HESI MED SURG 2023 TEST BANK / MED SURG EXAM TEST BANK 600 QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+

HESI MED SURG 2023 TEST BANK / MED SURG EXAM

TEST BANK 600 QUESTIONS AND CORRECT

DETAILED ANSWERS (VERIFIED ANSWERS)

|ALREADY GRADED A+

A patient with an acute pharyngitis is seen at the clinic with fever and severe throat

pain that affects swallowing. On inspection the throat is reddened and edematous

with patchy yellow exudates. The nurse anticipates that collaborative management

will include

A. treatment with antibiotics.

B. treatment with antifungal agents.

C. a throat culture or rapid strep antigen test.

D. treatment with medication only if the pharyngitis does not resolve in 3 to 4

days. - ANSWER- C. a throat culture or rapid strep antigen test. Although

inadequately treated β-hemolytic streptococcal infections may lead to

rheumatic heart disease or glomerulonephritis, antibiotic treatment is not

recommended until strep infections are definitely diagnosed with culture or

antigen tests. The manifestations of viral and bacterial infections are similar,

and appearance is not diagnostic except when candidiasis is present.

Following a supraglottic laryngectomy, the patient is taught how to use the

supraglottic swallow to minimize the risk of aspiration. In teaching the patient

about this technique, the nurse instructs the patient to

A. perform Valsalva maneuver immediately after swallowing.

B. breathe between each Valsalva maneuver and cough sequence.

C. cough after swallowing to remove food from the top of the vocal cords.

D. practice swallowing thin, watery fluids before attempting to swallow solid

foods. - ANSWER- C. cough after swallowing to remove food from the top of

the vocal cords. A supraglottic laryngectomy involves removal of the epiglottis

and false vocal cords, and the removal of the epiglottis allows food to enter the

trachea. Supraglottic swallowing requires performance of the Valsalva

maneuver before placing food in the mouth and swallowing. The patient then

coughs to remove food from the top of the vocal cords, swallows again, and

then breathes after the food has been removed from the vocal cords.

A patient is admitted to the hospital with fever, chills, a productive cough with

rusty sputum, and pleuritic chest pain. Pneumococcal pneumonia is suspected. An

appropriate nursing diagnosis for the patient based on the patient's manifestations

is

A. hyperthermia related to acute infectious process.

B. chronic pain related to ineffective pain management.

C. risk for injury related to disorientation and confusion.

D. ineffective airway clearance related to retained secretions. - ANSWER- A.

hyperthermia related to acute infectious process. The patient with

pneumococcal pneumonia is acutely ill with fever and the systemic

manifestations of fever, such as chills, thirst, headache, and malaise.

Interventions that monitor temperature and aid in lowering body temperature

are appropriate. Ineffective airway clearance would be manifested by

adventitious breath sounds and difficulty producing secretions. Disorientation

and confusion are not noted in this patient and are not typical unless the

patient is very hypoxemic. Pleuritic pain is an acute pain that is due to

inflammation of the pleura.

The resurgence in TB resulting from the emergence of multidrug-resistant strains

of Mycobacterium tuberculosis is primarily the result of

A. a lack of effective means to diagnose TB.

B. poor compliance with drug therapy in patients with TB.

C. the increased population of immunosuppressed individuals with AIDS. D.

indiscriminate use of antitubercular drugs in treatment of other infections. -

ANSWER- B. poor compliance with drug therapy in patients with TB. Drugresistant strains of TB have developed because TB patients' compliance to

drug therapy has been poor and there has been general decreased vigilance in

monitoring and follow-up of TB treatment. Antitubercular drugs are almost

exclusively used for TB infections. TB can be effectively diagnosed with

sputum cultures. The incidence of TB is at epidemic proportions in patients

with HIV, but this does not account for drug-resistant strains of TB.

The chronic inflammation of the bronchi characteristic of chronic obstructive

pulmonary disease (COPD) results in

A. collapse of small bronchioles on expiration.

B. permanent, abnormal dilation of the bronchi.

C. hyperplasia of mucus-secreting cells and bronchial edema.

D. destruction of the elastic and muscular structures of the bronchial wall. -

ANSWER- C. hyperplasia of mucus-secreting cells and bronchial edema.

Chronic bronchitis is characterized by chronic inflammation of the bronchial

lining, with edema and increased mucus production. Collapse of small

bronchioles on expiration is common in emphysema, and abnormal dilation of

the bronchi because of destruction of the elastic and muscular structures is

characteristic of bronchiectasis.

In teaching the patient with COPD about the need for physical exercise, the nurse

informs the patient that

A. all patients with COPD should be able to increase walking gradually up to 20

min/day.

B. a bronchodilator inhaler should be used to relieve exercise-induced dyspnea

immediately after exercise.

C. shortness of breath is expected during exercise but should return to baseline

within 5 minutes after the exercise.

D. monitoring the heart rate before and after exercise is the best way to determine

how much exercise can be tolerated. - ANSWER- C. shortness of breath is

expected during exercise but should return to baseline within 5 minutes after

the exercise.Shortness of breath usually increases during exercise, but the

activity is not being overdone if breathing returns to baseline within 5 minutes

after stopping. Bronchodilators can be administered 10 minutes before

exercise but should not be administered for at least 5 minutes after activity to

allow recovery. Patients are encouraged to walk 15 to 20 minutes a day with

gradual increases, but actual patterns will depend on patient tolerance.

Dyspnea most frequently limits exercise and is a better indication of exercise

tolerance than is heart rate in the patient with COPD.

When assessing a patient's nutritional-metabolic pattern related to hematologic

health, the nurse would:

A. Inspect the skin for petechiae.

B. Ask the patient about joint pain.

C. Assess for vitamin C deficiency.

D. Determine if the patient can perform ADLs. - ANSWER- A. Inspect the skin

for petechiae. Any changes in the skin's texture or color should be explored

when assessing the patient's nutritional-metabolic pattern related to

hematologic health. The presences of petechiae or ecchymotic areas could be

indicative of hematologic deficiencies related to poor nutritional intake or

related causes.

When assessing lab values on a patient admitted with septicemia, the nurse would

expect to find:

A. Increased platelets

B. Decreased red blood cells

C. Decreased erythrocyte sedimentation rate (ESR)

D. Increased bands in the WBC differential (shift to the left) - ANSWER- D.

Increased bands in the WBC differential (shift to the left) When infections are

severe, such as in septicemia, more granulocytes are released from the bone

marrow as a compensatory mechanism. To meet the increased demand, many

young, immature polymorphonuclear neutrophils (bands) are released into

circulation. WBCs are usually reported in order of maturity, with the less