Med Surg HESI 2026 realistic questions and verified answers
with 100% graduate pass.
Which statement made by a client with chronic pancreatitis indicates that further
education is needed?
I will cut back on smoking cigarettes daily. Correct
I will avoid drinking caffeinated beverages.
I will rest frequently and avoid vigorous exercise. Incorrect
I will eat a bland, low-fat, high-protein diet.
To prevent exacerbations of chronic pancreatitis, clients should be instructed to
avoid nicotine entirely. Additional teaching includes avoiding caffeinated beverages,
resting frequently as needed, and eating a bland diet low fat and high in protein.
How should the nurse position the electrodes for modified chest lead one (MCL I)
telemetry monitoring?
Negative polarity left shoulder, positive polarity right chest nipple line, ground left
chest nipple line. Correct
In MCL I monitoring, the positive electrode is placed on the client's mid-chest to the
right of the sternum, and the negative electrode is placed on the upper left part of
the chest. The ground may be placed anywhere, but is usually placed on the lower
left portion of the chest.
In preparing to administer intravenous albumin to a client following surgery, which
are the priority nursing interventions? (Select all that apply.)
Set the infusion pump to infuse the albumin within four hours. Correct
Compare the client's blood type with the label on the albumin.
Assign a UAP to monitor blood pressure q15 minutes.
Administer through a large gauge catheter. Correct
Monitor hemoglobin and hematocrit levels. Correct
Assess for increased bleeding after administration. Correct
Albumin should be infused within four hours because it does not contain any
preservatives. Any fluid remaining after four hours should be discarded. A large
gauge catheter allows for fast infusion rate, which may be necessary. Hemodilution
may decrease hemoglobin (HgB) and hematocrit (HCT) levels, so the HgB and HCT
levels should be monitored while monitoring for bleeding because of the increased
blood volume and blood pressure.
A client who has heart failure is admitted with a serum potassium level of 2.9
mEq/L (2.9 mmol/L). Which action is most important for the nurse to implement?
Give 20 mEq of potassium chloride.
Initiate continuous cardiac monitoring. Correct
Arrange a consultation with the dietician.
Teach about the side effects of diuretics.
Hypokalemia (normal 3.5 to 5 mEq/L [3.5 to 5 mmol/L]) causes changes in
myocardial irritability and ECG waveform, so it is most important for the nurse to
initiate continuous cardiac monitoring to identify ventricular ectopy or other life-
threatening dysrhythmias. After cardiac monitoring is initiated, then the potassium
chloride should be given so that the effects of potassium replacement on the
cardiac rhythm can be monitored.
,After checking the urinary drainage system for kinks in the tubing, the nurse
determines that a client who has returned from the post-anesthesia care has a
dark, concentrated urinary output of 54 mL for the last 2 hours. Which priority
nursing action should be implemented?
Report the findings to the surgeon. Correct
Irrigate the indwelling urinary catheter.
Apply manual pressure to the bladder.
Increase the IV flow rate for 15 minutes. Incorrect
After surgery, an adult who weighs 132 pounds (60 kg) should produce about 60 mL
of urine hourly (1 mL/kg/hour). Dark, concentrated, and low volume of urine output
should be reported to the surgeon.
Two days postoperative, a male client reports aching pain in his left leg. The nurse
assesses redness and warmth on the lower left calf. Which intervention would be
most helpful to this client?
Apply sequential compression devices (SCDs) bilaterally.
Assess for a positive Homan's sign in each leg. Incorrect
Pad all bony prominences on the affected leg.
Advise the client to remain in bed with the leg elevated. Correct
For a client exhibiting symptoms of deep vein thrombosis (DVT), a complication of
immobility, the initial care includes bedrest and elevation of the extremity.
Which description of pain is consistent with a diagnosis of rheumatoid arthritis?
Joint pain is worse in the morning and involves symmetric joints. Correct
Joint pain is better in the morning and worsens throughout the day.
Joint pain is consistent throughout the day and is relieved by pain
medication. Incorrect
Joint pain is worse during the day and involves unilateral joints.
Rheumatoid arthritis (RA) is an autoimmune disease that causes joint pain and
swelling. RA is characterized by pain that is worse when arising and involves
symmetric joints.
A client’s susceptibility to ulcerative colitis is most likely due to which aspect in the
client’s history?
Jewish European ancestry. Correct
H. pylori bowel infection.
Family history of irritable bowel syndrome.
Age between 25 and 55 years.
Ulcerative colitis is 4 to 5 times more common among individuals of Jewish
European or Ashkenazi ancestry.
While working in the emergency room, the nurse is exposed to a client with active
tuberculosis. When should the nurse plan to obtain a tuberculin skin test?
Immediately after the exposure.
Within one week of the exposure.
Four to six weeks after the exposure. Correct
Three months after the exposure.
A tuberculin skin test is effective 4 to 6 weeks after an exposure, so the individual
with a known exposure should wait 4 to 6 weeks before having a tuberculin skin
test.
