*NURSING > HESI > 1d.HESI_Practice_Test_Medical_Surgical_Assignment_Exam.pdfMiami Regional University Florida - NURSIN (All)

1d.HESI_Practice_Test_Medical_Surgical_Assignment_Exam.pdfMiami Regional University Florida - NURSING DE MSN5410

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The nurse is caring for a client who is two days postoperative. Which observation should alert the nurse to call the Rapid Response Team (RRA client is admitted to the hospital with a traumatic brain... injury after his head violently struck a brick wall during a gang fight. Which finding is most important for the nurse to assess further?The nurse is providing instructions about log rolling to a client who returns to the postoperative unit after a lumbar laminectomy. Which explanation should the nurse give the client about this technique?The nurse is preparing discharge instructions for a client who is going home with a surgical wound on the coccyx that is healing by secondary intention. What is the priority nursing diagnosis that should guide the discharge instruction plan?When planning care for a client with right renal calculi, which nursing diagnosis has the highest priority?A client with Meniere ' s disease is incapacitated by vertigo and is lying inA client who is admitted to the emergency department with a possible tension pneumothorax after a motor vehicle collision is having multiple diagnostic tests. Which Risk for injury. Sexual dysfunction. Deficient knowledge. Give the drug and allow the client to read and sign the consent form. Counter-sign the client's initials on the consent form after giving the drug. Withhold the drug until the client validates understanding of the surgical procedure and signs the consent form. Call the healthcare provider to explain the surgical procedure before the client signs the consent. 3/21/2021 HESI https://hesi-preparation-suite.elsevier.com/#/hesiPracticeTestResults/1388772/1096J1FX8H7 6/56 finding requires immediate action by the nurse? Rationale Immediate action is required for findings of a mediastinal shift, which can precipitate life-threatening cardiovascular collapse as the great cardiac vessels become kinked and compressed due to the tension pneumothorax. A client who is receiving the sixth unit of packed red blood cell transfusion is demonstrating signs and symptoms of a febrile, nonhemolytic reaction. What assessment finding is most important for the nurse to identify? Rationale The most common type of reaction is a febrile, nonhemolytic blood transfusion reaction related to leukocyte incompatibility, which causes chills, fever, headache, and flushing. Serum amylase of 132 units/L. Serum sodium of 134 mEq/L. Chest x-ray indicating a mediastinal shift. Abdominal x-ray air throughout intestines. Increased anxiety since the transfusion began. Drowsiness after receiving diphenhydramine (Benad bed grasping the side rails and staring at the television. Which nursing intervention should the nurse implement? What is the primary nursing problem for a client with asymptomatic primary syphilisA client in the preoperative holding area receives a prescription for midazolam (Versed) IV. The nurse determines that the surgical consent form needs to be signed by the client. Which action should the nurse implement?The nurse is providing discharge instructions to a client who has undergone a left orchiectomy for testicular cancer. Which statement indicates that the client understands his post-operative care and prognosis? Rub a liberal amount of cream into the skin thoroughly. Cover the skin with a gauze dressing after applying the cream. Leave the cream on the skin for 1 to 2 hours before the procedure. Use the smallest amount of cream necessary to numb the skin surface. "I should continue to perform testicular self-examination (TSE) monthly on my remaining testicle." "I should wear an athletic supporter and cup to prevent testicular cancer in my remaining testicle." 3/21/2021 HESI https://hesi-preparation-suite.elsevier.com/#/hesiPracticeTestResults/1388772/1096J1FX8H7 15/56 Rationale Although testicular cancer protocols, such as surgery, radiation, or chemotherapy, focus on the primary site of testicular cancer, these treatments do not reduce the risk of testicular cancer in the remaining testicle, so early recognition is the best prevention. The client's understanding is reflected in the statement to perform monthly TSE for changes in size, shape, or consistency of the testis that may indicate early cancer. A nurse is preparing a teaching plan for a client who is post-menopausal. Which measure is most important for the nurse to include to prevent [Show More]

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