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2023-2024 HESI Medical Surgical Final Exam With Answers (346 Solved Questions) - Document preview page 1

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2023-2024 HESI Medical Surgical Final Exam With Answers (346 Solved Questions)

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2023-2024 HESI Medical Surgical Final Exam With Answers (346 Solved Questions) - Page 1 preview imageMS4 HESI MED SURG FINAL EXAM FOR2023/20241.Following long-term administration of warfarin sodium to a client with a medical diagnosisofdeep vein thrombosis, the nurse should expect which treatment?a.The hemoglobin will be greater than 10 g/dlb.The hematocrit will be less than 35%d.The PTT will be 1.5 times the normal2.A client who has been takingfinasteride, an enzyme (5 alpha reductase) inhibitor used toshrink the prostate gland, is admitted because of continuing benign prostate prostatichypertrophy (BPH) symptoms when planning care. Which nursing problem should thenurseaddressfirst?a.Chronic painc.Risk for infectiond.Disturbed sleep pattern3.An older client has been diagnosed with chronic venous insufficiency. To preventvenousreturn, which action should the nurse encourage the client toa.Wear cotton socks and enclosed toe shoes whenever outsideb.Drink 8 to 10 ounces of water a dayc.Sit at the side of the bed for 15 minutes before standingd.Lie down in bed 2 times a day4.When caring for a client with a full thickness burn covering 40% of the body, thenurse observes pertinent drainage at the wound. Before reporting thisfinding to thehealthcare provider, the nurse should review which of the client’s laboratory values?a.Hematocritb.Platelet countd.Blood pH level5.An older client arrives at the outpatient eye surgery clinic for a right cataract extraction andimplant. During the immediate postoperative period, which intervention should thenurseimplementa.Provide an eye shield to be worn while sleepingb.Obtain vital signs every 2 hours during hospitalizationb.Urinaryc.The PT will be 1.5 times the normalc.White blood cell (WBC)
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2023-2024 HESI Medical Surgical Final Exam With Answers (346 Solved Questions) - Page 2 preview image
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2023-2024 HESI Medical Surgical Final Exam With Answers (346 Solved Questions) - Page 3 preview imagec.Encourage deep breathing and coughing exercisesd.Teach a family member to administer eye drops6.After several days of coughing and taking acetaminophen to treat temperatures of 101 F(38.3 C), a client with DI is admitted to the hospital with an upper respiratory infection. Severalhours after admission, the client reports having a severe headache and freezing dizzy. Whichintervention should the nurse implementfirst?a.Reassess vital signsb.Obtain sputum for culturec.Obtain afingerstick glucosed.Administer an antipyretic7.a client takes daily supplemental iron tablets for iron deficiency anemia reports feelingincreasingly fatigued. Which laboratory values should the nurse review?a.Serum electrolytesb.Complete blood countc.Liver enzymesd.Platelet count8.The nurse is caring for a client post anesthesia care unit (PACU) who underwent athoracotomy two hours ago. The nurse observes the following vital signs: heart rate140beats/minute, respirations 26 breaths/minute, and blood pressure 140/90 mmHg.Whichintervention is most important for the nurse to implement?a.Administer IVfluid bolus as prescribed by the healthcare providerb.Medicate for pain and monitor vital signs according to protocolc.Encourage the client to splint the incision with a pillow to cough and deep breathed.Apply oxygen at 10 L via non-rebreather mask and monitor pulse oximeter9.A client who was involved in a motor vehicle collision is admitted with a fractured left femurwhich is immobilized using a fracture traction splint in preparation for an open reductioninternalfraction (ORIF). The nurse determines that the client’s distal pulses are diminished inthe left foot. Which interventions should the nurse implement? (SATA)a.Offer ice chips and oral clear liquidse.Administer oral antispasmodics and narcotics analgesics10.A nurse is caring for a client with Diabetes Insipidus (DI). which data warrants themostimmediate intervention by the nurse?a.Dry skin with inelastic turgorb.Apical rate of 110 beats per minutec.Polyuria and excessive thirstb cd.Evaluate the application of the splint to the left.Monitor left leg for pain, pallor, paresthesia, paralysis, pressure.Verify pedal pulses using a doppler pulse deviced.Serum sodium of 185 mEq/L
