HESI RN MED SURG VERSION A & VERSION B
2025-2026 ACTUAL EXAM EACH EXAM
CONTAINS QUESTIONS AND CORRECT
DETAILED ANSWERS
When teaching a client with breast cancer about the prescribed radiation therapy for treatment, what
information is important to include?
A) Dry, itchy skin changes may occur.
B) There is a possibility of long bone pain.
C) Permanent pigment changes to the breast may result.
D) A low-residue diet may be ordered to reduce the likelihood of diarrhea. Correct Answer(s): A
* Side effects from radiation to the breast most often include temporary skin changes such as: dryness,
tenderness, redness, swelling, and pruritis (A). (B, C, and D) are not found in this situation.
Which action should the nurse implement on the scheduled day of surgery for a client with type 1
diabetes mellitus (DM)?
A) Obtain a prescription for an adjusted dose of insulin.
B) Administer an oral anti-diabetic agent.
C) Give an insulin dose using parameters of a sliding scale.
D) Withhold insulin while the client is NPO. Correct Answer(s): A
* Stressors, such as surgery, increase serum glucose levels. A client with type 1 DM who is NPO for
scheduled surgery should receive a prescribed adjusted dose of insulin (A). (B, C, and D) are not
indicated.
In planning care for a client with an acute stroke resulting in right-sided hemiplegia, which positioning
should the nurse should use to maintain optimal functioning?
A) Mid-Fowler's with knees supported.
B) Supine with trochanter rolls to the hips.
1|Page
,C) Sim's position alternated with right lateral position q2 hours.
D) Left lateral, supine, brief periods on the right side, and prone. Correct Answer(s): D
* After an acute stroke, a positioning and turning schedule that minimizes lying on the affected side,
which can impair circulation and cause pain, and includes the prone position (D) to help prevent flexion
contractures of the hips, prepares the client for optimal functioning and ambulating. (A, B, and C) do not
maintain the client for optimal functioning.
Which intervention should the nurse implement that best confirms placement of an endotracheal tube
(ET) tube?
A) Use an end-tital CO2 detector.
B) Ascultate for bilateral breath sounds.
C) Obtain pulse oximeter reading.
D) Check symmetrical chest movement. Correct Answer(s): A
* The end-tital carbon dioxide detector indicates the presence of CO2 by a color change or a number (A),
which is evidence that the ET is in the trachea, not the esophagus. Other assessments, such breath
sounds (B), pulse oximetry (C) and chest movement (D), are methods to evaluate the effectiveness of
ventilation and oxygenation, but do not measure CO2 in expired air from the ET.
A female client with hyperesthesia on the oncology unit is using a transcutaneous electrical nerve
stimulation (TENS) unit for chronic pain. Which nursing activity should the nurse implement instead of
delegating to a practical nurse (PN)?
A) Determine the client's level of discomfort using a pain rating scale.
B) Ask the client about her past experience with chronic pain.
C) Observe the client's facial expressions for pain and discomfort.
D) Evaluate the client's ability to adjust the voltage to control pain. Correct Answer(s): D
* The oncology nurse has the knowledge and experience with the use of a transcutaneous electrical
nerve stimulation (TENS) unit for chronic pain relief, so the nurse should evaluate the client's skill in
effectively controlling the pain by adjusting the voltage (D). The PN can collect data about the client's
pain (A, B, and C).
2|Page
,The nurse is caring for a client scheduled to undergo insertion of a percutaneous endoscopic
gastrostomy (PEG) tube. The client asks the nurse to explain how a PEG tube differs from a gastrostomy
tube (GT). Which explanation best describes how they are different?
A) Method of insertion.
B) Location of the tubes.
C) Diameter of the tubes.
D) Procedure for feedings. Correct Answer(s): A
* The best explanation of how a PEG tube differs from a GT is by the method of insertion (A). GT
insertion involves making an incision in the wall of the abdomen and suturing the tube to the gastric
wall. A PEG tube is inserted with endoscopic visualization through the esophagus into the stomach and
then pulled through a stab wound in the abdominal wall. (B, C, and D) identify commonalities.
The nurse is caring for a client after a transurethral resection of the prostate and determines the client's
urinary catheter is not draining. What should the nurse implement?
A) Reposition the catheter drainage tubing.
B) Encourage the client to drink oral fluids.
C) Irrigate the catheter.
D) Change drainage unit tubing. Correct Answer(s): C
* Obstruction urinary flow after a TURP is most often due to blood clots, and sterile irrigation should be
implemented to remove the clots that are blocking the catheter (C). (A and B) will not relieve the
obstruction at this time. (D) is not necessary.
