HESI MED-SURG PRACTICE EXAM
WITH UPDATED QUESTIONS AND
VERIFIED ANSWERS 2026/2027
An adult client who is hospitalized after surgery reports sudden onset of chest pain and dyspnea. The
client appears anxious, restless, and mildly cyanotic. The nurse should further assess the client for which
condition?
Pulmonary embolism.
Heart failure.
Tuberculosis.
Bronchitis. - ANSWER-Pulmonary embolism.
Post-surgical clients are at an increased risk for deep vein thrombosis (DVT), which may result in
pulmonary embolism if the clot breaks off and travels to the lungs. Signs and symptoms of pulmonary
embolism include chest pain, dyspnea, anxiety, restlessness, and - in severe cases - cyanosis.
Jarvis, Physical Examination and Health Assessment, 7th ed., p.493
Which information should the nurse obtain when performing an initial assessment of a client who
presents to the emergency department with a painful ankle injury? (Select all that apply.)
Quality of the pain.
Signs of inflammation.
Ankle range of motion.
Muscle strength testing.
Visible deformities of the joint. - ANSWER-Quality of the pain.
,Signs of inflammation.
Ankle range of motion.
Visible deformities of the joint.
Initial assessment of a joint injury is performed to determine the extent of the damage. The nurse's
initial assessment of a painful ankle injury should include pain quality, the presence of deformities,
evidence of inflammation, and range of motion.
Jarvis Physical Examination and Health Assessment, 7th ed. p. 586-8
Which description of pain is consistent with a diagnosis of rheumatoid arthritis?
Joint pain is worse in the morning and involves symmetric joints.
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.
Joint pain is worse during the day and involves unilateral joints. - ANSWER-Joint pain is worse in the
morning and involves symmetric 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.
Jarvis. (2016), Physical Examination and Health Assessment, 7th Ed., Chapter 22; p. 586
Which physical assessment finding should the nurse anticipate in a client with long-term
gastroesophagealreflux disease (GERD)?
Hoarseness.
Dry mouth.
Mouth ulcers.
Weight loss. - ANSWER-Hoarseness.
,Dyspepsia and regurgitation are the main symptoms of gastroesophageal reflux disease (GERD);
however, hoarseness is one of the most common long-term symptoms of GERD due to the irritation of
the reflux of gastric secretions.
Ignatavicius, (2016). Medical-surgical nursing: Patient-centered collaborative care, eight edition., Ch. 49,
p. 1111.
A client presents with chronic venous insufficiency. Which assessment finding should the nurse
anticipate?
Bilateral lower leg stasis dermatitis.
Clubbing of fingers and toes.
Intermittent claudication.
Peripheral cyanosis. - ANSWER-Bilateral lower leg stasis dermatitis.
Clients who suffer from chroninc venous insufficiency often develop statsis dermatitis in the lower
extremities. Statis dermatitis appear as brownish-red discoloration on the lower extremities at the
ankles which can develop into stasis ulcers due to the pooling of the venous blood flow back to the
heart.
Ignatavicius, (2013). Medical-surgical nursing: Patient-centered collaborative care, 7th ed.., Ch. 33, p.
803.
A client has been hospitalized with a femur fracture and is being treated with traction. Which action by
the nurse is the priority when caring for this client?
Assess neurovascular status.
Change the client's position.
Inspect the traction equipment.
, Review pain medication orders. - ANSWER-Assess neurovascular status.
The use of traction for long bone fractures reduces the potential for damage to the surrounding tissues.
Reports of increased pain may indicate circulatory compromise or tissue damage (compartment
syndrome). Assessing the client's neurovascular status is the nurse's highest priority.
Ignatavicius, (2016). Medical-surgical nursing: Patient-centered collaborative care, eight edition., Ch. 51,
pp. 1051-80.
Which statement made by a client with chronic pancreatitis indicates that further education is needed?
I will cut back on smoking cigarettes daily.
I will avoid drinking caffeinated beverages.
I will rest frequently and avoid vigorous exercise.
I will eat a bland, low-fat, high-protein diet. - ANSWER-I will cut back on smoking cigarettes daily.
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.Ignatavicius, (2016). Medical-surgical nursing: Patient-centered
collaborative care, 8th ed., Ch. 59, pp. 1084-98.
The nurse is teaching a female client who uses a contraceptive diaphragm about reducing the risk for
toxic shock syndrome (TSS). Which information should the nurse include? (Select all that apply.)
Remove the diaphragm immediately after intercourse.
Wash the diaphragm with an alcohol solution.
Use the diaphragm to prevent conception during the menstrual cycle.
Do not leave the diaphragm in place longer than 8 hours after intercourse.
Replace the old diaphragm every 3 months. - ANSWER-Do not leave the diaphragm in place longer than
8 hours after intercourse.