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2023-2024 HESI Medical Surgical Final Exam With Answers (346 Solved Questions) - Page 4 preview imagec.d.b.Pain relief can be provided by shrinking tumors that press against spinal nerves11.The nurse assesses a client with petechiae and ecchymosis scattered across the armsandlegs. Which laboratory result should the nurse review?tb.Red blood cell countc.Hemoglobin levels white blood cell count12.A male client is admitted to the emergency department with vomiting of dark brown,foul-smelling emesis. He reports he had a surgical repair of a recurrent inguinal hernia oneweekago and complains of intense abdominal pain. After assessing that his bowel soundsare hyperactive, which prescription should the nurse implementfirst13.A client is admitted to the hospital for shortness of breath and chest pain after an episodeofsyncope. Which laboratoryfinding is most important for the nurse to report to the healthcareprovider?a.Hematocritb.Blood glucosec.Oxygen saturation14.A client is hospitalized after experiencing a myocardial infarction (MI) to reducecardiacworkload, which intervention should the nurse include in the client’s plan of care?a.Teach to sleep in a side-lying positionb.Encourage active range of motion exercisesd.Assist with ambulation in the hallway15.The healthcare provider prescribes radiation therapy (RT) for a client with terminalmetastaticwho is experiencing increased pain due to spinal compression. The clientasks the nurse why radiation therapy is prescribed. Which mechanism supports the use of RTinthe client’s metastatic cancer?a.Implementation of all possible treatments offers clients the best chance of survivalEvidence indicates that RT can prolong life in clients with metastatic cancersRT is an alternative to surgery that affects tumor growth and eradicates cancer16.The nurse is caring for a client diagnosed with psoriasis vulgaris who is receiving aPUVAtreatment. Which assessmentfinding indicates that the client has been overexposedto the treatment?a.Brown, rough, greasy, wart-like papules on the faceb.Thick skin plagues topped by silvery white scalesc.Requires sunglasses because sunlight hurts eyesd.Tenderness upon palpation and generalized erythemaInsert a nasogastric tube (NGT) and attach to low intermittent suctiond.Troponin Ic.Provide a bedside commode fora.Platelet
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2023-2024 HESI Medical Surgical Final Exam With Answers (346 Solved Questions) - Page 5 preview image17.An older client with long-term type 2 diabetes mellitus (DM) is seen in the clinic for aroutinehealth assessment. Which assessments would the nursetodetermineifthepatient with type 2 DM is experiencing long-term complications? (SATA)e.Signs of respiratory tract infection18.A client with a history of chronic obstructive disease (COPD) is admitted with pneumonia.Vital signs include oxygen saturation 89% temperature 100.5 F (C) heart rate 120 beats/minute, respirations 28 breaths/minute and blood pressure 170/90mmHg. Whichfindingwarrants immediate intervention by the nurse?a.Shortness of breath on exertionb.Coarse breath soundsd.Yellow expectorated sputum19.The nurse observes an increased number of blood clots in the drainage tubing of aclientwith continuous bladder irrigation following a transurethral resection of the prostate(TURP). What is the best initial nursing action?b.Measure the client’s intake and outputc.Administer a PRN dose of an antispasmodic agentd.Provide additional oralfluid intake20.The nurse assesses an adult client 24 hours after a bowel exploration and formation ofasigmoid colostomy. Which assessmentfinding should be reported to the surgeon?a.The fecal matter is brown and has a solid consistencyb.There are no bowel sounds in the left lower quadrantd.The stoma has streaks of bright red bloodSerum creatinine and blood urea nitrogen (BUN)c.Sensation in feet and legendsSkin condition of lowera.visual acuityc.Bilateral diffuse wheezinga.Increase the flow of the bladder irrigationc.The stoma mucosa is purple in
