Hesi RN Medical Surg

Hesi RN Medical Surg Related

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History and Physical
Nurses’ notes
Laboratory Results
Flow Sheet
The nurse is caring for a client who was admitted to the hospital with reports of shortness of breath, fever, fatigue, and oral thrush three days ago. The health care provider reviews the laboratory and diagnostic tests with the client and informs of the diagnosis of Pneumocystis pneumonia. The client reports that they recently tested HIV positive. The nurse reviews the client's medical record.
HIV diagnosed 4 months ago with no medications prescribed.
Note added to H&P reporting client wishes to be confidential since family and friends are unaware of the HIV diagnosis

What order(s) should the nurse anticipate being prescribed after an update is reported to the healthcare providers? Select all that apply.

  • A. Administer antiemetic
  • B. Monitor for adverse reaction to antibiotics
  • C. Increase IV fluids to 150 mL/hr
  • D. Initiate airborne isolation
  • E. Repeat CD4+ T-cell count STAT
Correct Answer: A,B,C

Rationale: Antiemetics , antibiotic monitoring , and increased fluids address emesis, treatment safety, and hydration in Pneumocystis pneumonia.

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A client with a fracture of the right femur has had skeletal traction applied. Which intervention should the nurse include in the client's nursing care plan?

  • A. Administer pain medication at designated Intervals around the clock.
  • B. Assess the pulses proximal to the fracture site.
  • C. Remove traction every shift and provide skin care.
  • D. Assess the pin sites for signs of infection.
Correct Answer: D

Rationale: Assessing pin sites for infection is critical in skeletal traction to prevent complications like osteomyelitis, which could delay healing.

The nurse is caring for a client in the post anesthesia care unit (PACU) who underwent a thoracotomy two hours ago. The nurse observes vital signs of a heart rate of 140 beats/minute, a respiratory rate of 26 breaths/minute, and a blood pressure of 140/90 mm Hg. Which intervention is most important for the nurse to implement?

  • A. Administer IV fluid bolus as prescribed by the healthcare provider.
  • B. Encourage the client to splint the Incision with a pillow to cough and deep breathe.
  • C. Medicate for pain and monitor vital signs according to protocol.
  • D. Apply oxygen at 10 L/minute via non-rebreather mask and monitor pulse oximeter.
Correct Answer: C

Rationale: Pain medication addresses tachycardia and tachypnea likely caused by postoperative pain, stabilizing vital signs.

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.

Which findings during the admission assessment should the nurse document that are related to a client diagnosed with Cushing's syndrome?

  • A. Visible swelling of the neck, with no pain.
  • B. Warm, soft, moist, salmon colored skin.
  • C. Central type obesity, with thin extremities.
  • D. Husky voice and troubled by hoarseness.
Correct Answer: C

Rationale: Central obesity with thin extremities is characteristic of Cushing's syndrome due to cortisol-induced fat redistribution.

The nurse is teaching a client with glomerulonephritis about self-care. Which dietary recommendation should the nurse encourage the client to follow?

  • A. Increase Intake of potassium rich foods such as bananas or cantaloupe.
  • B. Restrict protein intake by limiting meats and other high protein foods.
  • C. Limit oral fluid intake to 500 mL/day.
  • D. Increase intake of high fiber foods, such as bran cereal.
Correct Answer: B

Rationale: Restricting protein reduces kidney workload and proteinuria, preserving function in glomerulonephritis.

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