HESI RN Med Surg | Nurselytic

Questions 176

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HESI RN Med Surg Questions

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Question 1 of 5

A client who had a biliopancreatic diversion procedure (BDP) 3 months ago is admitted with severe dehydration. Which assessment finding warrants immediate intervention by the nurse?

Correct Answer: B

Rationale: Occult positive emesis indicates vomiting, which can exacerbate dehydration through significant fluid loss, requiring immediate intervention in a post-BDP client already dehydrated.

Question 2 of 5

The healthcare provider prescribes diazepam 8 mg IM every 4 hours PRN muscle spasms for a client with a fractured femur. The available vial is labeled, 'Diazepam Injection, USP 10 mg/2 mL.' How many mL should the nurse administer to the client? (Enter numerical value only. If rounding is required round to the nearest tenth.)

Correct Answer: 1.6 mL

Rationale: The vial provides 5 mg/mL (10 mg/2 mL). For an 8 mg dose, the nurse should administer 1.6 mL (8 mg ÷ 5 mg/mL), calculated to meet the prescribed dose.

Question 3 of 5

The mother of a 6-year-old girl is concerned about her child's obesity. The child's weight plots at the 75th percentile, and height at the 25th percentile. The child's body mass index (BMI) is at the 85th percentile for age and gender. Which intervention(s) should the nurse implement? Select all that apply.

Correct Answer: A,E

Rationale: Obtaining a diet history and assessing physical activity patterns identify unhealthy habits for targeted interventions. Other options are misleading or insufficient.

Question 4 of 5

A client experiencing a sudden onset of confusion and trouble speaking at home is transported to the emergency department. The client does not understand simple commands and appears very frustrated. Which intervention should the nurse perform in the immediate management of the client?

Correct Answer: D

Rationale: Determining symptom onset and progression is critical for diagnosing conditions like stroke, guiding urgent management decisions, and assessing eligibility for time-sensitive treatments.

Question 5 of 5

A preschool-aged child who is experiencing respiratory distress is brought to the emergency department by the parents. The child is anxious, has a temperature of 102.8° F (39.3° C), and is drooling from the mouth while leaning forward when sitting. Which action should the nurse prepare the child for next?

Correct Answer: C

Rationale: Symptoms suggest epiglottitis, requiring urgent intubation or tracheotomy to secure the airway. Other actions are not immediate priorities.

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