HESI Medical Surgical Practice Exam - Nurselytic

Correct Answer: C

Rationale: The correct answer is C: Monitor for the presence of Chvostek's sign. Chvostek's sign is a clinical indicator of hypocalcemia, a common complication after thyroidectomy. Numbness and tingling around the face are associated with hypocalcemia due to potential damage to the parathyroid glands during surgery, leading to decreased calcium levels. Inspecting the neck for swelling (choice
B) is important but does not directly address the presenting symptoms. Opening and preparing the tracheostomy kit (choice
A) is not necessary based on the client's current symptoms. Assessing lung sounds for laryngeal stridor (choice
D) is not directly related to the client's reported numbness and tingling of the face.

Correct Answer: A

Rationale: The correct answer is Atherosclerosis. It is the primary cause of coronary artery disease, as it involves the buildup of plaque in the arteries, restricting blood flow to the heart. Hyperlipidemia (choice
B) contributes to atherosclerosis by increasing cholesterol levels in the blood but is not the direct cause of coronary artery disease. Diabetes (choice
C) can accelerate atherosclerosis due to high blood sugar levels, but it is not the most common cause. Smoking (choice
D) is a significant risk factor for developing coronary artery disease but is not the primary cause.

Correct Answer: A

Rationale: The correct answer is A: Left ventricular atrophy. Older adults who lead sedentary lifestyles are at risk of developing left ventricular atrophy, which can lead to decreased cardiac output during physical exertion. This condition can contribute to the client's inability to perform activities requiring physical exertion.
Choice B, irregular heartbeats, may be a consideration due to the presence of a pacemaker, but the client's reported inability to perform physically exerting activities is more indicative of a structural issue like left ventricular atrophy rather than a rhythm-related problem. Peripheral vascular occlusion (
Choice
C) is less likely to be the cause of the client's symptoms compared to the cardiac-related issue of left ventricular atrophy. While assessing pacemaker function (
Choice
D) is important, the client's symptoms are more suggestive of a cardiac structural issue rather than a malfunction of the pacemaker.

Correct Answer: D

Rationale: The correct answer is D, 1 AM, while sleeping. Isophane insulin suspension NPH (Humulin N) peaks around 6-8 hours after administration, which increases the risk of hypoglycemia during the night.
Choice A, 11 AM, shortly before lunch, is incorrect because the peak effect of NPH insulin occurs much later.
Choice B, 1 PM, shortly after lunch, is incorrect as it is too early for the peak effect of NPH insulin.
Choice C, 6 PM, shortly after dinner, is also incorrect because the peak risk of hypoglycemia with NPH insulin occurs later in the night.

Correct Answer: B

Rationale: The correct answer is B: Moon face. Cushing's syndrome is characterized by excess cortisol levels, leading to the distinctive round and full face known as moon face. Hyperpigmentation (choice
A) may occur due to increased ACTH levels, but it is not a hallmark symptom like moon face. Hypotension (choice
C) is less common in Cushing's syndrome as cortisol typically leads to hypertension (choice
D) due to its effects on blood pressure regulation.