HESI - MEDICAL SURGICAL PRACTICE EXAM
1. 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)?
A. Serum PTT of 10 seconds
B. Serum calcium of 5 mg/dl
C. Oxygen saturation of 90%
D. Hemoglobin of 10 g/dl
Answer B. Serum calcium of 5 mg/dl.
TLS results in hyperkalemia, hypocalcemia, hyperuricemia, and hyperphosphatemia.
,2. A client is admitted to the hospital with a diagnosis of severe acute divertic-
ulitis. Which assessment finding should the nurse expect this client to exhibit?
A. Lower left quadrant pain and a low-grade fever
B. Severe pain at McBurney's point and nausea.
C. Abdominal pain and intermittent tenesmus
D. Exacerbations of severe diarrhea
Answer A. Lower left quadrant pain and a low-grade fever.
Left lower quadrant pain occurs with diverticulitis because the sigmoid colon is the most common area for diverticula,
and the inflammation of diverticula causes a low-grade fever.
3. During CPR, when attempting to ventilate a client's lungs, the nurse notes
that the chest is not moving. What action should the nurse take first?
,A. Use a laryngoscope to check for a foreign body lodged in the esophagus.
B. Reposition the head to validate that the head is in the proper position to
open the airway.
, C. Turn the client to the side and administer three back blows.
D. Perform a finger sweep of the mouth to remove any vomitus
Answer B. Reposition the head to validate that the head is in the proper position to open the airway.
The most frequent cause of inadequate aeration of the client's lungs during CPR is improper positioning of the head
resulting in occlusion of the airway. A foreign body can occlude the airway, but this is not common unless choking
preceded the cardiac emergency, and should not be the nurse's first action.
4. A client is admitted to the hospital with a medical diagnosis of pneumo-
coccal pneumonia. The nurse knows that the prognosis for gram-negative
pneumonias (such as E. coli, Klebsiella, Pseudomonas, and Proteus) is very poor
because
A. They occur in the lower love alveoli which are more sensitive to infection
1. 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)?
A. Serum PTT of 10 seconds
B. Serum calcium of 5 mg/dl
C. Oxygen saturation of 90%
D. Hemoglobin of 10 g/dl
Answer B. Serum calcium of 5 mg/dl.
TLS results in hyperkalemia, hypocalcemia, hyperuricemia, and hyperphosphatemia.
,2. A client is admitted to the hospital with a diagnosis of severe acute divertic-
ulitis. Which assessment finding should the nurse expect this client to exhibit?
A. Lower left quadrant pain and a low-grade fever
B. Severe pain at McBurney's point and nausea.
C. Abdominal pain and intermittent tenesmus
D. Exacerbations of severe diarrhea
Answer A. Lower left quadrant pain and a low-grade fever.
Left lower quadrant pain occurs with diverticulitis because the sigmoid colon is the most common area for diverticula,
and the inflammation of diverticula causes a low-grade fever.
3. During CPR, when attempting to ventilate a client's lungs, the nurse notes
that the chest is not moving. What action should the nurse take first?
,A. Use a laryngoscope to check for a foreign body lodged in the esophagus.
B. Reposition the head to validate that the head is in the proper position to
open the airway.
, C. Turn the client to the side and administer three back blows.
D. Perform a finger sweep of the mouth to remove any vomitus
Answer B. Reposition the head to validate that the head is in the proper position to open the airway.
The most frequent cause of inadequate aeration of the client's lungs during CPR is improper positioning of the head
resulting in occlusion of the airway. A foreign body can occlude the airway, but this is not common unless choking
preceded the cardiac emergency, and should not be the nurse's first action.
4. A client is admitted to the hospital with a medical diagnosis of pneumo-
coccal pneumonia. The nurse knows that the prognosis for gram-negative
pneumonias (such as E. coli, Klebsiella, Pseudomonas, and Proteus) is very poor
because
A. They occur in the lower love alveoli which are more sensitive to infection
