specimen

b)      b.palpate the suprapubic region

c)      c.instruct to wipe from front to back

d)      d.inquire about recent sexual activity 

ANS: A

 9 of 55 

A client tells the nurse that her biopsy results indicate that the cancer cells are well differentiated How should the nurse respond? 

a)      offer the client reassurance that this information indicates that the clients cancer cells are benign

b)      explain that these tissue cells often respond more effectively to radiation than to chemotherapy

c)      ask the client in the healthcare provider has giving her any information about the classification of her cancer

d)      help the client make plans to begin inmediate treatment since her cancer is likely to spread quickly 

ANS: C 

10 of 55 

A client with a chronic kidney disease is treated on hemodialysis. During the 1 treatment clients blood pressure drops from 150/90 to 80/30 Which action should the nurse take first? 

a.                  monitor bp q45 minutes

b.                  lower the head of the chair and elevate feet

c.                  stop dialysis treatment

d.                 administer 5%albumin IV 

ANS: C