, The nurse knows that lab values sometimes vary for the older client. Which data
would the nurse expect to find when reviewing laboratory values of an 80-year-old
male?
Increased WBC, decreased RBC.
Increased serum bilirubin, slightly increased liver enzymes.
Increased protein in the urine, slightly increased serum glucose levels. Correct
Decreased serum sodium, an increased urine specific gravity.
As older adults age, the protein found in urine slightly rises as a result of kidney
changes, and the serum glucose increases slightly, also due to changes in the
kidney.
The nurse is assessing a client's laboratory values following administration of
chemotherapy. Which lab value leads the nurse to suspect that the client is
experiencing tumor lysis syndrome (TLS)?
Serum PTT of 10 seconds.
Serum calcium of 5 mg/dL. Correct
Oxygen saturation of 90%.
Hemoglobin of 10 g/dL.
Tumor lysis symdrome (TLS) results in hyperkalemia, hypocalcemia, hyperuricemia,
and hyperphosphatemia. A serum calcium level of 5, which is low, is an indicator of
possible tumor lysis syndrome.
Which intervention should the nurse plan to implement when caring for a client who
has just undergone a right above-the-knee amputation?
Maintain the residual limb on three pillows at all times. Incorrect
Place a large tourniquet at the client's bedside. Correct
Apply constant, direct pressure to the residual limb.
Do not allow the client to lie in the prone position.
A large tourniquet should be placed in plain sight at the client's bedside, in the
event severe bleeding occurs. The purpose is to have the tourniquet available to
apply to the residual limb to control bleeding if hemorrhaging was to occur.
Creatinine
More SPECIFIC THAN BUN.
An elevated creatinine strongly indicates nephron loss, reducing filtration.
Which nail color alteration should the nurse expect to observe in a client with
chronic kidney disease?
Horizontal white banding. Correct
Diffuse blue discoloration.
Diffuse brown discoloration.
Thin, dark red vertical lines.
Fingernails and toenails can be affected by chronic kidney disease. This condition
may cause horizontal white lines or bands (leukonychia) to appear on the nails.
The nurse is providing dietary instructions to a 68-year-old client who is at high
risk for development of coronary heart disease (CHD). Which information should the
nurse include?
Limit dietary selection of cholesterol to 300 mg per day.
Increase intake of soluble fiber to 10 to 25 grams per day. Correct
Decrease plant stanols and sterols to less than 2 grams/day.
Ensure saturated fat is less than 30% of total caloric intake.
with 100% graduate pass.
Which statement made by a client with chronic pancreatitis indicates that further
education is needed?
I will cut back on smoking cigarettes daily. Correct
I will avoid drinking caffeinated beverages.
I will rest frequently and avoid vigorous exercise. Incorrect
I will eat a bland, low-fat, high-protein diet.
To prevent exacerbations of chronic pancreatitis, clients should be instructed to
avoid nicotine entirely. Additional teaching includes avoiding caffeinated beverages,
resting frequently as needed, and eating a bland diet low fat and high in protein.
How should the nurse position the electrodes for modified chest lead one (MCL I)
telemetry monitoring?
Negative polarity left shoulder, positive polarity right chest nipple line, ground left
chest nipple line. Correct
In MCL I monitoring, the positive electrode is placed on the client's mid-chest to the
right of the sternum, and the negative electrode is placed on the upper left part of
the chest. The ground may be placed anywhere, but is usually placed on the lower
left portion of the chest.
In preparing to administer intravenous albumin to a client following surgery, which
are the priority nursing interventions? (Select all that apply.)
Set the infusion pump to infuse the albumin within four hours. Correct
Compare the client's blood type with the label on the albumin.
Assign a UAP to monitor blood pressure q15 minutes.
Administer through a large gauge catheter. Correct
Monitor hemoglobin and hematocrit levels. Correct
Assess for increased bleeding after administration. Correct
Albumin should be infused within four hours because it does not contain any
preservatives. Any fluid remaining after four hours should be discarded. A large
gauge catheter allows for fast infusion rate, which may be necessary. Hemodilution
may decrease hemoglobin (HgB) and hematocrit (HCT) levels, so the HgB and HCT
levels should be monitored while monitoring for bleeding because of the increased
blood volume and blood pressure.
A client who has heart failure is admitted with a serum potassium level of 2.9
mEq/L (2.9 mmol/L). Which action is most important for the nurse to implement?
Give 20 mEq of potassium chloride.
Initiate continuous cardiac monitoring. Correct
Arrange a consultation with the dietician.
Teach about the side effects of diuretics.
Hypokalemia (normal 3.5 to 5 mEq/L [3.5 to 5 mmol/L]) causes changes in
myocardial irritability and ECG waveform, so it is most important for the nurse to
initiate continuous cardiac monitoring to identify ventricular ectopy or other life-
threatening dysrhythmias. After cardiac monitoring is initiated, then the potassium
chloride should be given so that the effects of potassium replacement on the
cardiac rhythm can be monitored.
