2024 HESI Medical Surgical Nursing Practice Exam With Answers (233 Solved Questions)

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MED SURGE HESI EXAM 2 WITH NGN (LATEST UPDATED 2024)1. The nurse is providing teaching to a client with Type 2 diabetes mellitus and peripheralneuropathy. Which information should the nurse provide?a. Family members can help with regular foot examsb. Heating pads are useful if on the low settingc. Aching feet may be soaked in lukewarm water for one hour or mored. Shoes should be worn outside the house, but it is fine to be barefoot inside - a. Familymembers can help with regular foot exams2. A client in the operating room received succinylcholine. The client is experiencing musclerigidity and has an extremely high temperature. What action should the nurse implement?a. Hold a prescription for dantrolene until fever is reducedb. Prepare ice packs for placement in the clients axillary areac. Call the PACU nurse to prepare for prolonged ventilator supportd. Determine if prescribed antibiotics were administered preoperatively - b. Prepare icepacks for placement in the clients axillary area3. The nurse is developing a plan of care for a client who reports blurred vision and who isnewly diagnosed with cardiovascular disease. Which outcome should the nurse include in theplan of care for this client?a. The nurse will encourage the client to walk thirty minutes every dayb. The clients family will state signs and symptoms about the diseasec. The clients daily blood pressure will be less than 140/80 this monthd. The client blood pressure readings will be less than 160/90 - c. The clients daily bloodpressure will be less than 140/80 this month

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4. The family suspects that acquired immune deficiency syndrome (AIDS) dementia isoccuring in their son who is human immunodeficiency virus (HIV) positive. Which symptomsconfirm their suspicions?a. He has begun to sleep 18 out of 24 hoursb. A change has recently occurred in his handwritingc. He refuses to see any of his friends or to return their phone callsd. He exhibits angry outburst when the subject of dying is approached - b. A change hasrecently occurred in his handwriting5. A hospitalized client with peripheral arterial disease (PAD) is instructed regarding leg andfoot care. Which statement by the client indicates to the nurse that learning has occurred?a. "Whenever I am sitting in a chair I will keep my legs up to reduce swelling"b. "I can use a mirror to check the bottoms of my feet for any signs of breakdown"c. "I will try to keep moving if leg pain occurs to help promote good circulation"d. "I will use my swimming pool early in the day while the water is still very cool" - b. "I canuse a mirror to check the bottoms of my feet for any signs of breakdown"6. While completing a health assessment for a client with migraine headaches, the nurseassesses bilateral weakness in the client's hand grips. The client reports joint pain andtrouble twisting a door knob due to weakness. Which action should the nurse take inresponse to these findings?a. Explain that relief of the migraine pain will reduce related symptomsb. Gather additional assessment data about the pain and weaknessc. Implement fall precautions to reduce the client's risk for injuryd. Consult with the occupational therapist for a functional assessment - d. Consult with theoccupational therapist for a functional assessment7. A client with Cushing's syndrome is recovering from an elective laparoscopic procedure.Which assessment finding warrant's immediate intervention by the nurse?

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a. Purple marks on skin of the abdomenb. Irregular apical pulsec. Quarter size blood spot on dressingd. Pitting ankle edema - b. Irregular apical pulse8. A client with lung cancer who wears a subcutaneous morphine sulfate patch for pain isshort of breath and is difficult to arouse. When performing a head to toe assessment, thenurse discovers four analgesic patches on the clients body. Which intervention should thenurse implement first?a. Remove all of the morphine patchesb. Administer a narcotic antagonistc. Apply oxygen per face maskd. Measure the client's blood pressure - b. Administer a narcotic antagonist9. A client receives prescriptions for a multidrug regimen for the treatment of tuberculosis.Which information should the nurse prioritize?a. Adherence to the regimen is imperativeb. Medications should be taken with foodc. Serum liver panels are collected regularlyd. Enhanced sun protection measures will be needed - a. Adherence to the regimen isimperative10. The nurse is preparing a client for surgery who was admitted to the emergency centerfollowing a motor vehicle collision. The client has an open fracture of the femur and isbleeding moderately from the bone protrusion site. During the prescriptive assessment, thenurse determines that the client currently receives heparin sodium 5,000 unitssubcutaneously daily. What is the priority nursing action?a. Notify the healthcare provider of the client's medication historyb. Observe the heparin injections sites for signs of bruisingc. Have the client sign the surgical and transfusion permits