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2023-2024 HESI Medical Surgical Final Exam With Answers (346 Solved Questions) - Page 6 preview image21.The nurse is caring for a client admitted to the hospital with a tentative diagnosis ofbacterialmeningitis. Which diagnostic procedure should the nurse prepare the client for thehealthcare provider?a.Skull radiographyb.Computerized tomography (CT) scanc.Magnetic resonance imaging (MRI)d.Lumbar puncture22.A young adult male client has a leg cast following an open reduction for fractured tibia. Heisin skeletal traction with 10 lbs of weight. Approximately two hours after returning to the unit,he reports severe pain in the affected extremity, and the nurse observes that the limb is blueand blunched. Which action should the nurse promotefirst?a.Release the traction and notify the healthcare providerb.Administer PRN pain medication routinely as prescribedd.Record the observations and check the imb every 15 minutes.23.A client is receiving combination chemotherapy for treatment of metastaticcarcinoma.When monitoring the client for systemic, side effects which assessmentfindings warrants intervention by the nurse?a.Polycythemiac.Ascitesd.nystagmus24.The nurse is planning care for an older adult male who experienced acerebrovascularaccident several weeks ago. Because of expressive aphasia, the clientoften becomes frustrated with the nursing staff. Which intervention should the nurseimplement?a.Encourage client’s use of picture chartsb.Ask the client simple questionsc.Teach the client use of basic sign languaged.Speak slowly to the client25.The nurse has determined that a client with trigeminal neuralgia has the nursingproblem,“imbalanced nutrition, less than body requirements”. Which causecontributing to the problem?a.Altered taste sensationb.Nauseac.Fatiguec.Notify the healthcare provider of the assessment findingsb.Leukopenia
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2023-2024 HESI Medical Surgical Final Exam With Answers (346 Solved Questions) - Page 7 preview image.Pain when eatingd26.A client with Cushing’s syndrome is recovering from an elective laparoscopicprocedure.Which assessmentfinding warrants immediate intervention by the nurse?b.Purple marks on skin of the abdomenc.Pitting ankle edemad.Quarter size blood spot on dressing27.The nurse is assessing a client who has herpes zoster. Which question will allow thenurseto gather further information about this condition?a.Has everyone at home already had varicella?b.Do you have any dry patches on your feet and hands?c.Do your family members share combs and brushes?d.Have the antifungal creams been effective?28.The healthcare provider prescribed D5W 1800 mL IV to infuse in 24 hours. TheIVadministration set delivers 60 microdroplets. The nurs should program the29.A client with COPD arrives at the emergency department reporting of shortness ofbreathupon exertion andweakness. The clientthe nurse of normally receiving dialysisthree times a week but missed the last treatment. The client’s serum potassium is 4.8 mEq/Land creatinine os 1.4, accompanied with a blood pressure of 200/120 mmHg. The clienthas salt crystals present on the skin. Whichfinding is most important for the nurse to bringtothe attention of the healthcare provider?a.Potassium levelb.Blood pressurec.Uremic frostd.Creatinine results30.The nurse determines that an adult client who is admitted to the post anesthesia careunit(PACU) following abdominal surgery has a tympanic temperature of 94.6 F(34,8 *C), apulse rate of 88 beats/minute, a respiratory rate of 14breaths/minute, and a blood pressureof 94.64mmHg. Which action should the nurse implement?b.Check the blood pressure everyfive minutes for one hourc.Ask the client to cough and deep breathed.Raise the head of the bed to 60 to 90 degrees.31.An adult client is diagnosed with restless leg syndrome and is referred to the sleep clinic.a.Irregular apical pulsea.Take the clients temperature using another methodANS 75
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2023-2024 HESI Medical Surgical Final Exam With Answers (346 Solved Questions) - Page 8 preview imageThe healthcare provider prescribessulfate 300 mg PO daily. Which laboratoryvaluesshould the nurse monitor?a.Serum electrolytesb.Platelet count and hematocritd.Neutrophils and eosinophils32.To reduce the risk for pulmonary complication for a client with Amyotrophic. LateralSclerosis(ALS), what interventions should the nurse implement? (SATA)b.Establish a regular bladder routined.Initiate passive range of motion exercises33.A client withureterolithiasisis preparing for discharge after a ureteroscopyremoval.Which instruction should the nurse include in this client’s postoperative dischargeteaching?a.Use incentive spirometerb.Report when hematuria becomes pink triggeredd.Restrict physical activities34.After assessing in a left lateral thoracentesis for a client with pleural effusion, the nursethe pleuralfluid samples and sends them to the labprocedure, whichfinding warrantsimmediate intervention by the nurse?a.Oxygen saturation 90% on 4 liters nasal cannulab.Left-sided pain on inhalationd.Decreased left lung breath sounds35.During a preoperative assessment phone call, a client states taking several “pills”everyday. Which response should the office nurse provide?a.