a client with cushings syndrome is recovering from an elective laparoscopic procedure which assessment finding warrants immediate intervention by the

HESI LPN

Medical Surgical Assignment Exam HESI Quizlet

1. A client with Cushing's Syndrome is recovering from an elective laparoscopic procedure. Which assessment finding warrants immediate intervention by the nurse?

A. Irregular apical pulse
B. Purple marks on the skin of the abdomen
C. Quarter-sized blood spot on the dressing
D. Pitting ankle edema

Correct answer: A

Rationale: The correct answer is A: Irregular apical pulse. In a client recovering from a laparoscopic procedure with Cushing's Syndrome, an irregular apical pulse can be indicative of a life-threatening arrhythmia and requires immediate intervention. Choices B, C, and D are not as urgent as an irregular apical pulse. Purple marks on the skin of the abdomen may be related to Cushing's Syndrome, a quarter-sized blood spot on the dressing can be managed with appropriate wound care, and pitting ankle edema may be expected postoperatively but does not require immediate intervention.

2. Which other congenital defects are common in children with Down syndrome?

A. Hypospadias
B. Pyloric stenosis
C. Heart defects
D. Hip dysplasia

Correct answer: C

Rationale: The correct answer is C: Heart defects. Many children with Down syndrome are born with congenital heart defects. These heart abnormalities are more prevalent in individuals with Down syndrome than in the general population. Choices A, B, and D are incorrect because while they may be congenital defects in children, they are not commonly associated with Down syndrome. Hypospadias is a urogenital condition, pyloric stenosis affects the stomach, and hip dysplasia involves the hip joint, but these are not typically seen as frequently as heart defects in children with Down syndrome.

3. A male client with diabetes mellitus is transferred from the hospital to a rehabilitation facility following treatment for a stroke resulting in right hemiplegia. He tells the nurse that his feet are always uncomfortably cool at night, preventing him from falling asleep. Which action should the nurse implement?

A. Provide a warming pad for his feet
B. Medicate the client with a prescribed sedative.
C. Use a bed cradle to keep the covers off his feet.
D. Place warm blankets next to the client's feet.

Correct answer: D

Rationale: Placing warm blankets next to the client's feet is the most appropriate action to provide warmth and comfort. This method is safe and effective in addressing the client's complaint of uncomfortably cool feet at night. Providing a warming pad (Choice A) may pose a risk of burns or injury, especially for a client with decreased sensation due to diabetes. Mediating the client with a sedative (Choice B) does not address the underlying issue of cool feet and may not be necessary. Using a bed cradle (Choice C) to hold the covers off the feet does not directly address the client's need for warmth and comfort.

4. An 82-year-old female client with type 2 diabetes and degenerative arthritis complains to the nurse that she has a hard time cutting her toenails. What should the nurse recommend?

A. Seek routine nail care with a podiatrist.
B. Encourage monthly pedicures at a nail salon.
C. Soak feet for 10 minutes before cutting nails.
D. Ask a family member to cut toenails.

Correct answer: A

Rationale: For an 82-year-old female client with type 2 diabetes and degenerative arthritis, the nurse should recommend seeking routine nail care with a podiatrist. This is crucial to ensure proper and safe toenail care, reducing the risk of injury and infection, which is especially important for diabetic clients. Encouraging monthly pedicures at a nail salon (choice B) may not address the underlying issues related to diabetes and arthritis. Soaking feet for 10 minutes before cutting nails (choice C) may help soften the nails but does not address the difficulty the client faces in cutting them. Asking a family member to cut toenails (choice D) may not guarantee the expertise needed for proper diabetic foot care, which a podiatrist can provide.

5. The nurse uses a diagram to show that the tetralogy of Fallot involves a combination of four congenital defects. What are the defects?

A. Aortic stenosis, atrial septal defect, overriding aorta, left ventricular hypertrophy
B. Pulmonary stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy
C. Aortic stenosis, atrial septal defect, overriding aorta, right ventricular hypertrophy
D. Pulmonary stenosis, ventricular septal defect, aortic hypertrophy, left ventricular hypertrophy

Correct answer: B

Rationale: The correct answer is B: Pulmonary stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy. Tetralogy of Fallot involves these four congenital defects. Choice A is incorrect because it includes aortic stenosis instead of pulmonary stenosis, atrial septal defect instead of ventricular septal defect, and left ventricular hypertrophy instead of right ventricular hypertrophy. Choice C is incorrect as it includes aortic stenosis and atrial septal defect instead of pulmonary stenosis and ventricular septal defect. Choice D is incorrect because it includes aortic hypertrophy instead of overriding aorta.