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d. Ensure that the potential for bleeding is explained to the client - a. Notify the healthcareprovider of the client's medication history11. A client with orthopnea expresses concern about the ability to "get enough air" during ascheduled thoracentesis. On which information should the nurse's response be based?a. A thoracentesis is a brief process that has minimal discomfortb. Orthopnea is frequently caused by a client's uncontrolled anxietyc. The procedure is performed with the client in an upright positiond. Extra pillows can be used if needed to elevate the client's head - c. The procedure isperformed with the client in an upright position12. What information should the nurse include in the teaching plan of a client diagnosed withgastroesophageal reflux disease (GERD)?a. Sleep without pillows at night to maintain neck alignmentb. Adjust food intake to three full meals per day and no snacksc. Minimize symptoms by wearing loose, comfortable clothingd. Avoid participation in any aerobic exercise programs - c. Minimize symptoms by wearingloose, comfortable clothing13. The nurse is caring for a client in the post anesthesia care unit (PACU) who underwent athoracotomy two hours ago. The nurse observes the following vital signs: heart rate 140bpm, respirations 26 breaths/minute and blood pressure 140/90. Which intervention ismost important for the nurse to implement?a. Medicate for pain and monitor vital signs according to protocolb. Adminsted intravenous fluid bolus as prescribed by the HCPc. Apply oxygen at 10 L via non-rebreather mask and monitor pulse oximeter.d. Encourage the client to splint the incision with a pillow to cough and deep breathe - a.Medicate for pain and monitor vital signs

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14. An adult is diagnosed with restless leg syndrome and is referred to the sleep clinic. TheHCP prescribed ferrous sulfate 325 PO daily. Which laboratory values should the nursemonitor ?a. Platelet count and hematocritb. Serum electrolytesc. Serum iron and ferritind. Neutrophils and eosinophils - c. Serum iron and ferritin15. While caring for a client with a full thickness burn covering 40% of the body, the nurseobserves purulent drainage at the wound. Before reporting this finding to the HCP , thenurse should review which of the client's laboratory values?a. White blood cell countb. Platelet countc. Blood pH leveld. Hematocrit - a. White blood cell count16. A client with a history of type 1 diabetes mellitus (DM) and asthma is readmitted to theunit for the third time in two months with a current fasting blood sugar of 325 mg/dl. Theclient describes to the nurse of not understanding why the blood glucose level continues tobe out of control. Which interventions should the nurse implement? Select all that apply.a. Have the client describe a typical day at work, home, and social activitiesb. Determine if the client is using a new insulin needle each administrationc. Evaluate the clients asthma medications that can elevate the blood glucosed. Ask the client if they want a different manufactures glucose monitoring devicee. Have the client demonstrate techniques used to monitor blood glucose levels - a. Have theclient describe a typical day at work, home, and social activitiese. Have the client demonstrate techniques used to monitor blood glucose levels17. The nurse assesses a client with cirrhosis and finds 4+ pitting edema of the feet and legs,and massive ascites. Which mechanism contributes to edema and ascites in clients withcirrhosis?

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a. Hyperaldosteronism causing an increased sodium reabsorption in renal tubulesb. Decreased portcaval pressure with greater collateral circulationc. Decreased renin-angiotensin response related to an increase in renal blood flowd. Hypoalbuminemia that results in a decreased colloid oncotic pressure - d.Hypoalbuminemia that results in a decreased colloid oncotic pressure18. An older client with long term type 2 diabetes mellitus (DM) is seen in the clinic for aroutine health assessment. Which assessments would the nurse complete if a patient withtype 2 diabetes mellitus (DM) is experiencing long term complications? Select all that apply.a. Signs of respiratory tract infectionb. Sensation in feet and legsc. Skin condition of lower extremitiesd. Serum creatinine and BUNe. Visual acuity - b. Sensation in feet and legsc. Skin condition of lower extremitiese. Visual acuity19. The nurse is caring for a client who is receiving teletherapy radiation for a malignanttumor. Which instructions regarding skin of the portal site should the nurse provide?a. Protect the skin of the radiation portal site from sunlight exposureb. Apply moisture lotions daily to the radiation portal sitec. Avoid washing the skin inside the radiation portal sited. Remove the ink marks of the portal after each radiation treatment - a. Protect the skin ofthe radiation portal site from sunlight exposure20. When conducting discharge teaching for a client diagnosed with diverticulitis, which dietinstruction should the nurse include?a. Have a small frequent meals and sit up for at least two hours after mealsb. Eat a bland diet and avoid spicy foodsc. Eat a high-fiber diet and increase fluid intake

