Evolve HESI Medical Surgical Practice Exam Quizlet

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A client diagnosed with a history of asthma and bronchitis arrives at the clinic with shortness of breath, productive cough with thickened, tenacious mucus, and the inability to walk up a flight of stairs without experiencing breathlessness. Which action is most important for the nurses to instruct the client about self-care?

  • A. Call the clinic if undesirable side effects of medications occur
  • B. Avoid crowded enclosed areas to reduce pathogen exposure
  • C. Increase the daily intake of oral fluids to liquefy secretions
  • D. Teach anxiety reduction methods for feelings of suffocation
Correct Answer: C

Rationale: Increasing the daily intake of oral fluids is crucial for clients with asthma and bronchitis as it helps to liquefy thickened mucus, making it easier to clear the airways and manage symptoms. This self-care measure can improve the client's ability to breathe more effectively. Choice A is not the most immediate concern when addressing thickened mucus and breathing difficulties. While avoiding crowded areas is beneficial to prevent respiratory infections, it is not directly related to managing thickened secretions. Teaching anxiety reduction methods is important for overall well-being, but it does not directly address the physiological issue of thickened mucus in the airways.

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A client with chronic renal failure is being treated with sodium polystyrene sulfonate (Kayexalate). The nurse should monitor the client for which of the following?

  • A. Hyponatremia.
  • B. Hypokalemia.
  • C. Hyperkalemia.
  • D. Hypocalcemia.
Correct Answer: C

Rationale: The correct answer is C: Hyperkalemia. Sodium polystyrene sulfonate (Kayexalate) is used to treat high potassium levels (hyperkalemia) by exchanging sodium ions for potassium ions in the large intestine, which is then eliminated through the feces. Therefore, the nurse should monitor the client for changes in potassium levels to ensure the effectiveness of the treatment. Choices A, B, and D are incorrect because sodium polystyrene sulfonate (Kayexalate) is not associated with causing hyponatremia, hypokalemia, or hypocalcemia.

The client has been managing angina episodes with nitroglycerin. Which of the following indicates the drug is effective?

  • A. Decreased chest pain.
  • B. Increased blood pressure.
  • C. Decreased blood pressure.
  • D. Decreased heart rate.
Correct Answer: A

Rationale: The correct answer is A: Decreased chest pain. Nitroglycerin is a vasodilator that works by decreasing myocardial oxygen consumption, which helps to reduce chest pain caused by angina. Therefore, a reduction in chest pain is a positive indicator of the drug's effectiveness. Choices B, C, and D are incorrect because nitroglycerin does not typically increase blood pressure or heart rate; instead, it often causes a decrease in blood pressure due to vasodilation and may cause a reflex tachycardia (increased heart rate) as a compensatory response to lowered blood pressure.

The nurse is monitoring a client with chronic renal failure who is receiving hemodialysis. The nurse should report which of the following findings immediately?

  • A. Clear dialysate outflow.
  • B. Weight gain of 2 lbs (0.9 kg) since the last treatment.
  • C. Blood pressure of 130/80 mm Hg.
  • D. Pulse rate of 72 bpm.
Correct Answer: B

Rationale: The correct answer is B. Weight gain of 2 lbs (0.9 kg) since the last treatment is concerning in a client undergoing hemodialysis with chronic renal failure as it may indicate fluid overload. This finding requires immediate reporting and intervention to prevent complications such as fluid retention, pulmonary edema, or exacerbation of heart failure. Choices A, C, and D are not findings that require immediate attention in this context. Clear dialysate outflow is a normal finding during hemodialysis, a blood pressure of 130/80 mm Hg is within a normal range for many clients, and a pulse rate of 72 bpm is also within the expected range for most individuals.

The nurse is instructing the client on insulin administration. The client's morning dose of insulin is 10 units of regular and 22 units of NPH. The nurse checks the dose accuracy with the client. The nurse determines that the client has prepared the correct dose when the syringe reads how many units?

  • A. 10 units.
  • B. 22 units.
  • C. 32 units.
  • D. 24 units.
Correct Answer: C

Rationale: The correct dose would be 32 units, which is the sum of 10 units of regular insulin and 22 units of NPH. It is essential to combine the doses of both types of insulin to ensure the client administers the correct total dose. Choices A and B represent the individual doses of regular and NPH insulin, respectively, not the combined total. Choice D is incorrect as it does not reflect the sum of both insulin doses.

The nurse is collecting information from a client with chronic pancreatitis who reports persistent gnawing abdominal pain. To help the client manage the pain, which assessment data is most important for the nurse to obtain?

  • A. Presence and activity of bowel sounds
  • B. Color and consistency of feces
  • C. Eating patterns and dietary intake
  • D. Level and amount of physical activity
Correct Answer: C

Rationale: In chronic pancreatitis, managing abdominal pain is crucial, and assessing the client's eating patterns and dietary intake is essential. Dietary modifications can help alleviate symptoms and reduce the workload on the pancreas. Choices A, B, and D are not directly related to pain management in chronic pancreatitis. Bowel sounds, fecal characteristics, and physical activity may provide important information in other conditions but are not the priority in this scenario.

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