A client is admitted after blunt abdominal injury. Which assessment finding requires immediate action
by the nurse?
A) Radiating abdominal pain with left lower quadrant palpation.
B) Grimacing after palpation of the right hypochondriac region.
C) Rebound tenderness with abdominal palpation.
D) Bluish periumbilical skin discoloration. Correct Answer(s): D
3|Page
, * Immediate action is indicated for intraperitoneal hemorrhage which causes periumbilical discoloration
(D) and indicates the presence of a splenic rupture, a life-threatening complication of blunt abdominal
injury. (A, B, and C) indicate inflammation of the appendix or gallbladder but do not represent an acute
finding as a result of blunt abdominal trauma.
The PET (positron emission tomography) scan is commonly used with oncology clients to provide for
which diagnostic information?
A) A description of inflammation, infection, and tumors.
B) Continuous visualization of intracranial neoplasms.
C) Imaging of tumors without exposure to radiation.
D) An image that describes metastatic sites of cancer. Correct Answer(s): D
* PET scans provide information regarding certain diseases of the heart (determination of tissue
viability), brain (dementia, Parkinson's disease), and early detection of tumors and their aggressiveness.
This diagnostic test scans the body to detect the spread of cancer (metastasis) (D). (A, B, and C) are not
the purpose of PET.
A client with rheumatoid arthritis is prescribed piroxicam (Feldene), a nonsteroidal anti-inflammatory
drug (NSAID). Which effect is characteristic of (NSAIDs) used for treating rheumatoid arthritis?
A) Production of replacement cartilage is stimulated.
B) Further destruction of the articular cartilage is prevented.
C) Inflammation is reduced by inhibiting prostaglandin synthesis.
D) Bradykinin is inhibited, thereby reducing acute and chronic pain. Correct Answer(s): C
* Nonsteroidal anti-inflammatory drugs (NSAIDs), used for treating rheumatoid arthritis, inhibit the
synthesis of prostaglandins and relieve associated pain (C), but they do not generate new cartilage (A).
NSAIDs are not an effective treatment to inhibit bradykinin (D). Joint destruction is not preventable with
this disease process (B).
A deficiency of intrinsic factor should alert the nurse to assess a client's history for which condition?
A) Emphysema.
B) Hemophilia.
C) Pernicious anemia.
4|Page
2025-2026 ACTUAL EXAM EACH EXAM
CONTAINS QUESTIONS AND CORRECT
DETAILED ANSWERS
When teaching a client with breast cancer about the prescribed radiation therapy for treatment, what
information is important to include?
A) Dry, itchy skin changes may occur.
B) There is a possibility of long bone pain.
C) Permanent pigment changes to the breast may result.
D) A low-residue diet may be ordered to reduce the likelihood of diarrhea. Correct Answer(s): A
* Side effects from radiation to the breast most often include temporary skin changes such as: dryness,
tenderness, redness, swelling, and pruritis (A). (B, C, and D) are not found in this situation.
Which action should the nurse implement on the scheduled day of surgery for a client with type 1
diabetes mellitus (DM)?
A) Obtain a prescription for an adjusted dose of insulin.
B) Administer an oral anti-diabetic agent.
C) Give an insulin dose using parameters of a sliding scale.
D) Withhold insulin while the client is NPO. Correct Answer(s): A
* Stressors, such as surgery, increase serum glucose levels. A client with type 1 DM who is NPO for
scheduled surgery should receive a prescribed adjusted dose of insulin (A). (B, C, and D) are not
indicated.
In planning care for a client with an acute stroke resulting in right-sided hemiplegia, which positioning
should the nurse should use to maintain optimal functioning?
A) Mid-Fowler's with knees supported.
B) Supine with trochanter rolls to the hips.
1|Page
,C) Sim's position alternated with right lateral position q2 hours.
D) Left lateral, supine, brief periods on the right side, and prone. Correct Answer(s): D
* After an acute stroke, a positioning and turning schedule that minimizes lying on the affected side,
which can impair circulation and cause pain, and includes the prone position (D) to help prevent flexion
contractures of the hips, prepares the client for optimal functioning and ambulating. (A, B, and C) do not
maintain the client for optimal functioning.
Which intervention should the nurse implement that best confirms placement of an endotracheal tube
(ET) tube?
A) Use an end-tital CO2 detector.
B) Ascultate for bilateral breath sounds.
C) Obtain pulse oximeter reading.