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d. Eat a soft diet with increased intake of milk and milk products - c. Eat a high-fiber diet andincrease fluid intake21. An adult who was recently diagnosed with glaucoma tells the nurse, "it feels like I amdriving through a tunnel". The client expresses great concern about going blind. Whichnursing instruction is most important for the nurse to provide this client?a. Maintain prescribed eye drop regimenb. Avoid frequent eye pressure measurementsc. Wear a prescription glassesd. Eat a diet high in carotene - a. Maintain prescribed eye drop regimen22. Which client has the highest risk for developing skin cancer?a. A 70-year-old fair-skinned client who works as a secretaryb. A 65-year-old fair-skinned lenient who is a construction workerc. A 16-year-old dark skinned client who tans in tanning beds once a weekd. A 25-year-old dark skinned client whose mother had skin cancer - b. A 65-year-old fair-skinned lenient who is a construction worker23. During spring break, a young adult presents to the urgent care clinic reports a stiff neck,a fever for the past 6 hours, and a headache. Which intervention is most important for thenurse to implement first?a. Initiate isolation precautionsb. Administer an antipyreticc. Draw blood culturesd. Prepare for a lumbar puncture - a. Initiate isolation precautions24. The nurse assesses a client with petechiae and ecchymosis scattered across the armsand legs. Which laboratory results should the nurse review?a. Red blood cell countb. Platelet count

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c. Hemoglobin levelsd. White blood cell count - b. Platelet count25. An older adult client with a long history of chronic obstructive pulmonary disease (COPD)is admitted with progressive shortness of breath and a persistent cough. The client isanxious and is complaining of a dry mouth. Which intervention should the nurse implement?a. Assist client to an upright positionb. Administer a prescribed sedativec. Apply a high-flow venturi maskd. Encourage client to drink water - a. Assist client to an upright position26. The nurse is providing discharge instructions to a client who is receiving prednisone 5mg PO daily for a rash due to contact with poison ivy. Which symptoms should the nurse tellthe client to report to the HCP?a. Rapid weight gainb. Abdominal striaec. Moon facesd. Gastric irritation - a. Rapid weight gain27. A client with cholithiasis is admitted with jaundice due to obstruction of the common bileduct. Which finding is most important for the nurse to report to the HCP?a. Distended, hard, and rigid abdomenb. Clay-colored stoolc. Radiating, sharp pain in right shoulderd. Bile-stained emesis - a. Distended, hard, and rigid abdomen28. A client with chronic kidney disease is started on hemodialysis. During the first dialysistreatment, the client's blood pressure drops from 150/90 to 80/30. Which action should thenurse take first?a. Stop the dialysis treatment

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b. Adminster 5% albumin IVc. Monitor blood pressure Q45Md. Lower the head of the chair and elevate feet - a. Stop the dialysis treatment29. The nurse is collecting information from a client with chronic pancreatitis who reportspersistent gnawing abdominal pain. To help the client manage the pain, which assessmentdata is most important for the nurse to obtain?a. Presence and activity of bowel soundsb. Color and consistency of fecesc. Eating patterns and dietary intaked. Level and amount of physical activity - c. Eating patterns and dietary intake30 A client who had a C-5 spinal cord injury 2 years ago is admitted to the emergencydepartment with the diagnosis of autonomic dysreflexia secondary to full bladder. Whichassessment finding should the nurse expect this client to exhibit?a. Complaints of chest pain and shortness of breathb. Hypotension and venous pooling in the extremitiesc. Profuse diaphoresis and severe, pounding headached. Pain and a burning sensation upon urination and hematuria - d. Pain and a burningsensation upon urination and hematuria31. The nurse is obtaining a health history from a new client who has a history of kidneystones. Which statement by the client indicates an increased risk for renal calculi?a. Eats a vegetarian diet with cheese 2 to 3 times a dayb. Experiences additional stress since adopting a childc. Jogs more frequently than usual daily routined. Drinks several bottles of carbonate water daily - a. Eats a vegetarian diet with cheese 2 to3 times a day

