HESI RN Medical Surgical Nursing

HESI RN Medical Surgical Nursing Related

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History and Physical
Nurses' Notes
Orders
Imaging Studies
The client is a young male who appears to be 25 to 30 years old. He was found unconscious on a sidewalk by a jogger who was passing by. The jogger called an ambulance, and the emergency medical technicians (EMTS) transported the client to the hospital. The client is arousable but unable to say what his name is or what happened to him. A STAT head computed tomography (CT) scan in the emergency department showed no abnormalities, so the client will be admitted to the medical floor for observation and further tests.

Exhibits
The nurse provides education about seizures to the client and asks the client to explain what he understands about his condition.

The nurse provides education about seizures to the client and asks the client to explain what he understands about his condition. For each statement click to specify if the client demonstrates an understanding or no understanding.

  • A. I can stop taking the phenytoin If I go for a while and don't have a seizure.'
  • B. Having a medic alert bracelet might be a good idea, but it is up to me to decide if I want it or not.'
  • C. I don't need to go to the hospital if I have another seizure unless it is a very long seizure or if I have several in a row.'
  • D. There are really no lifestyle changes that I can do that will affect my risk for having another seizure.'
  • E. I may never know why I started having seizures.'
Correct Answer: E

Rationale: Only the statement about unknown seizure causes shows understanding; others reflect misconceptions about medication, safety, and lifestyle.

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An adult client is admitted to the medical unit due to rectal bleeding after a colonoscopy in which a polyp was biopsied and cauterized. Which Intervention should the nurse do first?

  • A. Palpate all peripheral pulses in the extremities.
  • B. Encourage cough and deep breathing exercises.
  • C. Complete a focused assessment of the abdomen.
  • D. Initiate measurement of fluid intake and output.
Correct Answer: C

Rationale: A focused abdominal assessment determines the severity of bleeding and guides further interventions, prioritizing over pulses, respiratory exercises, or fluid monitoring.

The nurse has determined that a client with trigeminal neuralgia has the nursing problem, 'Imbalanced nutrition, less than body requirements.' Which cause is most likely contributing to the problem?

  • A. Fatigue.
  • B. Pain when eating.
  • C. Nausea.
  • D. Altered taste sensation.
Correct Answer: B

Rationale: Severe facial pain from trigeminal neuralgia deters eating, leading to imbalanced nutrition.

A client with chronic venous insufficiency is being discharged from the hospital, and plans to return home. Which client statement indicates an understanding of home care instructions?

  • A. I will lift weights every other day.'
  • B. I will be able to stand as long as my legs do not hurt.'
  • C. I will avoid sitting and crossing my legs.'
  • D. I will need to get someone to walk my dog.'
Correct Answer: C

Rationale: Avoiding prolonged sitting and leg crossing improves venous return, aligning with chronic venous insufficiency management.

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. After obtaining vital signs, the nurse should implement which intervention?

  • A. Place an indwelling urinary catheter and measure strict Intake and output.
  • B. Initiate bilateral intermittent sequential pneumatic compression devices.
  • C. Administer aspirin to prevent further det formation and platelet dumping.
  • D. Obtain a focused history to determine recent bleeding and use of anticoagulants.
Correct Answer: D

Rationale: A focused history assesses for stroke risk factors like anticoagulant use, critical for managing neurological symptoms.

A client with pancreatitis is receiving 0.9% normal saline, and the prescribed IV infusion rate was increased from 100 mL/hour to 150 mL/hour. Which assessment finding indicates to the nurse that the prescription has a therapeutic outcome?

  • A. An increase in the hematocrit (HCT) from 42% (0.42 volume fraction) to 52% (0.52 volume fraction).
  • B. An increase in the blood glucose level from 130 mg/dl. (7.22 mmol/L).
  • C. A decrease in blood urea nitrogen (BUN) from 36 mg/dL (12.9 mmol/L) to 23 mg/dL (8.21 mmol/L).
  • D. A decrease in serum amylase from 24 units/dl (240 units) to 12 units/dl. (120 units/L);
Correct Answer: C

Rationale: A decrease in BUN indicates improved renal perfusion, a therapeutic outcome of increased IV fluids. Increased hematocrit suggests fluid volume deficit, increased blood glucose is undesirable, and amylase decrease is not directly related to fluid increase.

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