HESI RN
Hesi RN Medical Surg Questions
Extract:
History and Physical
A 59-year-old male client presents to the clinic reporting pain in the right great toe. The client says that the pain feels like it is another attack of gout, which he has had on 2 other occasions in the last 4 months. The client tells the nurses that the pain started about 9 days ago in the evening and that it got very painful and swollen shortly thereafter. In the past, the gout attacks have resolved without treatment after about 5 days, but the client reports that his condition has not improved and that he is unable to walk or work without excruciating pain in the great toe joint. The client has type 2 diabetes mellitus, osteoarthritis, hypertension, obesity, and sleep apnea. Currently, the client takes daily metformin, daily aspirin, daily enalapril, and ibuprofen as needed for pain. The client reports that he has never smoked or used tobacco products. He does not use recreational drugs. Typically, he drinks 2 to 3 dark beers nightly.
The healthcare provider is considering medications to treat the client's gout.
Question 1 of 5
A 59-year-old male client presents to the clinic reporting pain in the right great toe. For each medication used to treat gout, choose the most likely therapeutic outcome and the teaching associated with the medication.
Correct Answer: A,B,C,D
Rationale: Colchicine and prednisone reduce inflammation, naproxen alleviates pain and inflammation, and allopurinol prevents uric acid buildup, addressing both acute and chronic gout management.
Extract:
Question 2 of 5
An adult client who was recently diagnosed with glaucoma tells the nurse, 'It feels like I am driving through a tunnel.' The client expresses great concern about going blind. Which nursing instruction is most important for the nurse to provide this client?
Correct Answer: C
Rationale: Adhering to eye drops controls intraocular pressure, critical for preventing vision loss in glaucoma.
Extract:
Orders
Laboratory Results
Day 1, 1000
Serum uric acid, blood urea nitrogen (BUN), creatinine (Cr)
X-ray of right foot
Day 1, 1015
Acetaminophen 650 mg PO now
Question 3 of 5
Based on the client's laboratory findings, the nurse recognizes that the client is having an acute gout attack and is most at risk for SwellingBruisingInfectionInflammationRash and DiscolorationErythemaCyanosisPallorEcchymosis in his affected joint.
Correct Answer: A,B
Rationale: Inflammation and discoloration are hallmark symptoms of gout due to urate crystal-induced immune response and increased blood flow.
Extract:
Question 4 of 5
Which findings during the admission assessment should the nurse document that are related to a client diagnosed with Cushing's syndrome?
Correct Answer: C
Rationale: Central obesity with thin extremities is characteristic of Cushing's syndrome due to cortisol-induced fat redistribution.
Question 5 of 5
While caring for a client with a full thickness burn covering 40% of the body, the nurse observes purulent drainage at the wound. Before reporting this finding to the healthcare provider, the nurse should review which of the client's laboratory values?
Correct Answer: C
Rationale: WBC count indicates infection, as purulent drainage suggests bacterial colonization requiring prompt intervention.