HESI RN Medical Surgical EXAM
The nurse is assessing a clients laboratory values following the administration of chemotherapy. Which
lab value leads the nurse to suspect that the client is experiencing tumor lysis syndrome?
A. Hemoglobin of 10 g/dl
B. Serum calcium of 5mg/dl
C. Serum PTT of 1...
hesi rn medical surgical exam the nurse is assessing a clients laboratory values following the administration of chemotherapy which lab value leads the nurse to suspect that
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HESI RN Medical Surgical EXAM
The nurse is assessing a clients laboratory values following the administration of chemotherapy. Which
lab value leads the nurse to suspect that the client is experiencing tumor lysis syndrome?
A. Hemoglobin of 10 g/dl
B. Serum calcium of 5mg/dl
C. Serum PTT of 10 seconds
D. Oxygen saturation of 90%
Answer: B
TLS results in hyperkalemia, hypocalcemia, hyperuricemia, and hyperphosphatemia. A serum calcium
level of 5 is low and so is an indicator of possible TLS.
A client is admitted to the hospital with severe acute diverticulitis. Which assessment finding should the
nurse expect this client to exhibit?
A. Severe pain at McBurney's point and nausea.
B. Lower left quadrant pain and a low grade fever.
C. Abdominal pain and intermittent tenesmus.
D. Exacerbations of severe diarrhea.
Answer: B
Left lower quadrant pain occurs with diverticulitis because the sigmoid colon is the most common area
for diverticula and the inflammation of diverticula causes a low grade fever.
A is indicative of appendicitis. C and D are indicitive of ulcerative colitis.
,A client is placed on a mechanical ventilator following a cerebral hemorrhage, and vecuronium bromide
(Norcuron) 0.04 mg/kg q12 hours IV is prescribed. What is the priority nursing diagnosis for this client?
A. Potential for injury related to impaired lung expansion.
B. Impaired communication related to paralysis of skeletal muscles.
C. High risk for infection related to increased intracranial pressure.
D. Social isolation related to inability to communicate.
Answer: B
To increase the client's tolerance of endotracheal intubation and/or mechanical ventilation, a skeletal-
muscle relaxant, such as vecuronium, is usually prescribed. Impaired communication is a serious
outcome because the client cannot communicate his/her needs due to intubation and diaphragmatic
paralysis caused by the drug.
The nurse would be correct in withholding a dose of digoxin in a client with congestive heart failure
without specific instrucions from the healthcare provider if the client's
A. Serum potassium level is a 3
B. Blood pressure is 104/68
C. Serum digoxin level is 1.5
D. apical pulse is 68/min
Answer: A
Hypokalemia can precipitate digoxin toxicity in persons receiving digoxin which will increase the chance
of dangerous dysrhythmias. The therapeutic range for digoxin is 0.8 to 2 ng/ml. The nurse should also
hold the digoxin if the apical pulse is below 60/min.
After the fourth dose of gentamicin sulfate (Garamycin) IV, the nurse plans to draw blood samples to
determine peak and trough levels. When are the best times to draw these samples?
, A) 15 minutes before and 15 minutes after the next dose.
B) One hour before and one hour after the next dose.
C) 5 minutes before and 30 minutes after the next dose.
D) 30 minutes before and 30 minutes after the next dose.
Answer: C
Peak drug serum levels are achieved 30 minutes after IV administration of aminoglycosides. The best
time to draw a trough is the closest time to the next administration.
In preparing a discharge plan for a 22-year-old male client diagnosed with Buerger's disease
(thromboangiitis obliterans), which referral is most important?
A. A twelve step recovery program.
B. Smoking cessation program.
C. Genetic counseling.
D. Clinical nutritionist.
Answer: B
Buerger's disease is strongly related to smoking. The most effective means of controlling the symptoms
and disease progression is through smoking cessation.
Which symptoms should the nurse expect a client to exhibit who is known to have a
pheochromocytoma?
A) Numbness, tingling, and cramps in the extremities.
B) Headache, diaphoresis, and palpitations.
C) Cyanosis, fever, and classic signs of shock.
D) Nausea, vomiting, and muscular weakness.
Answer: B
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