NUR 280 EXAM QUESTIONS AND ANSWERS 2023/2024 REVISION GUIDE
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2023 HESI MED-SURG RN CUSTOM EXAM FOR MED SURG II
CLASS COMPLETE ALL 160 QUESTIONS AND CORRECT
DETAILED ANSWERS
1. While assessing a client with diabetes mellitus, the nurse observes an absence of
hair growth
on 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 - ANSWER: 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. 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 - ANSWER: 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
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. - ANSWER: 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.
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 - ANSWER: 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. 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.
b. Look for an increase in today's LDH compared to the previous one to assess
for possible liver damage. c. Expect to find an increase in today's APTT as compared
to last quarter's due
to bleeding.
,d. Determine if there is a decrease in serum potassium due to renal compromise. -
ANSWER: ANS: B
Frequent and/or large doses of acetaminophen can cause an increase in liver
enzymes,
indicating possible liver damage (B). If the client reported unusual bleeding, or an
increase in
aspirin usage, it would be important for the nurse to assess for increased bleeding
and monitor
(A and/or C). (D) is not affected by increases in acetaminophen doses.
6. Aspirin is prescribed for a 9-year-old child with rheumatic fever to control the
inflammatory
process, promote comfort, and reduce fever. What intervention is most important
for the
nurse to implement?
a. Instruct the parents to hold the aspirin until the child has first had a tepid sponge
bath.
b. Administer the aspirin with at least two ounces of water or juice.
c. Notify the healthcare provider if the child complains of ringing in the ears.
d. Advise the parents to question the child about seeing yellow halos around objects
- ANSWER: ANS: C
Ringing in the ears (tinnitus) (C) is an important sign of aspirin overdosage and
should be
reported immediately. Though a tepid sponge bath may lower the child's
temperature, the
prescription for aspirin should not be held (A). Aspirin should be taken with at least
eight
ounces of water to completely wash the tablet into the stomach and to help prevent
GI
discomfort (B). Yellow halos are associated with Digoxin toxicity, not aspirin (D)
7. Which signs or symptoms are characteristic of an adult client diagnosed with
Cushing's
syndrome?
a. Husky voice and complaints of hoarseness.
b. Warm, soft, moist, salmon-colored skin.
c. Visible swelling of the neck, with no pain.
d. Central-type obesity, with thin extremities. - ANSWER: ANS: D
The classic picture of Cushing's syndrome in the adult is central-type obesity with
thin
extremities (D), along with a "buffalo hump" in the supraclavicular area, heavy trunk,
and
thin fragile skin. The symptoms described in (A) are clinical manifestations of
hypothyroidism, and in (B) of hyperthyroidism. (C) may indicate a goiter or a tumor
of the
thyroid gland
, 8. A charge nurse agrees to cover another nurse's assignment during a lunch break.
Based on the
status report provided by the nurse who is leaving for lunch, which client should be
checked
first by the charge nurse? The client
a. admitted yesterday with diabetec ketoacidosis whose blood glucose level
is now 195 mg/dl.
b. with an ileal conduit created two days ago with a scant amount of blood in
the drainage pouch.
c. post-triple coronary bypass four days ago who has serosanguinous drainage
in the chest tube.
d. with a pneumothorax secondary to a gunshot wound with a current pulse
oximeter reading of 90%. - ANSWER: ANS: D
A pulse oximeter reading of 90% indicates an arterial blood gas of less than 80 to 100
and
should be assessed immediately (D). (A) is an expected finding. (B) is not an unusual
finding.
(C) is an expected finding for this client.
9. An outcome for treatment of peripheral vascular disease is, "The client will have
decreased
venous congestion." What client behavior would indicate to the nurse that this
outcome has
been met?
a. Avoids prolonged sitting or standing.
b. Avoids trauma and irritation to skin.
c. Wears protective shoes.
d. Quits smoking - ANSWER: ANS: A
Client behaviors indicating that the expected outcome of, "decreased venous
congestion" has
been met would include elevating the legs, increasing walking time, and an
observable
decrease in edema of the lower extremities (A). (B and C) would be appropriate for
outcomes
for, "Attains or maintains tissue integrity." (D) would be an appropriate outcome for,
"Demonstrates an increase in arterial blood supply to extremities."
10. The healthcare provider performs a paracentesis on a client with ascites and 3
liters of fluid
are removed. Which assessment parameter is most critical for the nurse to monitor
following
the procedure?
a. Pedal pulses.
b. Breath sounds.
c. Gag reflex.
d. Vital signs - ANSWER: ANS: D
Life-threatening complications such as hypovolemia and sepsis can occur following a
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