“Obtain a copy of your medications records from your healthcare provider”b.“Bring all your pill containers to your preoperative appointment”c.“Discuss with your healthcare provider which medications to take before surgery”d.“Bring copies of all your prescriptions to your preoperative appointment”36.Which food is most important for the nurse to encourage a client with osteomalacia toe.Teach the client breathing exercisesc.Subcutaneous emphysema around insertion sitec.Serum iron and ferritinc.Perform chest physiotherapyc.Monitor urinary stream for decreaseda.Encourage use of incentive spirometer
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2023-2024 HESI Medical Surgical Final Exam With Answers (346 Solved Questions) - Page 9 preview imagec.Teach the client to elevate the head of the bed on blocksinclude in a daily diet?b.Citrus fruits and juicesc.Red meats and eggsd.Green leafy vegetables37.The healthcare provider prescribes metoclopramide 7.5 mg/mL IM every 3 hours PRNvomiting for a client who is receiving chemotherapy. The nurse preparesusing a 2 mLprefilled syringe cartridge labeled, “metoclopramide 5 mg/mL” How many mL should thenurseadminister?ANS: 338.The nurse is assessing a client’s arteriovenous (AV)fistula. Whichfinding providesevidenceof its normal function?a.Ecchymotic areab.Enlarg ed veinc.Pulselessnessd.redness39.Which instruction should the nurse include in the discharge teaching for a client whohasgastroesophageal reflux?a.Encourage the client to lie down and rest after mealsb.Remind the client to avoid high-fiber foodsd.Instruct the client to use antacids only as a last resort40.The home health nurse is evaluating a male client who manages his asthma andmeasureshis peak expiratoryflow rate (PEFR). Today he is experiencing an acuteexacerbation and tellsthe nurse his PERF is 60% of his personal-best reading. He isexperiencing expiratory and inspiratory wheezes and has a RR of 24 breaths/minute, andoxygen saturation rate of 94% onroom air. Which PRN medication should the nurse instructthe client to use?a.Albuterol 2.5 to 5 mg per nebulizationb.Epinephrine auto-injector 0.15mgc.Salmeterol 2 puffs per measured- dose inhaledd.Oxygen at 6 liter.minute by nasal cannula41.The nurse assesses a client who is newly diagnosed with hyperthyroidism and observesthatthe clients eyeballs are protuberant causign a wide eyed appearance and eye discomfort.42.The nurse prepares a teaching plan for an adult client with metabolic syndrome. WhichObtain prescription for artificial tear dropsa.Fortified milk and cereals
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2023-2024 HESI Medical Surgical Final Exam With Answers (346 Solved Questions) - Page 10 preview imageComplete the full course of antibioticsfinding should the nurse address to help the client reduce the risk for diabetes mellitus andvascular disease?(Select all that apply)s43.A client with gouty arthritis reports tenderness and swelling of the right ankle and greattoe.The nurse observes the area of inflammation. The client receives prescriptions forcolchicine and indomethacin, Which instruction should the nurse include in the dischargeteaching?A.Limit use of mobility equipment to avoid muscle atrophyB.Massage joints to relax muscles and decrease painC.Substitute natural fruit juices for carbonated drinks44.After teaching a female client newly diagnosed with cholecystitis about recommendeddietchanges, the nurse evaluates the clients learning. Elimination of which food choices bythe client indicates teaching is successful?45.A client with chronic obstructive pulmonary disease (COPD) is admitted to a non-emergentcholecystectomy. The admission arterial blood gas ) ABG PCO2 48 mmHG46.A client with pyelonephritis is receiving discharge instructions with the goal to preventreadmission.Which instruction is most important