HESI MEDSURG III FINAL EXAM ACTUAL EXAM 160 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+

HESI MEDSURG III FINAL EXAM 2023-2024 ACTUAL

EXAM 160 QUESTIONS AND CORRECT DETAILED

ANSWERS WITH RATIONALES (VERIFIED ANSWERS)

|ALREADY GRADED A+

A patient who was involved in a motor vehicle crash has had a

tracheostomy placed to allow for continued mechanical ventilation. How

should the nurse interpret the following arterial blood gas results: pH

7.48, PaO2 85 mm Hg, PaCO2 32 mm Hg, and HCO3 25 mEq/L?

a. Metabolic acidosis

c.Respiratory acidosis

b.Metabolic alkalosis

d.Respiratory alkalosis - ANSWER- d.Respiratory alkalosis

The nurse notes that a patient who was admitted with diabetic

ketoacidosis has rapid, deep respirations. Which action should the nurse

take?

a. Give the prescribed PRN lorazepam (Ativan).

b. Encourage the patient to take deep slow breaths.

c. Start the prescribed PRN oxygen at 2 to 4 L/min.

d. Administer the prescribed normal saline bolus and insulin. -

ANSWER- d. Administer the prescribed normal saline bolus and insulin.

Rationale: The rapid, deep (Kussmaul) respirations indicate a

metabolic acidosis and the need for correction of the acidosis with a

saline bolus to prevent hypovolemia followed by insulin

administration to allow glucose to reenter the cells. Oxygen therapy

is not indicated because there is no indication that the increased

respiratory rate is related to hypoxemia. The respiratory pattern is

compensatory, and the patient will not be able to slow the

respiratory rate. Lorazepam administration will slow the

respiratory rate and increase the level of acidosis.

The nurse is caring for a patient who has a calcium level of 12.1 mg/dL.

Which nursing action should the nurse include on the care plan?

a. Maintain the patient on bed rest.

b. Auscultate lung sounds every 4 hours.

c. Monitor for Trousseau's and Chvostek's signs.

d. Encourage fluid intake up to 4000 mL every day. - ANSWER- d.

Encourage fluid intake up to 4000 mL every day.

A patient has a serum calcium level of 7.0 mEq/L. Which assessment

finding is most important for the nurse to report to the health care

provider?

a.The patient is experiencing laryngeal stridor.

b.The patient complains of generalized fatigue.

c.The patient's bowels have not moved for 4 days.

d.The patient has numbness and tingling of the lips. - ANSWER- a.The

patient is experiencing laryngeal stridor.

Rationale: Hypocalcemia can cause laryngeal stridor, which may

lead to respiratory arrest. Rapid action is required to correct the

patient's calcium level. The other data are also consistent with

hypocalcemia, but do not indicate a need for as immediate action as

laryngospasm.

Following a thyroidectomy, a patient complains of "a tingling feeling

around my mouth." Which assessment should the nurse complete?

a. Presence of the Chvostek's sign

b. Abnormal serum potassium level

c. Decreased thyroid hormone level

d. Bleeding on the patient's dressing - ANSWER- a. Presence of the

Chvostek's sign

Rationale: The patient's symptoms indicate possible hypocalcemia,

which can occur secondary to parathyroid injury or removal during

thyroidectomy. There is no indication of a need to check the

potassium level, the thyroid hormone level, or for bleeding.

To determine possible causes, the nurse will ask a patient admitted with

acute glomerulonephritis about

a. recent bladder infection.

c. recent sore throat and fever.

b. history of kidney stones.

d. history of high blood pressure. - ANSWER- c. recent sore throat and

fever.

Rationale: Acute glomerulonephritis frequently occurs after a

streptococcal infection such as strep throat. It is not caused by

kidney stones, hypertension, or urinary tract infection.

Which finding for a patient admitted with glomerulonephritis indicates

to the nurse that treatment has been effective?

a. The patient denies pain with voiding.

b. The urine dipstick is negative for nitrites.

c. The antistreptolysin-O (ASO) titer has decreased.

d. The periorbital and peripheral edema are resolved. - ANSWER- d.

The periorbital and peripheral edema are resolved.

Rationale: Because edema is a common clinical manifestation of

glomerulonephritis, resolution of the edema indicates that the

prescribed therapies have been effective. Nitrites will be negative

and the patient will not experience dysuria because the patient does

not have a urinary tract infection. Antibodies to streptococcus will

persist after a streptococcal infection.

A 56-yr-old female patient is admitted to the hospital with new-onset

nephrotic syndrome. Which assessment data will the nurse expect?

a. Poor skin turgor

c. Elevated urine ketones

b. Recent weight gain

d. Decreased blood pressure - ANSWER- b. Recent weight gain