HESI RN MED SURG EXAM PACK-EXAM MERGED
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(Thoracentesis) What Position you going to place them in? - -----ANSWER---->Upright leaning over table
to increase lung expansion
Metabolic Acidosis Respirations - - -----ANSWER---->Kussmaul respirations
Wheezing - -----ANSWER---->are short high pitched sounds made on expiratory
Abnormal Breathe sounds - - -----ANSWER---->used to describe bronchial or bronchovesicular sounds
heard in the peripheral lung fields.
Adventitous sounds - - -----ANSWER---->are extra breath sounds that are abnormal
The presence of bronchovesicular breath sounds in the peripheral lung fields is described as? - - -----
ANSWER---->abnormal lung sounds
To prepare the patient for a thoracentesis, the nurse positions the patient - - -----ANSWER---->sitting
upright with the elbows on an over-the-bed table.
Bronchoscopy - -----ANSWER---->After procedure keep the patient NPO until gag reflux returns.
Hypoxemia - - -----ANSWER---->PaO2 is at 55% and SpO2 is 88
,What test do you use to verify pulmonary embolus? - - -----ANSWER---->CT scan
A patient with an SaO2 of 85% has a PaO2 of 50mm Hg. This indicates? - - -----ANSWER---->shift to the
left in the oxygen-hemoglobin dissociation curve that could be caused by hypothermia.
Normal Arterial Blood Gases - - -----ANSWER---->pH 7.35-7.45, PaO2 80-100mm Hg, SaO2 >95%, PaCO2
32-48 mm Hg, HCO3- 22-26 mEq/L
To determine when the patient with a tracheostomy tube can be effectively swallow, the nurse deflates
the cuff and? - - -----ANSWER---->has the patient drink a small amount of blue-colored water, observing
for coughing and colored secretions.
When obtaining a health history from a patient with possible cancer of the mouth, the nurse would
expect the patient to report? - - -----ANSWER---->Heavy tobacco and alcohol use.
The most normal functioning method of speech restoration in the patient with a total larynectomy is - - -
----ANSWER---->a voice presthesis
A patients tracheostomy tube becomes dislodged with vigorous coughing. The first action by the nurse is
to? - - -----ANSWER---->attempt to replace the tube
What will the nurse teach a patient with pneumonia? - - -----ANSWER---->Deep breathing and coughing
Fine Crackles - - -----ANSWER---->short-duration, discontinuous, high pitched sounds heard just before
the end of inspiration. In pneumonia or heart failure.
Coarse Crackles - - -----ANSWER---->long duration, discontinuous, low pitched sounds caused by air
passing through airway intermittently occluded by mucus, unstable bronchial wall, or fold of mucosa;
evident with inspiration. COPD, heart failure, and pneumonia.
Absent breath sounds - - -----ANSWER---->no sound evident over entire lung or area of lung. Pleural
effusion or lobectomy
,Peritonsillar abscess - - -----ANSWER---->is a complication of acute pharyngitis or acute tonsillitis when
bacterial infection invades one or both tonsils. The tonsil may enlarge sufficiently to threaten airway
patency. Also known as the hot potato voice. The patient experience a high fever, leukocytosis, and chills.
Sputum Test for TB - - -----ANSWER---->3 seperate sputum test over 3 days. Airborne precautions until 3
negative sputum samples. HEPA mask required.
INH - - -----ANSWER---->latent TB and treat 6 to 9 months.
Rifampin side effects and considerations - - -----ANSWER---->Hepatitis, thrombocytopenia, orange
discoloration of bodily fluids (Sputum, urine, sweat, tears).
BCG or Bacille Calmette-Guerin - -----ANSWER---->Immigrants have been vaccinate in parts of the world
with high TB. Do not give TB test only chest x-ray.
A patient with pneumonia has a nursing diagnosis pf ineffective airway clearance related to pain, fatigue,
and thick secretions. An appropriate nursing intervention for the patient is to - - -----ANSWER----
>Encourage fluid intake of 3L/day
Diagnose Pulmonary Emboli - -----ANSWER---->with at CAT scan or MRI
Hypothermia - - -----ANSWER---->SPO2 96%. What is the nurse going to do? Turn oxygen up.
Symptom of primary pulmonary hypertension - - -----ANSWER---->dyspnea with exertion
Sepsis - - -----ANSWER---->2 blood draws from 2 different sites before start ABT
Pseudomonis - - -----ANSWER---->thick green mucous
Proventil side effects - - -----ANSWER---->tachycardia, BP changes, nervousness, palpitations, muscle
tremors, nausea, vomiting, vertigo, insomnia, dry mouth, headache, hypokalemia.
, On examining a patient 8 hours after formation of a colostomy, the nurse would expect to find - - -----
ANSWER---->a brick-red, puffy stoma that oozes blood.
A patient is admitted to the emergency department with acute abdominal pain. The nursing intervention
that should be implemented first is - - -----ANSWER---->measurement of vital signs
The nurse identifies a need for additional teaching when a patient with acute infectious diarrhea states, -
- -----ANSWER---->"I may use over-the-counter lopermide (Immodium) or Parepectolin as need to control
the diarrhea."
Following a Billroth II procedure, a patient develops dumping syndrome. The nurse explains that the
symptoms associated with this problem are caused by - - -----ANSWER---->movement of fluid into the
small bowel because concentrated food and fluids move rapidly into the intestine
Nursing management of the patient with chronic gastritis includes teaching the patient to - - -----
ANSWER---->Maintain a non irritating diet with six small meals a day
Following a patient's esophagogastrostomy for cancer of the esophagus, it is important for the nurse to -
- -----ANSWER---->maintain the patient in sem-fowler's or fowler's position
The nurse teaches the patient with a hiatal hernia or GERD to control symptoms by - - -----ANSWER----
>Sleeping with the head of the bed elevated on 4 to 6 inch blocks
A patient treated for vomiting for several days from an unknown cause is admitted to the hospital. The
nurse anticipates collaborative care to include - - -----ANSWER---->IV replacement of fluid and
electrolytes.
The nurse is caring for a patient receiving 1000mL of PN solution over 24 hours. When it is time to
change the solution, 150mL remain in the bottle. The most appropriate action by the nurse is to - - -----
ANSWER---->Hang a new solution and discard the unused solution.
Before administering a bolus of intermittent tube feeding to a patient with percutaneous endoscopic
gastrostomy (PEG), the nurse aspirates 220mL of gastric contents. The nurse should - - -----ANSWER----
>return the aspirate to the stomach and continue with the tube feeding as planned.
