HESI RN MED SURG VERSION A &
VERSION B 2024-2025 ACTUAL EXAM EACH
EXAM CONTAINS 125 QUESTIONS AND
CORRECT DETAILED ANSWERS
1. The nurse is assessing a client with acute pancreatitis. Which finding requires
the most immediate intervention by the nurse?
A.
The client's amylase level is three times higher than the normal level.
B.
The client has a carpal spasm when taking a blood pressure.
C.
On a 1 to 10 scale, the client tells the nurse that her epigastric pain is at 7.
,D.
The client states that she will continue to drink alcohol after going home.
Answer B
The nurse is assessing a client with acute pancreatitis. Which finding requires the most immediate intervention by the
nurse?
Rationale
AnswerA positive Trousseau sign indicates hypocalcemia and always requires further assessment and intervention,
regardless of the cause (40% to 75% of those with acute pancreatitis experience hypocalcemia, which can have serious,
systemic ettects). A key diagnostic finding of pancreatitis is serum amylase and lipase levels that are two to five times
higher than the normal value. Severe boring pain is an expected symptom for this diagnosis, but dealing with the
hypocalcemia is a priority over administering an analgesic. Long-term planning and teaching do not have the same
immediate importance as a positive Trousseau sign.
2. A 55-year-old male client has been admitted to the hospital with a medical
,diagnosis of chronic obstructive pulmonary disease (COPD). Which risk factor
is the most significant in the development of this client's COPD?
A.
The client's father was diagnosed with COPD in his 50s.
B.
A close family member contracted tuberculosis last year.
C.
The client smokes one to two packs of cigarettes per day.
D.
The client has been 40 pounds overweight for 15 years.
Answer C
, Rationale
AnswerSmoking, considered to be a modifiable risk factor, is the most significant risk factor for the development of
COPD. The exact mechanism of genetic and hereditary implications for the development of COPD is still under
VERSION B 2024-2025 ACTUAL EXAM EACH
EXAM CONTAINS 125 QUESTIONS AND
CORRECT DETAILED ANSWERS
1. The nurse is assessing a client with acute pancreatitis. Which finding requires
the most immediate intervention by the nurse?
A.
The client's amylase level is three times higher than the normal level.
B.
The client has a carpal spasm when taking a blood pressure.
C.
On a 1 to 10 scale, the client tells the nurse that her epigastric pain is at 7.
,D.
The client states that she will continue to drink alcohol after going home.
Answer B
The nurse is assessing a client with acute pancreatitis. Which finding requires the most immediate intervention by the
nurse?
Rationale
AnswerA positive Trousseau sign indicates hypocalcemia and always requires further assessment and intervention,
regardless of the cause (40% to 75% of those with acute pancreatitis experience hypocalcemia, which can have serious,
systemic ettects). A key diagnostic finding of pancreatitis is serum amylase and lipase levels that are two to five times
higher than the normal value. Severe boring pain is an expected symptom for this diagnosis, but dealing with the
hypocalcemia is a priority over administering an analgesic. Long-term planning and teaching do not have the same
immediate importance as a positive Trousseau sign.
2. A 55-year-old male client has been admitted to the hospital with a medical
,diagnosis of chronic obstructive pulmonary disease (COPD). Which risk factor
is the most significant in the development of this client's COPD?
A.
The client's father was diagnosed with COPD in his 50s.
B.
A close family member contracted tuberculosis last year.
C.
The client smokes one to two packs of cigarettes per day.
D.
The client has been 40 pounds overweight for 15 years.
Answer C
, Rationale
AnswerSmoking, considered to be a modifiable risk factor, is the most significant risk factor for the development of
COPD. The exact mechanism of genetic and hereditary implications for the development of COPD is still under