to include in the discharge teachingplan.47.A client with heart failure is receiving intravenousfluids at 125 ml/hour. The nurseobservesan increased jugular venous distention. Which assessment should the nurse makebefore reporting to the healthcare provider.b.Assess for inflammation of the calves48.The nurse is caring for a client after a cerebrovascular accident (CVA) who is adapting tofunctional changes in mobility. The client continues to experience awareness of the urge tourinate and retains a large amount of residual urine after voiding. Which action should thenurseinclude?49.Which dietary instruction is most important for the nurse to explain to a client who hadagastric bypass surgery?a.Sipfluids with each mealD.Return for periodic liver functions studiesWhole milk and daily ice cream servingsRemind the client to practice pelvicfloor (Kegel) exercises regularlyBlood pressure of 150/96Abdominal obesitylcemiaHyperIncreased triglyceride levelAdminister a PRN bronchodilatora.Observe for change in breathing pattern
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2023-2024 HESI Medical Surgical Final Exam With Answers (346 Solved Questions) - Page 11 preview imageb.Eat small frequent mealsc.Chew Slowly and thoroughly
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2023-2024 HESI Medical Surgical Final Exam With Answers (346 Solved Questions) - Page 12 preview imageD. avoid washing the skin inside the radiation portal site..Initiate airborne particulate isolation precautionsd.Reduce intake of fatty foods50.The nurse is providing teaching to a client with Type 2 diabetes mellitus andperipheralneuropathy. What information should the nurse provide?A.Heading pads are useful if on the lowest settingB.Shoes should be worn outside the house, but it isfine to be barefoot inside.C.Family members can help with regular foot examsD.Aching feet may be soaked in lukewarm water for one hour or more51.A client with a history of heart failure reports increasing fatigue over the past week. Onassessment the nurse obtains the following blood pressure 122/70 mmgHg, and respiratoryrate24 breaths/minute. While waiting for an electrocardiogram (ECG),,52.The nurse assists a client with parkinson's disease to ambulate in the hallway.The clientappears to “Freeze” and then tells the nurse of pretending to step over a crack on thefloor.Howshould the nurse respond?53.When completing a health assessnent for a client with migraine headachesm the nurseassesses bilateral weakness in the … trouble twisting a door knob due to weakness. Whataction should the nurse take in response to thesefindings?54.A client is admitted with a deep and productive cough, hemophytisis, and a low gradefever.The client’s Mantoux skin test has 15mm induration. Which intervention should the nurseimplementfirst?A.Provide a mask for the client to wear in public areasBC.Administer the initial dose of rifampin and isonaizaidD.Collect a sputum specimen for acid fast baccilus55.The nurse is caring for a client who is receiving teletheraphy radiation for a maliganttumor.Which instructions regarding skin care of the-Rythm of apical pulse-Re-orient the client to his present location and circumstancesC. Gather additional assessment data about the pain and weakness
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2023-2024 HESI Medical Surgical Final Exam With Answers (346 Solved Questions) - Page 13 preview image1.Following long-term administration of warfarinsodium to a client with a medical diagnosis ofdeepvein thrombosis, the nurse should expect whichtreatment?a.The hemoglobin will be greater than 10 g/dlb.The hematocrit will be less than 35%c.The PT will be 1.5 times the normal-goodd.The PTT will be 1.5 times the normal-2.A client who has been takingfinasteride, anenzyme (5 alpha reductase) inhibitor used toshrinkthe prostate gland, is admitted because ofcontinuing benign prostate prostatic hypertrophy(BPH) symptoms when planning care. Whichnursing problem should the nurseaddressfirst?a.Chronic painb.Urinary retention-goodc.Risk for infectiond.Disturbed sleep pattern3.An older client has been diagnosed with chronicvenous insufficiency. To prevent venousreturn,which action should the nurse encourage theclient toa.Wear cotton socks and enclosed toe shoes wheneveroutside(-goodb.Drink 8 to 10 ounces of water a dayc.Sit at the side of the bed for 15 minutes before standingd.Lie down in bed 2 times a day4.When caring for a client with a full thicknessburncovering40%ofthebody,thenurseobservespertinentdrainageatthewound.Before reporting thisfinding to the healthcareprovider, the nurse should review which of theclient’s laboratory values?a.HematocritbPlatelet count (other pick)
