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EVOLVE MED SURG HESI ACTUAL EXAM WITH QUESTIONS AND CORRECT VERIFIED ANSWERS AND WELL ELABORATED RATIONALES| EVOLVE MED SURG HESI NEWEST 2024 EXAM (BRAND NEW!!)$17.39
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EVOLVE MED SURG HESI ACTUAL EXAM WITH QUESTIONS AND CORRECT VERIFIED ANSWERS AND WELL ELABORATED RATIONALES| EVOLVE MED SURG HESI NEWEST 2024 EXAM (BRAND NEW!!)
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Course
EVOLVE MED SURG HESI
Institution
EVOLVE MED SURG HESI
EVOLVE MED SURG HESI ACTUAL EXAM WITH QUESTIONS AND CORRECT VERIFIED ANSWERS AND WELL ELABORATED RATIONALES| EVOLVE MED SURG HESI NEWEST 2024 EXAM (BRAND NEW!!)
EVOLVE MED SURG HESI 2024-2025 ACTUAL
EXAM WITH QUESTIONS AND CORRECT
VERIFIED ANSWERS AND WELL ELABORATED
RATIONALES| EVOLVE MED SURG HESI NEWEST
2024 EXAM (BRAND NEW!!)
The nurse is concerned about infection for a client after an
esophagogastrostomy for oesophageal cancer. Which actions should the nurse
include in the client's plan of care? (Select all that apply.)
A. Frequent oral care every 2 hours while awake.
B. Use incentive spirometer every 2 hours.
C. Empty contents from NG tube every 8 hours.
D. Ambulate within 1 hour of return from the PACU.
E. Limit visitors until postoperative day 2. - ANSWER-Correct Answer: A,B,C
Rationale:One hour post op is too soon to ambulate for this client. Visitors help
support the patient and are encouraged to visit. Oral care is necessary as the
client will be NPO. To decrease the risk of infection, post operatively,
implement routine pulmonary exercises. The client will have an NG tube in
place, likely to intermittent suction, to decompress the stomach post-surgery.
The client is return demonstrating wrapping of the left limb amputated above
the knee. The nurse evaluates the client is starting the wrapping method
correctly when the client places the end of the bandage at which point?
A. Around the waist
B. At the inner aspect of the left stump
C. At the outer aspect of the left stump
D. At the left groin area - ANSWER-Correct Answer: A
Rationale: The waist is the anchor point for the bandage for an above the knee
amputation.
,A nurse is assisting an 82-year-old client with ambulation and is concerned that
the client may fall. Which area contains the older person's center of gravity?
A. Head and neck
B. Upper torso
C. Bilateral arms
D. Feet and legs - ANSWER-Correct Answer: B
Rationale: Stooped posture results in the upper torso becoming the centre of
gravity for older persons. The centre of gravity for adults is the hips. However,
as a person grows older, a stooped posture is common because of changes
caused by osteoporosis and normal bone degeneration. Furthermore, the knees,
hips, and elbows flex. The head and neck and feet and legs are not the centre of
gravity in the older adult. Although the arms comprise a part of the upper torso,
they do not reflect the best and most complete answer.
A client with hypertension has been receiving ramipril, 5 mg PO, daily for 2
weeks and is scheduled to receive a dose at 0900. At 0830, the client's blood
pressure is 120/70 mm Hg. Which action should the nurse take?
A. Administer the prescribed dose at the scheduled time.
B. Hold the dose and contact the health care provider.
C. Hold the dose and recheck the blood pressure in 1 hour.
D. Check the health care provider's prescription to clarify the dose. - ANSWER-
Correct Answer: A
Rationale: The client's blood pressure is within normal limits, indicating that the
ramipril, an antihypertensive, is having the desired effect and should be
administered. Options B and C would be appropriate if the client's blood
pressure was excessively low (<100 mm Hg systolic) or if the client were
exhibiting signs of hypotension such as dizziness. This prescribed dose is within
the normal dosage range, as defined by the manufacturer; therefore, option D is
not necessary
The nurse is providing care for a client diagnosed with trigeminal neuralgia (tic
douloureux). Which symptoms will the nurse be looking for in the focused
assessment related to this condition? (Select all that apply.)
,A. Facial muscle spasms
B. Sudden facial pain
C. Unilateral facial weakness
D. Difficulty in chewing
E. Tinnitus
F. Hearing difficulties - ANSWER-Correct Answer: A,B
Rationale: Trigeminal neuralgia is characterized by paroxysms of pain, similar
to an electric shock, in the area innervated by one or more branches of the
trigeminal nerve (cranial V). The remaining symptoms are not related to
trigeminal neuralgia.
In caring for a client with acute diverticulitis, which assessment data warrants
an immediate nursing action?
A. The client has a rigid hard abdomen and elevated WBC.
B. The client has left lower quadrant pain and an elevated temperature.
C.The client is refusing to eat any of the meal and is complaining of nausea.
D. The client has not had a bowel movement in 2 days and has a soft abdomen. -
ANSWER-Correct Answer: A
Rationale: A hard rigid abdomen and elevated WBC is indicative of peritonitis,
which is a medical emergency and should be reported to the health care provider
immediately. Options B and C are expected clinical manifestations of
diverticulitis. Option D does not warrant immediate intervention.
The nurse is caring for a client with a fractured right elbow. Which assessment
finding has the highest priority and requires immediate intervention?
A. Ecchymosis over the right elbow area
B. Deep unrelenting pain in the right arm
C. An oedematous right elbow
D. The presence of crepitus in the right elbow - ANSWER-Correct Answer: B
, Rationale: Compartment syndrome is a condition involving increased pressure
and constriction of the nerves and vessels within an anatomic compartment,
causing pain uncontrolled by opioids and neurovascular compromise. Option A
is an expected finding. Option C related to compartment syndrome cannot be
seen, and any visible oedema is an expected finding related to the injury. Option
D is an expected finding.
The nurse notes that a client who is scheduled for surgery the next morning has
an elevated blood urea nitrogen (BUN) level. Which condition is most likely to
have contributed to this finding?
A. Myocardial infarction 2 months ago
B. Anorexia and vomiting for the past 2 days
C. Recently diagnosed type 2 diabetes mellitus
D. Skeletal traction for a right hip fracture - ANSWER-Correct Answer: B
Rationale: The blood urea nitrogen (BUN) level indicates the effectiveness of
the kidneys in filtering waste from the blood. Dehydration, which could be
caused by vomiting, would cause an increased BUN level. Option A would
affect serum enzyme levels, not the BUN level. Option C would primarily affect
the blood glucose level; renal failure that could increase the BUN level would
be unlikely in a client newly diagnosed with type 2 diabetes. Effects of option D
might affect the complete blood count (CBC) but would not directly increase
the BUN level.
Which instruction is best for the nurse to provide to a client with emphysema
and chronic fatigue?
A. "Pace your activities and schedule rest periods."
B. "Increase the amount of oxygen you use at night."
C. "Obtain medical evaluation for antibiotic therapy."
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