Hesi RN Medical Surg

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History and Physical
A 34-year-old male client presents to the emergency department (ED) for an acute asthma attack which began after jogging through a local park. The client is able to answer questions, pausing every few words to catch his breath. The client reports using a rescue inhaler three times, but he just couldn't catch his breath.
The client reports that symptoms seem worse when outdoors and when exercising and that episodes like this make him extremely nervous. The client reports that it has been a couple of months since he had an asthma attack, and he came to the ED today because he noticed that his inhaler was expired and was worried the medication was not working.

Click the assessment data which indicates the interventions were successful and which assessment data provides no indication that the interventions were successful. Each column must have at least one, but may have more than one answer selected.

  • A. Lung sounds clear
  • B. Client can now speak in full sentences without pausing
  • C. Respirations 16 breaths/minute
  • D. Client reports, "It's a lot easier to breathe now."
  • E. Blood Pressure 122/84 mmHg
Correct Answer: A

Rationale: Improved airflow and reduced wheezing directly indicate successful bronchodilation from interventions like beta-agonists, alleviating asthma symptoms.

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The nurse is caring for a client who reports a sudden, severe headache, and facial numbness. The nurse asks the client to smile and observes an uneven smile with facial droop to the right side and a hand grasp strength that is weaker on the right than the left. The client denies a recent history of headaches or trauma. Which intervention should the nurse perform in the immediate management of the client?

  • A. Verify prescribed laboratory tests include prothrombin time and platelet count.
  • B. Administer aspirin to prevent further clot formation and platelet clumping.
  • C. Maintain elevated positioning of the dependent joints on affected side.
  • D. Start two large bore IV catheters and review inclusion criteria for IV fibrinolytic therapy.
Correct Answer: D

Rationale: IV catheters and fibrinolytic criteria review are critical for potential thrombolytic therapy in suspected ischemic stroke.

The nurse is performing a physical assessment of a client. Which finding should the nurse recognize is a result of a compromised peripheral arterial circulation of the lower extremity?

  • A. Uneven hair distribution.
  • B. Lower leg edema.
  • C. Bronze pigmentation.
  • D. Bounding peripheral pulse.
Correct Answer: A

Rationale: Uneven hair distribution results from reduced blood flow impairing hair follicle nutrition, a sign of peripheral arterial disease.

History & Physical
Initial Assessment Findings
Chief Complaint: Acute asthma attack after jogging; worsened by outdoor activity and exercise.
Current Treatment: Used rescue inhaler three times, expired inhaler, worried about effectiveness.
Patient Data
Exhibits
The nurse has identified the priority problem for the client and now must determine proper care interventions.

Based on the client's history and the assessment data, what action(s) should the nurse anticipate? Select all that apply.

  • A. Administer medications as ordered.
  • B. Provide client teaching.
  • C. Place the client in Trendelenburg position
  • D. Ask the client for a list of current medications.
  • E. Notify the healthcare provider of the client's need for intubation
  • F. Apply oxygen via nasal cannula
Correct Answer: A,B,D,F

Rationale: Administering medications and oxygen (F) address the acute asthma attack. Obtaining a medication list ensures safe treatment, and teaching prevents future exacerbations. Trendelenburg position is inappropriate, and intubation is premature without further assessment.

The nurse is preparing a client for surgery who was admitted from the emergency department following a motor vehicle collision. The client has an open fracture of the femur and is bleeding moderately from the bone protrusion site. During the preoperative assessment, the nurse determines that the client currently receives heparin sodium 5,000 units SUBQ daily. Which nursing action is a priority?

  • A. Notify the healthcare provider of the client's medication history.
  • B. Have the client sign the surgical and transfusion permits.
  • C. Observe the heparin injections sites for signs of bruising.
  • D. Ensure that the potential for bleeding is explained to the client.
Correct Answer: A

Rationale: Notifying the provider about heparin use is critical to manage perioperative bleeding risk due to its anticoagulant effects.

When conducting discharge teaching for a client diagnosed with diverticulosis, which diet instruction should the nurse include?

  • A. Eat a soft diet with increased intake of milk and milk products.
  • B. Have small frequent meals and sit up for at least two hours after meals.
  • C. Eat a bland diet and avoid spicy foods.
  • D. Eat a high fiber diet and increase fluid intake.
Correct Answer: D

Rationale: A high-fiber diet with increased fluids promotes bowel regularity, reducing diverticulosis complications.

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