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2023-2024 HESI Medical Surgical Final Exam With Answers (346 Solved Questions) - Page 14 preview imageb.White blood cell (WBC) count (on quizlet)-goodc.Blood pH level5.An older client arrives at the outpatient eye surgery clinic for a rightcataract extraction andimplant. During the immediate postoperativeperiod, which intervention should the nurseimplementa.Provide an eye shield to be worn while sleeping-goodb.Obtain vital signs every 2 hours during hospitalizationc.Encourage deep breathing and coughing exercisesd.Teach a family member to administer eye drops6.After several days of coughing and takingacetaminophen to treat temperatures of 101 F (38.3C), a client with DI is admitted to the hospital with anupper respiratory infection. Several hours afteradmission, the client reports having a severeheadache and freling dizzy. Which intervention shouldthe nurse implementfirst?a.Reassess vital signsb.Obtain sputum for culturec.Obtain afingerstick glucose-goodd.Administer an antipyretic7.a client takes daily supplemental iron tabletsfor iron deficiency anemia reports feelingincreasingly fatigued. Which laboratory valuesshould the nurse review?a.Serum electrolytesb.Complete blood count-goodc.Liver enzymes
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2023-2024 HESI Medical Surgical Final Exam With Answers (346 Solved Questions) - Page 15 preview imaged.Platelet count8.The nurse is caring for a client post anesthesia careunit (PACU) who underwent a thoracotomy two hoursago. The nurse observes the following vital signs: heartrate 140 beats/ minute, respirations 26 breaths/minute,and blood pressure 140/90 mmHg. Which interventionismost important for the nurse to implement?a.Administer IVfluid bolus as prescribed by the healthcareproviderb.Medicate for pain and monitor vital signs according toprotocol-i put thisc.Encourage the client to splint the incision with a pillow tocough and deep breathed.Apply oxygen at 10 L via non-rebreather mask and monitorpulse oximeter9.A client who was involved in a motor vehicle collisionis admitted with a fractured left femur which isimmobilized using a fracture traction splint inpreparation for an open reduction internalfraction(ORIF). The nurse determines that the client’s distalpulses are diminished in the left foot. Whichinterventions should the nurse implement? (SATA)-gooda.Offer ice chips and oral clear liquidsb.Verify pedal pulses using a doppler pulse devicec.Monitor left leg for pain, pallor, paresthesia, paralysis,pressured.Evaluate the application of the splint to the left lege.Administer oral antispasmodics and narcotics analgesics10.A nurse is caring for a client with DiabetesInsipidus (DI). which data warrants the mostimmediate intervention by the nurse?-g00da.Dry skin with inelastic turgor
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2023-2024 HESI Medical Surgical Final Exam With Answers (346 Solved Questions) - Page 16 preview imageb.Apical rate of 110 beats per minutec.Polyuria and excessive thirstd.Serum sodium of 185 mEq/L11.The nurse assesses a client with petechiae andecchymosis scattered across the arms andlegs.Which laboratory result should the nurse review?a.Platelet count -goodb.Red blood cell countc.Hemoglobin levelsd.White blood cell count12.A male client is admitted to the emergencydepartment with vomiting of dark brown, foul-smelling emesis. He reports he had a surgicalrepair of a recurrent inguinal hernia one weekagoand complains of intense abdominal pain. Afterassessing that his bowel sounds are hyperactive,which prescription should the nurse implementfirstInsert a nasogastric tube (NGT) and attach to low intermittentsuction-good13.A client is admitted to the hospital for shortness ofbreath and chest pain after an episode ofsyncope.Which laboratoryfinding is most important for thenurse to report to the healthcare provider?a.Hematocritb.Blood glucosec.Oxygen saturationd.Troponin I-good14.A client is hospitalized after experiencing amyocardial infarction (MI) to reduce cardiacworkload, which intervention should the nurseinclude in the client’s plan of care?a.Teach to sleep in a side-lying position
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