HESI MED SURG V2 EXAM BRAND NEW Q&AS + GUARANTEED A+
1. While assessing a client with diabetes mellitus, the nurse observes an absence of hair
growth on
... [Show More] the client's legs. What additional assessment provides further data to support
this finding?
a. Palpate for the presence of femoral pulses bilaterally.
b. Assess for the presence of a positive Homan's sign.
c. Observe the appearance of the skin on the client's legs.
d. Watch the client's posture and balance during ambulation.
2. The healthcare provider prescribes 15 mg/kg of Streptomycin for an infant weighing 4
pounds. The drug is diluted in 25 ml of D5W to run over 8 hours. How much
Streptomycin will the infant receive?
a. 9 mg.
b. 18 mg.
c. 27 mg.
d. 36 mg.
3. In assessing a client with preeclampsia who is receiving magnesium sulfate, the nurse
determines that her deep tendon reflexes are 1+; respiratory rate is 12 breaths/minute;
urinary output is 90 ml in 4 hours; magnesium sulfate level is 9 mg/dl. Based on these
findings, what intervention should the nurse implement?
a. Continue the magnesium sulfate infusion as prescribed.
b. Decrease the magnesium sulfate infusion by one-half.
c. Stop the magnesium sulfate infusion immediately.
d. Administer calcium gluconate immediately.
4. A client is on a mechanical ventilator. Which client response indicates that the
neuromuscular blocker tubocurarine chloride (Tubarine) is effective?
a. The client’s expremities are paralyzed.
b. The peripheral nerve stimulator causes twitching.
c. The client clinches fist upon command.
d. The client’s Glagow Coma Scale score is 14.
5. An elderly female client comes to the clinic for a regular check-up. The client tells the
nurse that she has increased her daily doses of acetaminophen (Tylenol) for the past
month to control joint pain. Based on this client's comment, what previous lab values
should the nurse compare with today's lab report?
a. Look at last quarter's hemoglobin and hematocrit, expecting an increase today due to
dehydration.
Answer Section
MULTIPLE CHOICE
1. ANS: C
Signs of chronic arterial insufficiency include decreased hair growth in the legs and feet,
absent or decreased pedal pulses, infection in the foot, poor wound healing, thickened
nails, and a shiny appearance of the skin (C). Femoral pulses
(A) should still be palpable in the diabetic with chronic arterial insufficiency. A positive
Homan's sign is an indicator of deep vein thrombosis (B).
(D) would probably not be affected significantly by chronic arterial insufficiency.
2. ANS: C
4 lbs / 2.2 = 1.8 kg. 1.8 x 15 = 27 mg (C).
NOTE, the fact that the drug is diluted in 25 ml of D5W, is not relevant to the calculation
requested.
3. ANS: C
The client is exhibiting symptoms of magnesium sulfate toxicity--decreased reflexes
(normal is
+2), a low normal respiratory rate (normal is 12 to 20 breaths/min), a less than average
urinary output (30 ml/hour is average), and a low magnesium sulfate level (normal is 4
to 8mg/dl). Based on these findings, the nurse should stop the infusion (C). (A) is
contraindicated. (B) would not fully alleviate the magnesium sulfate toxicity symptoms.
(D) (the antagonist for magnesium sulfate) would be indicated if the respiratory rate
were less than 12 breaths/minute.
4. ANS: A
This medication causes paralysis (A) following intravenous injection. Peak effects
persist for 35 to 60 minutes. (B and C) would not be possible if the medication is
effective. The Glasgow coma scale is used to evaluate the neurological status of the client
and does not evaluate the effectiveness (D) of this medication.
5. ANS: B [Show Less]