Medical Surgical Assignment Exam HESI

Medical Surgical Assignment Exam HESI Related

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The nurse prepares a teaching plan for an adult client with metabolic syndrome. Which findings should the nurse address to help the client reduce the risk for diabetes mellitus and vascular disease? (Select all that apply)

  • A. Abdominal obesity
  • B. Blood pressure of 150/96 mmHg
  • C. Increased triglyceride levels
  • D. All of the above
Correct Answer: D

Rationale: The correct answer is D, as all the listed factors - abdominal obesity, high blood pressure, and increased triglyceride levels - are components of metabolic syndrome. Addressing these findings is crucial to help reduce the client's risk for developing diabetes mellitus and vascular disease. Abdominal obesity is a key feature of metabolic syndrome, high blood pressure (150/96 mmHg) is a risk factor, and increased triglyceride levels are also indicative of the syndrome. Educating the client on lifestyle modifications, such as healthy eating habits, regular physical activity, and monitoring these parameters, is essential in managing metabolic syndrome and preventing associated complications. Choices A, B, and C are all correct, making choice D the correct answer.

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The nurse is providing postoperative care for a client who had a thyroidectomy. Which assessment finding requires immediate intervention?

  • A. Hoarseness and weak voice
  • B. Calcium level of 8.0 mg/dL (2.0 mmol/L)
  • C. Heart rate of 110 beats per minute
  • D. Difficulty swallowing
Correct Answer: D

Rationale: Difficulty swallowing can indicate swelling or hematoma formation, which may compromise the airway and requires immediate intervention. Hoarseness and a weak voice are expected post-thyroidectomy due to manipulation of the laryngeal nerves but do not require immediate intervention. A calcium level of 8.0 mg/dL is within the normal range (8.5-10.5 mg/dL) and may not require immediate intervention. A heart rate of 110 beats per minute may be elevated due to stress or pain postoperatively, but it does not indicate an immediate threat to the airway.

A young client who is being taught how to use an inhaler for symptoms of asthma tells the nurse about the intention to use the inhaler but plans to continue smoking cigarettes. In evaluating the client's response, what is the best initial action by the nurse?

  • A. Explain the risks of smoking with asthma.
  • B. Revise the plan of care.
  • C. Encourage the client to reduce smoking gradually.
  • D. Provide resources for smoking cessation.
Correct Answer: B

Rationale: The best initial action by the nurse is to revise the plan of care. This is necessary to address the client's intention to continue smoking and ensure that appropriate support and education are provided. Choice A is not the best initial action as the client is already aware of the risks of smoking with asthma. Choice C might not be effective as the client's intention to continue smoking poses a significant risk to their health. Choice D, providing resources for smoking cessation, is important but revising the plan of care should come first to address the immediate concern.

Which of the following is a priority assessment for a client receiving intravenous vancomycin?

  • A. Respiratory rate
  • B. Blood pressure
  • C. Urine output
  • D. Hearing acuity
Correct Answer: D

Rationale: The correct answer is D, Hearing acuity. Vancomycin is known to cause ototoxicity, which can result in hearing loss. Monitoring the client's hearing acuity is crucial to detect any early signs of ototoxicity. Assessing respiratory rate, blood pressure, and urine output are important assessments in general patient care but are not the priority when specifically monitoring for vancomycin-induced ototoxicity.

During the initial assessment of an older male client with obesity and diabetes who develops intermittent claudication, which additional information obtained by the nurse is most significant?

  • A. Smokes 1.5 packs of cigarettes daily.
  • B. Exercises regularly.
  • C. Has a high-fat diet.
  • D. Consumes alcohol daily.
Correct Answer: A

Rationale: The correct answer is A: 'Smokes 1.5 packs of cigarettes daily.' Smoking is a significant risk factor for peripheral arterial disease, a condition that can lead to intermittent claudication. The nicotine and other chemicals in cigarettes can damage blood vessels, leading to reduced blood flow and increased risk of developing circulation problems. Choices B, C, and D are less significant in the context of intermittent claudication. Regular exercise, a high-fat diet, and daily alcohol consumption may have health implications, but they are not as directly linked to the development of intermittent claudication in the presence of obesity, diabetes, and smoking.

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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