Question

The nurse is developing a teaching plan for a client with peripheral arterial disease (PAD) who has a history of a myocardial infarction (MI) and smokes two packs of cigarettes daily. Which instruction has the greatest priority?

Answer 1

Correct Answers:

Enroll in a smoking cessation program.

Rationale :

🚬Smoking is the most significant modifiable risk factor for worsening peripheral arterial disease (PAD) and increasing cardiovascular events such as myocardial infarctions.

❌Continued tobacco use promotes vasoconstriction, reduces peripheral perfusion, and contributes to plaque formation.

⚠️While foot care and dietary modifications are important, smoking cessation has the greatest impact on reducing disease progression and complications.

💁‍♂️Enrolling the client in a smoking cessation program provides structured support to break nicotine addiction and improve vascular outcomes.

📌Core Message

Smoking cessation is the most critical step to slow PAD progression and reduce cardiovascular risks.

Answer 2

Correct Answers:

0.4

Rationale :

🧮Enoxaparin is supplied as 60 mg in 0.6 mL, which equals 100 mg/mL.

📏To give 40 mg, the nurse calculates the required volume using a proportional formula: (40 mg ÷ 60 mg) × 0.6 mL = 0.4 mL.

💉This ensures the client receives the correct therapeutic dose while avoiding over- or under-dosing.

🧪Rounding to the nearest tenth improves precision and prevents dosing errors in subcutaneous administration.

📌Core Message

The nurse should give 0.4 mL to deliver a 40 mg dose from a 60 mg/0.6 mL enoxaparin prefilled syringe.

Answer 3

Correct Answers:

Eats a vegetarian diet with cheese 2 to 3 times a day.

Rationale :

🧀Consuming large amounts of cheese, a high-calcium food, increases the risk of forming calcium oxalate stones, the most common type of renal calculi.

🥦While vegetarian diets are generally healthy, they can include oxalate-rich foods like spinach and nuts, which compound the risk.

🚰Hydration helps reduce stone risk, but excessive dietary calcium can override its benefit.

📋The other options—stress, carbonated water, and jogging—do not directly influence stone formation as much as dietary intake does.

📌Core Message

A high cheese intake in a vegetarian diet raises the risk of calcium oxalate kidney stones.

Answer 4

Correct Answers:

The client cleaned house with cleaning supplies.

Rationale :

🧽Household cleaning products often contain chemicals that can irritate the airways and are known triggers for asthma.

🌬️Exposure to these irritants can directly induce bronchospasm and worsen asthma symptoms.

🤒Viral infections, weight gain, and genetics can influence asthma, but they are not immediate environmental triggers.

💨Avoiding known triggers is essential for asthma control and prevention of exacerbations.

📌Core Message

Cleaning supply fumes are a common and significant trigger for asthma exacerbations.

Answer 5

Correct Answers:

Reduce roughage in the diet.

Rationale :

🥗During acute diverticulitis, reducing roughage and high-fiber foods helps prevent irritation of inflamed diverticula.

🍞Fiber is reintroduced gradually after the inflammation subsides to help prevent future flare-ups.

🥤Although hydration and fat reduction are beneficial long term, they do not address acute inflammation.

⚠️Eating roughage during an active episode can worsen symptoms and delay healing.

📌Core Message

A low-fiber diet during acute diverticulitis reduces irritation and supports healing.

Answer 6

Correct Answers:

"If I'm out in the sun, I need to use a very strong sunblock."

Rationale :

🌞Clients with SLE are photosensitive, and UV exposure can trigger flares and worsen skin lesions.

🧴Using a strong sunblock protects the skin and reduces disease activity.

🚫Tanning booths also emit harmful UV radiation and should be avoided entirely.

🔬SLE is not contagious, and skin care involves protection, not isolation or drying agents.

📌Core Message

Strong sunblock is vital to protect photosensitive skin and prevent SLE flare-ups.

Answer 7

Correct Answers:

Keep the client NPO.

Rationale :

🚫Clients with postoperative strictures after bariatric surgery who present with vomiting and anorexia should be kept NPO to prevent further irritation.

💧This allows for proper fluid resuscitation and reduces the risk of aspiration or perforation.

🥤Oral intake, including protein shakes or meals, is contraindicated until GI patency is confirmed.

💊Vitamin supplementation is important long-term, but not during an acute obstructive episode.

📌Core Message

In cases of GI obstruction, keeping the client NPO is crucial to avoid complications and support healing.

Answer 8

Correct Answers:

Remove objects that could cause injury.

Rationale :

🛑During a seizure, removing objects around the client prevents trauma and injury.

🔁Clients may thrash or move involuntarily, making the environment the first safety priority.

🛏️While placing pillows is supportive, clearing the area addresses the broader safety risk.

💨Oxygen can be applied later if needed, but it’s not the first intervention during a seizure.

📌Core Message

Removing dangerous objects ensures seizure safety and prevents trauma during the episode.

