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HESI RN Med Surg 3 Questions

Extract:

Laboratory Results
0600
Laboratory Test
Results
Reference Range
pH
7.23
7.35 to 7.45
Partial pressure of oxygen (PaO2)
89 mm Hg
80 to 100 mm Hg
Partial
37 mm
35 to 45


Question 1 of 5

Based on the ABG values, the nurse knows that the client has [condition] related to [cause].

Correct Answer: D,G

Rationale: Uncompensated metabolic acidosis is characterized by a low pH (7.23) and normal PaCOâ‚‚ (37 mmHg), indicating a primary metabolic problem without respiratory compensation. The lack of insulin in type 1 diabetes leads to ketone formation and metabolic acidosis.

Extract:


Question 2 of 5

A female client admitted with possible pneumonia and systemic inflammatory response syndrome (SIRS) is manifesting low oxygen saturation rates. Which additional finding(s) associated with SIRS should the nurse report to the health care provider (HCP)? Select all that apply.

Correct Answer: A,B,C,D

Rationale: Respiratory rate -22, heart rate -90, hypothermia <36°C, and WBC >12,000/mm³ meet SIRS criteria, indicating systemic inflammation.

Question 3 of 5

A client with a gunshot wound is brought to the emergency department (ED) with a bullet entry at the spinal level of C8 and T1. The client is able to move the upper arms. To further assess the client's spinal nerve function, which action should the nurse implement?

Correct Answer: C

Rationale: The C8 and T1 spinal nerves control hand and finger movements. Testing grip strength assesses nerve integrity at the injury level.

Question 4 of 5

After 15 minutes of cardiopulmonary resuscitation (CPR) and multiple defibrillations, a client has return of spontaneous circulation (ROSC) with a heart rate of 130 beats/minute and ST elevation in leads I,II, III, aVF, aVL, V5, V6. Which serum laboratory values are most important for the nurse to monitor?

Correct Answer: D

Rationale: Troponin is the most specific and sensitive biomarker for myocardial infarction, indicated by ST elevation in multiple leads.

Question 5 of 5

A client has been treated for uncontrolled atrial fibrillation with cardioversion. Following the cardioversion, which assessment finding indicates to the nurse that the desired outcome was achieved?

Correct Answer: A

Rationale: The goal of cardioversion for atrial fibrillation (AFib) is to restore a normal sinus rhythm (NSR). NSR indicates that the atria and ventricles are depolarizing in a coordinated manner, reducing the risk of thromboembolism, stroke, and hemodynamic instability. A heart rate of 84 beats/minute is within the normal range, confirming the success of the procedure.

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