D) Check symmetrical chest movement. Correct Answer(s): A
* The end-tital carbon dioxide detector indicates the presence of CO2 by a color change or a number (A),
which is evidence that the ET is in the trachea, not the esophagus. Other assessments, such breath
sounds (B), pulse oximetry (C) and chest movement (D), are methods to evaluate the effectiveness of
ventilation and oxygenation, but do not measure CO2 in expired air from the ET.
A female client with hyperesthesia on the oncology unit is using a transcutaneous electrical nerve
stimulation (TENS) unit for chronic pain. Which nursing activity should the nurse implement instead of
delegating to a practical nurse (PN)?
A) Determine the client's level of discomfort using a pain rating scale.
B) Ask the client about her past experience with chronic pain.
C) Observe the client's facial expressions for pain and discomfort.
D) Evaluate the client's ability to adjust the voltage to control pain. Correct Answer(s): D
* The oncology nurse has the knowledge and experience with the use of a transcutaneous electrical
nerve stimulation (TENS) unit for chronic pain relief, so the nurse should evaluate the client's skill in
effectively controlling the pain by adjusting the voltage (D). The PN can collect data about the client's
pain (A, B, and C).
2|Page
,The nurse is caring for a client scheduled to undergo insertion of a percutaneous endoscopic
gastrostomy (PEG) tube. The client asks the nurse to explain how a PEG tube differs from a gastrostomy
tube (GT). Which explanation best describes how they are different?
A) Method of insertion.
B) Location of the tubes.
C) Diameter of the tubes.
D) Procedure for feedings. Correct Answer(s): A
* The best explanation of how a PEG tube differs from a GT is by the method of insertion (A). GT
insertion involves making an incision in the wall of the abdomen and suturing the tube to the gastric
wall. A PEG tube is inserted with endoscopic visualization through the esophagus into the stomach and
then pulled through a stab wound in the abdominal wall. (B, C, and D) identify commonalities.
The nurse is caring for a client after a transurethral resection of the prostate and determines the client's
urinary catheter is not draining. What should the nurse implement?
A) Reposition the catheter drainage tubing.
B) Encourage the client to drink oral fluids.
C) Irrigate the catheter.
D) Change drainage unit tubing. Correct Answer(s): C
* Obstruction urinary flow after a TURP is most often due to blood clots, and sterile irrigation should be
implemented to remove the clots that are blocking the catheter (C). (A and B) will not relieve the
obstruction at this time. (D) is not necessary.
A client is admitted after blunt abdominal injury. Which assessment finding requires immediate action
by the nurse?
A) Radiating abdominal pain with left lower quadrant palpation.
B) Grimacing after palpation of the right hypochondriac region.
C) Rebound tenderness with abdominal palpation.
D) Bluish periumbilical skin discoloration. Correct Answer(s): D
3|Page
, * Immediate action is indicated for intraperitoneal hemorrhage which causes periumbilical discoloration
(D) and indicates the presence of a splenic rupture, a life-threatening complication of blunt abdominal
injury. (A, B, and C) indicate inflammation of the appendix or gallbladder but do not represent an acute
finding as a result of blunt abdominal trauma.
The PET (positron emission tomography) scan is commonly used with oncology clients to provide for
which diagnostic information?
A) A description of inflammation, infection, and tumors.
B) Continuous visualization of intracranial neoplasms.
C) Imaging of tumors without exposure to radiation.
D) An image that describes metastatic sites of cancer. Correct Answer(s): D
* PET scans provide information regarding certain diseases of the heart (determination of tissue
viability), brain (dementia, Parkinson's disease), and early detection of tumors and their aggressiveness.
This diagnostic test scans the body to detect the spread of cancer (metastasis) (D). (A, B, and C) are not
the purpose of PET.
A client with rheumatoid arthritis is prescribed piroxicam (Feldene), a nonsteroidal anti-inflammatory
drug (NSAID). Which effect is characteristic of (NSAIDs) used for treating rheumatoid arthritis?
A) Production of replacement cartilage is stimulated.
B) Further destruction of the articular cartilage is prevented.
C) Inflammation is reduced by inhibiting prostaglandin synthesis.
D) Bradykinin is inhibited, thereby reducing acute and chronic pain. Correct Answer(s): C
* Nonsteroidal anti-inflammatory drugs (NSAIDs), used for treating rheumatoid arthritis, inhibit the
synthesis of prostaglandins and relieve associated pain (C), but they do not generate new cartilage (A).
NSAIDs are not an effective treatment to inhibit bradykinin (D). Joint destruction is not preventable with
this disease process (B).
A deficiency of intrinsic factor should alert the nurse to assess a client's history for which condition?
A) Emphysema.
B) Hemophilia.
C) Pernicious anemia.
4|Page
