Medical Surgical Assignment Exam HESI

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An overweight, young adult male who was recently diagnosed with type 2 diabetes mellitus is admitted for a hernia repair. He tells the nurse that he is feeling very weak and jittery. Which actions should the nurse implement? (Select all that apply)

  • A. Check his fingerstick glucose
  • B. Assess his skin temperature and moisture
  • C. Measure his pulse and BP
  • D. All of the Above
Correct Answer: D

Rationale: In this scenario, the patient is a young adult male with type 2 diabetes mellitus admitted for a hernia repair who is experiencing weakness and jitteriness. Checking his fingerstick glucose is crucial to assess his blood sugar levels, which can directly impact his symptoms. Assessing his skin temperature and moisture is important to evaluate his peripheral circulation and hydration status. Measuring his pulse and blood pressure helps in gauging his cardiovascular status. Therefore, all the actions mentioned in choices A, B, and C are appropriate for the nurse to implement in this situation to identify the underlying cause of the patient's symptoms. Choice D, 'All of the Above,' is the correct answer because all these actions are necessary for a comprehensive assessment of the patient's condition. Choices A, B, and C are incorrect individually as they each address different aspects of the patient's condition, and a holistic approach is needed to provide optimal care in this situation.

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The nurse is reviewing blood pressure readings for a group of clients on a medical unit. Which client is at the highest risk for complications related to hypertension?

  • A. Post-menopausal Caucasian female who overeats and is 20% above her ideal body weight.
  • B. Young adult Hispanic female who has hemoglobin at 11 g/dl (110 g/L) and drinks beer daily.
  • C. Older adult who consumes a diet of smoked, cured, and pickled foods.
  • D. Middle-aged African-American male who has a serum creatinine level of 2.9 mg/dL (256.4 micromol/L).
Correct Answer: D

Rationale: The correct answer is D. An elevated serum creatinine level indicates kidney damage, which significantly increases the risk of complications from hypertension. High blood pressure can damage the kidneys over time, leading to impaired kidney function. Choices A, B, and C do not directly correlate with increased risk of complications related to hypertension. Choice A focuses on obesity and overeating, Choice B on anemia and alcohol consumption, and Choice C on a diet high in sodium and nitrates, none of which are as directly related to hypertension complications as kidney damage.

A client with chronic obstructive pulmonary disease (COPD) presented with shortness of breath. Oxygen therapy was started at 2 liters/minute via nasal cannula. The arterial blood gases (ABGs) after treatment were pH 7.36, PaO2 52, PaCO2 59, HCO3 33. Which statement describes the most likely cause of the simultaneous increase in both PaO2 and PaCO2?

  • A. The client is hyperventilating due to anxiety.
  • B. The hypoxic drive was reduced by the oxygen therapy.
  • C. The client is experiencing respiratory alkalosis.
  • D. The client is experiencing metabolic acidosis.
Correct Answer: B

Rationale: Oxygen therapy can reduce the hypoxic drive in COPD patients, leading to increased PaCO2 levels while improving oxygenation (PaO2). In this case, the increase in PaO2 and PaCO2 is due to the reduction of the hypoxic drive by the supplemental oxygen. Choice A is incorrect because hyperventilation would lead to decreased PaCO2. Choice C is incorrect as the ABG values do not indicate respiratory alkalosis. Choice D is incorrect as the ABG values do not support metabolic acidosis.

After hospitalization for SIADH, a client develops pontine myelinolysis. Which intervention should the nurse implement first?

  • A. Reorient the client to the room
  • B. Place an eye patch on one eye
  • C. Evaluate the client's ability to swallow
  • D. Perform range of motion exercises
Correct Answer: C

Rationale: Evaluating the client's ability to swallow is the priority intervention in this scenario. Pontine myelinolysis can affect neurological functions, including swallowing ability, putting the client at risk for aspiration. Assessing the client's ability to swallow will help prevent complications such as aspiration pneumonia. Reorienting the client to the room, placing an eye patch, or performing range of motion exercises are not as critical as ensuring the client can safely swallow.

The nurse is assessing a client who has herpes zoster. Which question will allow the nurse to gather further information about this condition?

  • A. Has everyone at home already had varicella?
  • B. Have the antifungal creams been effective?
  • C. Do your family members share combs and brushes?
  • D. Do you have any dry patches on your feet and hands?
Correct Answer: A

Rationale: The correct answer is A: 'Has everyone at home already had varicella?' Herpes zoster (shingles) is caused by the reactivation of the varicella-zoster virus, the same virus that causes chickenpox. By knowing if others at home had varicella (chickenpox), the nurse can assess the risk of transmission and provide appropriate guidance. Choice B is incorrect because antifungal creams are not effective for herpes zoster, which is a viral infection. Choice C is irrelevant to herpes zoster as it pertains to sharing personal items that may transmit head lice or certain skin infections. Choice D is also unrelated as it focuses on dry patches, not typical manifestations of herpes zoster which presents as a painful rash.

The nurse is evaluating teaching about drug therapy to treat gout. Which statement by the client demonstrates an understanding of the use of allopurinol to treat Gout?

  • A. I need to take the prescribed amount of the drug to get rid of my gout.
  • B. I need to take this drug every day to keep from having any flare-ups.
  • C. I should take this drug when I have gout attacks to reduce symptoms.
  • D. The pain and swelling can be controlled by taking this drug every day.
Correct Answer: B

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

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