,After checking the urinary drainage system for kinks in the tubing, the nurse
determines that a client who has returned from the post-anesthesia care has a
dark, concentrated urinary output of 54 mL for the last 2 hours. Which priority
nursing action should be implemented?
Report the findings to the surgeon. Correct
Irrigate the indwelling urinary catheter.
Apply manual pressure to the bladder.
Increase the IV flow rate for 15 minutes. Incorrect
After surgery, an adult who weighs 132 pounds (60 kg) should produce about 60 mL
of urine hourly (1 mL/kg/hour). Dark, concentrated, and low volume of urine output
should be reported to the surgeon.
Two days postoperative, a male client reports aching pain in his left leg. The nurse
assesses redness and warmth on the lower left calf. Which intervention would be
most helpful to this client?
Apply sequential compression devices (SCDs) bilaterally.
Assess for a positive Homan's sign in each leg. Incorrect
Pad all bony prominences on the affected leg.
Advise the client to remain in bed with the leg elevated. Correct
For a client exhibiting symptoms of deep vein thrombosis (DVT), a complication of
immobility, the initial care includes bedrest and elevation of the extremity.
Which description of pain is consistent with a diagnosis of rheumatoid arthritis?
Joint pain is worse in the morning and involves symmetric joints. Correct
Joint pain is better in the morning and worsens throughout the day.
Joint pain is consistent throughout the day and is relieved by pain
medication. Incorrect
Joint pain is worse during the day and involves unilateral joints.
Rheumatoid arthritis (RA) is an autoimmune disease that causes joint pain and
swelling. RA is characterized by pain that is worse when arising and involves
symmetric joints.
A client’s susceptibility to ulcerative colitis is most likely due to which aspect in the
client’s history?
Jewish European ancestry. Correct
H. pylori bowel infection.
Family history of irritable bowel syndrome.
Age between 25 and 55 years.
Ulcerative colitis is 4 to 5 times more common among individuals of Jewish
European or Ashkenazi ancestry.
While working in the emergency room, the nurse is exposed to a client with active
tuberculosis. When should the nurse plan to obtain a tuberculin skin test?
Immediately after the exposure.
Within one week of the exposure.
Four to six weeks after the exposure. Correct
Three months after the exposure.
A tuberculin skin test is effective 4 to 6 weeks after an exposure, so the individual
with a known exposure should wait 4 to 6 weeks before having a tuberculin skin
test.
, The nurse knows that lab values sometimes vary for the older client. Which data
would the nurse expect to find when reviewing laboratory values of an 80-year-old
male?
Increased WBC, decreased RBC.
Increased serum bilirubin, slightly increased liver enzymes.
Increased protein in the urine, slightly increased serum glucose levels. Correct
Decreased serum sodium, an increased urine specific gravity.
As older adults age, the protein found in urine slightly rises as a result of kidney
changes, and the serum glucose increases slightly, also due to changes in the
kidney.
The nurse is assessing a client's laboratory values following administration of
chemotherapy. Which lab value leads the nurse to suspect that the client is
experiencing tumor lysis syndrome (TLS)?
Serum PTT of 10 seconds.
Serum calcium of 5 mg/dL. Correct
Oxygen saturation of 90%.
Hemoglobin of 10 g/dL.
Tumor lysis symdrome (TLS) results in hyperkalemia, hypocalcemia, hyperuricemia,
and hyperphosphatemia. A serum calcium level of 5, which is low, is an indicator of
possible tumor lysis syndrome.
Which intervention should the nurse plan to implement when caring for a client who
has just undergone a right above-the-knee amputation?
Maintain the residual limb on three pillows at all times. Incorrect
Place a large tourniquet at the client's bedside. Correct
Apply constant, direct pressure to the residual limb.
Do not allow the client to lie in the prone position.
A large tourniquet should be placed in plain sight at the client's bedside, in the
event severe bleeding occurs. The purpose is to have the tourniquet available to
apply to the residual limb to control bleeding if hemorrhaging was to occur.
Creatinine
More SPECIFIC THAN BUN.
An elevated creatinine strongly indicates nephron loss, reducing filtration.
Which nail color alteration should the nurse expect to observe in a client with
chronic kidney disease?
Horizontal white banding. Correct
Diffuse blue discoloration.
Diffuse brown discoloration.
Thin, dark red vertical lines.
Fingernails and toenails can be affected by chronic kidney disease. This condition
may cause horizontal white lines or bands (leukonychia) to appear on the nails.
The nurse is providing dietary instructions to a 68-year-old client who is at high
risk for development of coronary heart disease (CHD). Which information should the
nurse include?
Limit dietary selection of cholesterol to 300 mg per day.
Increase intake of soluble fiber to 10 to 25 grams per day. Correct
Decrease plant stanols and sterols to less than 2 grams/day.
Ensure saturated fat is less than 30% of total caloric intake.