Replace the old diaphragm every 3 months.
WITH UPDATED QUESTIONS AND
VERIFIED ANSWERS 2026/2027
An adult client who is hospitalized after surgery reports sudden onset of chest pain and dyspnea. The
client appears anxious, restless, and mildly cyanotic. The nurse should further assess the client for which
condition?
Pulmonary embolism.
Heart failure.
Tuberculosis.
Bronchitis. - ANSWER-Pulmonary embolism.
Post-surgical clients are at an increased risk for deep vein thrombosis (DVT), which may result in
pulmonary embolism if the clot breaks off and travels to the lungs. Signs and symptoms of pulmonary
embolism include chest pain, dyspnea, anxiety, restlessness, and - in severe cases - cyanosis.
Jarvis, Physical Examination and Health Assessment, 7th ed., p.493
Which information should the nurse obtain when performing an initial assessment of a client who
presents to the emergency department with a painful ankle injury? (Select all that apply.)
Quality of the pain.
Signs of inflammation.
Ankle range of motion.
Muscle strength testing.
Visible deformities of the joint. - ANSWER-Quality of the pain.
,Signs of inflammation.
Ankle range of motion.
Visible deformities of the joint.
Initial assessment of a joint injury is performed to determine the extent of the damage. The nurse's
initial assessment of a painful ankle injury should include pain quality, the presence of deformities,
evidence of inflammation, and range of motion.
Jarvis Physical Examination and Health Assessment, 7th ed. p. 586-8
Which description of pain is consistent with a diagnosis of rheumatoid arthritis?
Joint pain is worse in the morning and involves symmetric joints.
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.
Joint pain is worse during the day and involves unilateral joints. - ANSWER-Joint pain is worse in the
morning and involves symmetric 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.
Jarvis. (2016), Physical Examination and Health Assessment, 7th Ed., Chapter 22; p. 586
Which physical assessment finding should the nurse anticipate in a client with long-term
gastroesophagealreflux disease (GERD)?
Hoarseness.
Dry mouth.
Mouth ulcers.
Weight loss. - ANSWER-Hoarseness.
,Dyspepsia and regurgitation are the main symptoms of gastroesophageal reflux disease (GERD);
however, hoarseness is one of the most common long-term symptoms of GERD due to the irritation of
the reflux of gastric secretions.
Ignatavicius, (2016). Medical-surgical nursing: Patient-centered collaborative care, eight edition., Ch. 49,
p. 1111.
A client presents with chronic venous insufficiency. Which assessment finding should the nurse
anticipate?
Bilateral lower leg stasis dermatitis.
Clubbing of fingers and toes.
Intermittent claudication.
Peripheral cyanosis. - ANSWER-Bilateral lower leg stasis dermatitis.
Clients who suffer from chroninc venous insufficiency often develop statsis dermatitis in the lower
extremities. Statis dermatitis appear as brownish-red discoloration on the lower extremities at the
ankles which can develop into stasis ulcers due to the pooling of the venous blood flow back to the
heart.
Ignatavicius, (2013). Medical-surgical nursing: Patient-centered collaborative care, 7th ed.., Ch. 33, p.
803.
A client has been hospitalized with a femur fracture and is being treated with traction. Which action by
the nurse is the priority when caring for this client?
Assess neurovascular status.
Change the client's position.
Inspect the traction equipment.
, Review pain medication orders. - ANSWER-Assess neurovascular status.
The use of traction for long bone fractures reduces the potential for damage to the surrounding tissues.
Reports of increased pain may indicate circulatory compromise or tissue damage (compartment
syndrome). Assessing the client's neurovascular status is the nurse's highest priority.
Ignatavicius, (2016). Medical-surgical nursing: Patient-centered collaborative care, eight edition., Ch. 51,
pp. 1051-80.
Which statement made by a client with chronic pancreatitis indicates that further education is needed?
I will cut back on smoking cigarettes daily.
I will avoid drinking caffeinated beverages.
I will rest frequently and avoid vigorous exercise.
I will eat a bland, low-fat, high-protein diet. - ANSWER-I will cut back on smoking cigarettes daily.
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.Ignatavicius, (2016). Medical-surgical nursing: Patient-centered
collaborative care, 8th ed., Ch. 59, pp. 1084-98.
The nurse is teaching a female client who uses a contraceptive diaphragm about reducing the risk for
toxic shock syndrome (TSS). Which information should the nurse include? (Select all that apply.)
Remove the diaphragm immediately after intercourse.
Wash the diaphragm with an alcohol solution.
Use the diaphragm to prevent conception during the menstrual cycle.
Do not leave the diaphragm in place longer than 8 hours after intercourse.
Replace the old diaphragm every 3 months. - ANSWER-Do not leave the diaphragm in place longer than
8 hours after intercourse.
Replace the old diaphragm every 3 months.