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32. A client tells the clinic nurse about expericing burning on uriantion, and assssmentreveals that the client had sexual intercourse four days ago with a person who was casuallymet. Which action should the nurse implement?a. Observe the perineal area for a chancroid-like lesionb. Obtain specimen of urethral drainage for culturec. Assess for perineal itching, erythema, and excoriationd. Identify all sexual paterns in the last four days - b. Obtain specimen of urethral drainagefor culture33. An adult client is admitted with flank pain and is diagnosed with acute pyelonephritis.What is the priority nursing action?a. Monitor hemoglobin and hematocritb. Encourage turning and deep breathingc. Administer IV antibiotics as prescribedd. Auscultate for presence of bowel sounds - c. Administer IV antibiotics as prescribed34. Which food is most important for the nurse to encourage a client with osteomalacia toinclude in a daily diet?a. Fortified milk and cerealsb. Citrus fruits and juicesc. Green leafy vegetablesd. Red meats and eggs - a. Fortified milk and cereals35. A client with Herpes zoster (shingles) on the thorax tells the nurse of having difficultysleeping. Which is the probable etiology of this problem?a. Frequent coughb. Painc. Nocturiad. Dyspnea - b. Pain

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36. A client with cholelithiasis has a gallstone lodged in the common bile duct and is unableto eat or drink without becoming nauseated and vomiting. Which finding should the nursereport to the healthcare providera. Belchingb. Amber urinec. Yellow sclerad. Flatulence - c. Yellow sclera37. While caring for a client with Amyotrophic Lateral Sclerosis (ALS), the nurse performs aneurological assessment every four hours. Which assessment finding warrants immediateintervention by the nursea. Inappropriate laughterb. Increasing anxietyc. Weakened cough effortd. Asymmetrical weakness - c. Weakened cough effort38. The nurse is caring for a client who is postoperative for a femoral head fracture repair.Which intervention(s) should the nurse plan to administer for deep vein thrombosisprophylaxis? Select all that apply.a. Pneumatic compression devicesb. Incentive spirometryc. Assisted ambulationd. Patient-controlled analgesice. Calf-pump exercisesf. Prescribed anticoagulant therapy - a. Pneumatic compression devicese. Calf-pump exercisesf. Prescribed anticoagulant therapy39. A client with gouty arthritis reports tenderness and swelling of the right right ankle andgreat toe. The nurse observes the area of inflammation extends above the ankle area. The

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client receives prescriptions for colchicine and indomethacin. Which instruction should thenurse include in the discharge teaching?a. Eat a high protein foods to achieve ideal body weightb. Drink a least 8 cups (1920) mL of water per dayc. Use electric heating pad when pain is at its worsed. Encourage active range of motion to limit stiffness - b. Drink a least 8 cups (1920) mL ofwater per day40. A client with a history of peptic ulcer disease (PUD) is admitted after vomiting bright redblood several times over the course of 2 hours. In reviewing the laboratory results, thenurse finds the clients hemoglobin is 12 g/dL and the hematocrit is 35%. Which actionshould the nurse prepare to take?a. Continue to monitor for blood lossb. Administer 1,000 mL normal salinec. Transfuse 2 units of plateletsd. Prepare for client for emergency surgery - b. Administer 1,000 mL normal saline41. An obese client with emphysema who smokes at least a pack of cigarettes daily isadmitted after experiencing a sudden increase in dyspnea and activity intolerance. Oxygentherapy is initiated and it is determined that the client will be discharged with oxygen. Whichinformation is most important for the nurse to emphasize in the discharge teaching plan?a. Methods for weight lossb. Guidelines for oxygen usec. Approaches to conserve energyd. Strategies for smoking cessation - b. Guidelines for oxygen use42. A client arrives at the medical-surgical unit 4 hours after a transurethral resection ofthe prostate. A triple-lumen catheter for a continuous bladder irrigation with normal salineis infused and the nurse observes dark, pink tinged outflow with blood clots in the tubing andcollection bag. Which action should the nurse take?