Answer 9

Correct Answers:

Lung sounds.
Oxygen saturation.
Urinary output.

Rationale :

💁‍♂️Lung sounds help evaluate if pulmonary congestion has improved after diuretic administration.

📊Monitoring oxygen saturation confirms whether gas exchange has improved.

💧Tracking urinary output assesses if the furosemide is working to relieve fluid overload.

🧪Skin turgor and pain assessment don’t directly evaluate diuretic efficacy in acute pulmonary cases.

📌Core Message

Monitor lung sounds, oxygen saturation, and urine output to assess response to furosemide in fluid overload.

Answer 10

Correct Answers:

"I will wash my hands with warm soapy water before sticking my finger."

Rationale :

🧼Proper hand hygiene prevents contamination and ensures accurate blood glucose readings.

🩸Pricking the side of the finger pad is less painful and yields better blood flow than the center.

📅Hemoglobin A1C reflects long-term control and is measured every 3–6 months, not daily or weekly.

📟SMBG monitors do not measure A1C; they assess immediate glucose levels.

📌Core Message

Washing hands before SMBG ensures accurate glucose readings and reduces infection risk.

HESI RN Med- surg 2024 Exam-4

No.

1 :
The nurse is developing a teaching plan for a client with peripheral arterial disease (PAD) who has a history of a myocardial infarction (MI) and smokes two packs of cigarettes daily. Which instruction has the greatest priority?

2 :
The nurse is preparing a prescription for enoxaparin 40 mg subcutaneous (sub) daily. Enoxaparin is available in a pre-filled cartridge labelled, "60 mg per 0.6 mall" How many mL should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

3 :
The nurse is obtaining a health history from a new client who has a history of kidney stones. Which statement by the client indicates an increased risk for renal calculi?

4 :
An adult client has been admitted to the hospital with asthma exacerbation. Which trigger should the nurse identify as being the most significant cause of this client's asthma complications?

5 :
Which diet modification should the nurse suggest to a client who was recently diagnosed with diverticulitis?

6 :
Which statement by a client with systemic lupus erythematosus (SLE) indicates the best understanding of proper skin care?

8 :
After placing a client who is having a seizure in the side-lying position, which intervention should the nurse implement?

10 :
A client is newly diagnosed with type 2 diabetes mellitus. The nurse is educating the client about self-monitoring blood glucose (SMBG) and haemoglobin A1C. Which statement by the client indicates teaching has been effective?

HESI RN Med- surg 2024 Exam-4

No.

1 : The nurse is developing a teaching plan for a client with peripheral arterial disease (PAD) who has a history of a myocardial infarction (MI) and smokes two packs of cigarettes daily. Which instruction has the greatest priority?

2 : The nurse is preparing a prescription for enoxaparin 40 mg subcutaneous (sub) daily. Enoxaparin is available in a pre-filled cartridge labelled, "60 mg per 0.6 mall" How many mL should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

3 : The nurse is obtaining a health history from a new client who has a history of kidney stones. Which statement by the client indicates an increased risk for renal calculi?

4 : An adult client has been admitted to the hospital with asthma exacerbation. Which trigger should the nurse identify as being the most significant cause of this client's asthma complications?

5 : Which diet modification should the nurse suggest to a client who was recently diagnosed with diverticulitis?

6 : Which statement by a client with systemic lupus erythematosus (SLE) indicates the best understanding of proper skin care?

8 : After placing a client who is having a seizure in the side-lying position, which intervention should the nurse implement?

10 : A client is newly diagnosed with type 2 diabetes mellitus. The nurse is educating the client about self-monitoring blood glucose (SMBG) and haemoglobin A1C. Which statement by the client indicates teaching has been effective?

1 :
The nurse is developing a teaching plan for a client with peripheral arterial disease (PAD) who has a history of a myocardial infarction (MI) and smokes two packs of cigarettes daily. Which instruction has the greatest priority?

2 :
The nurse is preparing a prescription for enoxaparin 40 mg subcutaneous (sub) daily. Enoxaparin is available in a pre-filled cartridge labelled, "60 mg per 0.6 mall" How many mL should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

3 :
The nurse is obtaining a health history from a new client who has a history of kidney stones. Which statement by the client indicates an increased risk for renal calculi?

4 :
An adult client has been admitted to the hospital with asthma exacerbation. Which trigger should the nurse identify as being the most significant cause of this client's asthma complications?

5 :
Which diet modification should the nurse suggest to a client who was recently diagnosed with diverticulitis?

6 :
Which statement by a client with systemic lupus erythematosus (SLE) indicates the best understanding of proper skin care?

8 :
After placing a client who is having a seizure in the side-lying position, which intervention should the nurse implement?

10 :
A client is newly diagnosed with type 2 diabetes mellitus. The nurse is educating the client about self-monitoring blood glucose (SMBG) and haemoglobin A1C. Which statement by the client indicates teaching has been effective?