HESI Med Surg Final Exam - Questions with Verified Answers A client with Addison's disease started taking hydrocortisone in a divided daily dose last
... [Show More] week. It is most important for the nurse to monitor which serum laboratory value? A. Osmolarity B. Glucose C. Albumin D. Platelets A client with acquired immunodeficiency syndrome (AIDS) has impaired gas exchange from a respiratory infection. Which assessment finding warrants immediate intervention by the nurse? A. Elevated temperature B. Generalized weakness C. Diminished lung sounds D. Pain when swallowing An older male client tells the nurse that he is losing 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. Review the client's fluid intake prior to bedtime C. Palpate the bladder above the symphysis pubis D. Obtain a fingerstick blood glucose level Fluids are restricted to 1,500 ml daily for a male client with acute kidney injury (AKI). He is frustrated and complaining of constant thirst, and the nurse discovers that the family is providing the client with additional fluids. Which intervention should the nurse implement? A. Remove all sources of liquids from the client's room B. Allow family to give client a measured amount of ice chips C. Restrict family visiting until the client's condition is stable D. Provide the client with oral swabs to moisten his mouth During a paracentesis, two liters of fluid are removed from the abdomen of a client with ascites. A drainage bag is placed, and 50 ml of clear, straw-colored fluid drains within the first hour. What action should the nurse implement? A. Palpate for abdominal distention B. Send fluid to the lab for analysis C. Continue to monitor the fluid output D. Clamp the drainage tube for 5 minutes While assessing a client with degenerative joint disease, the nurse observes Heberden's nodes, large prominences on the client's fingers that are reddened. The client reports that the nodes are painful. Which action should the nurse take? A. Review the client's dietary intake of high-protein foods B. Notify the healthcare provider of the finding immediately C. Discuss approaches to the chronic pain control with the client D. Assess the client's radial pulses and capillary refill time A client who took a camping vacation two weeks ago in a county with a tropical climate comes to the clinic describing vague symptoms and diarrhea for the past week. Which finding is most important for the nurse report to the healthcare provider? A. Weakness and fatigue B. Intestinal cramping C. Weight loss D. Jaundiced sclera Ten hours following thrombolysis for an ST elevation myocardial infarction (STEMI), a client is receiving a lidocaine infusion for isolated runs of ventricular tachycardia (VT). Which finding should the nurse document in the electronic medical record as a therapeutic response to the lidocaine infusion? A. Stabilization of blood pressure ranges B. Cessation of chest pain C. Reduce heart rate D. Decreased frequency of episodes of VT After a computer tomography (CT) scan with intravenous contrast medium, a client returns to the room complaining of shortness of breath and itching. Which intervention should the nurse implement? A. Call respiratory therapy to give a breathing treatment B. Send another nurse for an emergency tracheotomy set C. Prepare a dose of epinephrine (Adrenalin) D. Review the client's complete list of allergies The nurse reports that a client is at risk for a brain attack (stroke) based on which assessment finding? A. Nuchal rigidity B. Carotid bruit C. Jugular vein distention D. Palpable cervical lymph node The nurse is preparing to administer enoxaparin (Lovenox) 135 mg subcutaneously. The medication is available in a cartridge labeled 150 mg/ml. How many ml should the nurse administer? (enter numeric value only. If rounding is required, round to the nearest tenth.) 0.9 ml The nurse is obtaining a client's fingerstick glucose level. After gently milking the client's finger, the nurse observes that the distal tip of the finger appears reddened and engorged. What action should the nurse take? A. Collect the blood sample B. Assess radial pulse volume C. Apply pressure to the site D. Select another finger A client admitted to a surgical unit is being evaluated for an intestinal obstruction. The healthcare provider prescribes a nasogastric tube (NGT) to be inserted and placed to intermittent low wall suction. Which intervention should the nurse implement to facilitate proper tube placement? A. Soak nasogastric tube in warm water B. Insert tube with client's head tilted back C. Apply suction while inserting tube D. Elevate head of bed 60 to 90 degrees A young female client with seven children is having frequent morning headaches, dizziness, and blurred vision. Her blood pressure (BP) is 168/104 mmHg. The client reports that her husband recently lost his job and she is not sleeping well. After administering a STAT dose of an antihypertensive IV medication, which intervention is most important for the nurse to implement? A. Measure urine output hourly to assess for rental perfusion B. Request a prescription for pain medication C. Use an automated BP machine to monitor for hypotension D. Provide a quiet environment with low lighting The wife of a client with Parkinson's disease expresses concern because her husband has lost so much weight. Which teaching is best for the nurse to provide? A. Invite friends over regularly to share in meal times B. Encourage the client to drink clear liquids between meals C. Coach the client to make an intentional effort to swallow D. Talk to the healthcare provider about prescribing an appetite stimulant [Show Less]