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a. Monitoring catheter drainageb. Decreasing the flow ratec. Irrigating the catheter manuallyd. Discounting infusing solution - a. Monitoring catheter drainage43. The nurse is planning care for an older adult client who experienced a cerebrovascularaccident several weeks ago. The client has expressive aphasia and often becomes frustratedwith the nursing staff. Which intervention should the nurse implement?a. Teach the client use of basic sign languageb. Speak slowly to the clientc. Encourage clients use of picture chartsd. Ask the client simple questions - c. Encourage clients use of picture charts44. After three days of persistent epigastric pain, a female client presents to the clinic. Shehas been taking oral antacids without relief. Her visit signs are heart rate 122 beats/minute,respirations 16 breaths/minute, oxygen saturation 96%, and blood pressure 116/70. Thenurse obtains a 12-lead electrocardiogram (ECG). Which assessment finding is most critical?a. Irregular pulse rateb. Bile colored emesisc. ST elevation in three leadsd. Complaint of radiating jaw pain - c. ST elevation in three leads45. A client with acute renal injury (AKI) weighs 50kg and has a potassium level of 6.7 isadmitted to the hospital. Which prescribed medication should the nurse administer first?a. Calcium acetate one tablet by mouthb. Sodium polystyrene sulfonate 15 grams by mouthc. Epostein alfa, recombinant 2,500 units subcutaneouslyd. Sevelamer one tablet by mouth - b. Sodium polystyrene sulfonate 15 grams by mouth

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46. The nurse observes an increased number of blood clots in the drainage tubing of a clientwith continuous bladder irrigation following a trans-rethral resection of the prostate(TURP). What is the best initial nursing action?a. Provide additional oral fluid intakeb. Measure the client's intake and outputc. Increase the flow of the bladder irrigationd. Administer a PRN dose of an antispasmodics agent - c. Increase the flow of the bladderirrigation47. A cardiac catheterization of a client with heart disease indicates the following blockages:95% proximal left anterior descending (LAD), 99% proximal circumflex, and ? % proximalright coronary artery (RCA). The client later asks the nurse "what does all this mean forme?" What information should the nurse provide?a. Blood supply to the heart is diminished by artherosclerotic lesions, which necessitatelifestyle changesb. Blood vessels supplying the pumping chamber have blockages indicating a past heartattackc. Three main arteries have major blockages, with only 1 to 5% of blood flow getting throughto the heart muscled. The heart is not receiving enough blood, so there is a risk of heart failure and fluidretention - c. Three main arteries have major blockages, with only 1 to 5% of blood flowgetting through to the heart muscle48. Four days following an abdominal aortic aneurysm repair, the client is exhibiting edemaof both lower extremities, and pedal pulses are not palpable. Which action should the nurseimplement first?a. Elevate extremities on pillowsb. Evaluate edema for pittingc. Assess pulses with a vascular dopplerd. Wrap the feet with warmed blankets - c. Assess pulses with a vascular doppler

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49. A client who was involved in a motor vehicle collision is admitted with a fractured leftfemur which is immobilized using a fracture traction splint in preparation for an openreduction internal fraction (ORIF). The nurse determines that the clients distal pulses arediminished in the left foot. Which interventions should the nurse implement? Select all thatapply.a. Verify pedal pulses using a doppler pulse pulse deviceb. Evaluate the application of the splint to the left legc. Offer ice chips and oral clear liquidsd. Monitor left leg for pain, pallor, parenthesis, paralysis, pressuree. Administer oral antispasmodics and narcotic analgesics - a. Verify pedal pulses using adoppler pulse pulse deviceb. Evaluate the application of the splint to the left legd. Monitor left leg for pain, pallor, parenthesis, paralysis, pressure50. The nurse is caring for a client with a lower left lobe pulmonary abscess. Which positionshould the nurse instruct the client to maintain?a. Left lateralb. Supine, knees flexedc. Dorsal recumbentd. Knee-chest - a. Left lateral51. The healthcare provider prescribes diagnostic tests for a client whose chest x-rayindicates pneumonia. Which diagnostic test should the nurse review for implementation inthe most therapeutic treatment of pneumonia?a. Sputum culture and sensitivityb. Blood culturesc. Arterial blood gasses (ABG)d. Computerized tomography (CT) of the chest - a. Sputum culture and sensitivity52. A male client with heart failure (HF) calls the clinic and reports that he cannot put hisshoes on because they are too tight. Which additional information should the nurse obtain?

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