Med Surg Test bank (Red HESI Test bank MedSurg and other resources)question s and answers, 2023/2024

Med Surg Test
bank (Red HESI
Test bank MedSurg and other
resources)question
s and answers,
2023/2024
1. The arterial blood gas (ABG) readings that
indicate compensated respiratory acidosis are a
PaCO2 of
A. 30 mm Hg and bicarbonate level of 24 mEq/L.
B. 30 mm Hg and bicarbonate level of 30 mEq/L.
C. 50 mm Hg and bicarbonate level of 20 mEq/L.
D. 50 mm Hg and bicarbonate level of 30 mEq/L. -
ANSWER-D. 50 mm Hg and bicarbonate level of 30
mEq/L. If compensation is present, carbon dioxide
and bicarbonate are abnormal (or nearly so) in
opposite directions (e.g., one is acidotic and the
other alkalotic).
2. A patient admitted to the emergency department
with tension pneumothorax and mediastinal shift
following an automobile crash is most likely to exhibit
A. bradycardia.
B. severe hypotension.
C. mediastinal flutter.
D. a sucking chest wound. - ANSWER-B. severe
hypotension. Mediastinal shift may cause
compression of the lung in the direction of the shift
and compression, traction, torsion, or kinking of the
great vessels. Blood return to the heart is
dangerously impaired and causes a subsequent
decrease in cardiac output and blood pressure.
Tachycardia is a clinical manifestation of tension
pneumothorax. An uncovered opened
pneumothorax is associated with a sucking chest
wound and mediastinal flutter.
3. In preparing the preoperative teaching plan for a
patient who is to undergo a total laryngectomy, a
nurse should give highest priority to the
A. tracheostomy being in place for 2 to 3 days.
B. patient's not being able to speak normally again.
C. insertion of a gastrostomy feeding tube during
surgery.
D. patient's not being able to perform deep-breathing
exercises. - ANSWER-B. patient's not being able to
speak normally again. Patients who have a total
laryngectomy have a permanent tracheostomy and
will need to learn how to speak using alternative
methods, such as an artificial larynx. The
tracheostomy will be permanent to allow normal
breathing patterns and air exchange. After surgery,
the patient's nutrition is supplemented with enteral
feedings, and when the patient can swallow
secretions, oral feedings can begin. Deep-breathing
exercises should be performed with the patient at
least every 2 hours to prevent further pulmonary
complications.
4. After a posterior nasal pack is inserted by a
physician, the patient is very anxious and states, "I
don't feel like I'm breathing right." The immediate
intervention the nurse should initiate is to
A. monitor ABGs.
B. reassure the patient that this is normal discomfort.
C. cut the pack strings and pull the packing out with
a hemostat.
D. direct a flashlight into the patient's mouth and
inspect the oral cavity. - ANSWER-D. direct a
flashlight into the patient's mouth and inspect the
oral cavity. The nurse should inspect the oral cavity
for the presence of blood, soft palate necrosis, and
proper placement of the posterior plug. If the
posterior plug is visible, the physician should be
notified for readjustment of the packing.
Reassurance, cutting the strings, and ABGs are not
top priority interventions. The nurse needs further
data before intervening.
5. A nurse is performing assessment for a patient
diagnosed with chronic obstructive pulmonary
disease (COPD). Which of the following findings
should the nurse expect to observe?
A. Nonproductive cough
B. Prolonged inspiration
C. Vesicular breath sounds
D. Increased anterior-posterior chest diameter -
ANSWER-D. Increased anterior-posterior chest
diameter An increased anterior-posterior diameter is
a compensatory mechanism experienced by patients
with COPD and is caused by air-trapping. Patients
with COPD have a productive cough, often
expectorating copious amounts of sputum. Because
of air-trapping, patients with COPD experience a
prolonged expiration because the rate of gas on
exhalation takes longer to escape. Chest
auscultation for patients with COPD often reveals
wheezing, crackles, and other adventitious breath
sounds.
6. A nurse is working on a respiratory care unit
where many of the patients are affected by asthma.
Which of the following actions by the nurse would
most likely increase respiratory difficulty for the
patients?
A. Wearing perfume to work
B. Encouraging patients to ambulate daily C.
Allowing the patients to eat green leafy vegetables
D. Withholding antibiotic therapy until cultures are
obtained - ANSWER-A. Wearing perfume to work
People with asthma should avoid extrinsic allergens
and irritants (e.g., dust, pollen, smoke, certain foods,
colognes and perfumes, certain types of
medications) because their airways become
inflamed, producing shortness of breath, chest
tightness, and wheezing. Many green leafy
vegetables are rich in vitamins, minerals, and
proteins, which incorporate healthy lifestyle patterns
into the patients' daily living routines. Routine
exercise is a part of a prudent lifestyle, and for
patients with asthma the physical and psychosocial
effects of ambulation can incorporate feelings of
well-being, strength, and enhancement of physical
endurance. Antibiotic therapy is always initiated after
cultures are obtained so that the sensitivity to the
organism can be readily identified.