HESI RN Med Surg | Nurselytic

Questions 176

HESI RN

HESI RN Test Bank

HESI RN Med Surg Questions

Extract:


Question 1 of 5

The nurse is caring for a client receiving thrombolytic therapy following an acute myocardial infarction (MI). Which nursing problem should the nurse identify as priority for this client?

Correct Answer: A

Rationale: Thrombolytic therapy increases bleeding risk, making the risk for injury due to bleeding the priority, as it can lead to severe complications like hemorrhage, requiring immediate monitoring and intervention.

Question 2 of 5

The nurse is providing discharge instructions to the caregiver of an infant with recurrent otitis media. Which statement made by the caregiver should the nurse recognize as needing additional education about minimizing subsequent infections?

Correct Answer: A

Rationale: Benzocaine drops do not prevent otitis media and may cause harm. Other statements reflect correct preventive measures.

Extract:

History and Physical
Nurses’ Notes
Flow sheet
Orders
Imaging Studies
A 19-year-old female client presents to the emergency department reporting tightness in her chest and difficulty breathing. The client's friend, who accompanied the client to the emergency department, reports she was at a park playing soccer with a group of college friends when the symptoms started. The park is close to a residential area where a fire was burning and there was a moderate breeze in the air. The client reported itching eyes and coughing. Approximately 15 minutes into the game, the client stopped running and held her hand on her chest, saying it felt tight. The client had difficulty catching her breath.
Home Medications
Albuterol/ipratropium every 4 hours by inhaler PRN for shortness of breath, last dose 2 days ago
Fluticasone/vilanterol 100/25 mcg inhaled daily, last dose 3 days ago
Ibuprofen 600 mg PO PRN for pain, last dose this morning for headache


Question 3 of 5

What finding(s) are cues for a respiratory problem? Select all that apply.

Correct Answer: A,B,D,E,F,G

Rationale: Sitting upright, chest tightness, tachypnea, restlessness, dyspnea, and low pulse oxygenation (85%) are direct indicators of respiratory distress, unlike medication compliance which is not a symptom.

Extract:


Question 4 of 5

The nurse is providing discharge instructions to the caregiver of an infant with recurrent otitis media. Which statement made by the caregiver should the nurse recognize as needing additional education about minimizing subsequent infections?

Correct Answer: A

Rationale: Benzocaine drops do not prevent otitis media and may cause harm. Other statements reflect correct preventive measures.

Question 5 of 5

The nurse is assessing the lung sounds of a preschooler. Which action should the nurse implement to ensure the child's cooperation?

Correct Answer: B

Rationale: Allowing the child to use a stethoscope on a stuffed animal helps the child understand the purpose of the stethoscope, reduces fear of the unfamiliar device, and encourages cooperation. Other options may distract the child or alter breathing patterns, interfering with the assessment.

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