HESI RN MED SURG TEST QUESTIONS
AND ANSWERS | COMPREHENSIVE
MEDICAL SURGICAL NURSING STUDY
GUIDE 2026 | GRADED A+ |
GUARANTEED SUCCESS
Updated 2026 Questions and Answers | 100% Verified
Exam Prep and Comprehensive Rationales Included
,In assessing a client diagnosed with primary C
aldosteronism, the nurse expects the laboratory test Rationale:Clients with primary aldosteronism exhibit a profound decline in serum
results to indicate a decreased serum level of which levels of potassium; hypokalemia; hypertension is the most prominent and
substance? universal sign. The serum sodium level is normal or elevated, depending on the
A. amount of water resorbed with the sodium. Option B is influenced by parathyroid
Sodium hormone (PTH). Option D is not affected by primary aldosteronism.
B.
Phosphate
C.
Potassium
D.
Glucose
The nurse is completing an admission interview for a C
client with Parkinson disease. Which question will provide Rationale:Clients with Parkinson disease frequently experience difficulty in
additional information about manifestations that the client initiating, maintaining, and performing motor activities. They may even experience
is likely to experience? being rooted to the spot and unable to move. Parkinson disease does not
A. typically cause option A, B, or D.
"Have you ever experienced any paralysis of your arms or
legs?"
B.
"Do you have frequent blackout spells?"
C.
"Have you ever been frozen in one spot, unable to
move?"
D.
"Do you have headaches, especially ones with throbbing
pain?"
Client census is often used to determine staffing needs. C
Which method of obtaining census determination for a Rationale:An average daily census is determined by trend data and takes into
particular unit provides the best formula for determining account seasonal and daily fluctuations, so it is the best method for determining
long-range staffing patterns? staffing needs. Options A and B provide data at a certain point in time, and that
A. data could change quickly. It is unrealistic to expect to obtain an hourly census,
Midnight census and such data would only provide information about a certain point in time.
B.
Oncoming shift census
C.
Average daily census
D.
Hourly census
,A male client has just undergone a laryngectomy and has B
a cuffed tracheostomy tube in place. When initiating Rationale:The cuff should be inflated before the feeding to block the trachea and
bolus tube feedings postoperatively, when should the prevent food from entering if oral feedings are started while a cuffed
nurse inflate the cuff? tracheostomy tube is in place. It should remain inflated throughout the feeding to
A. prevent aspiration of food into the respiratory system. Options A and D place the
Immediately after feeding client at risk for aspiration. Option C places the client at risk for tracheal wall
B. necrosis.
Just prior to tube feeding
C.
Continuous inflation is required
D.
Inflation is not required
A client with a nasogastric tube attached to low suction B
states that she is nauseated. The nurse assesses that there Rationale:The immediate priority is to determine if the tube is functioning
has been no drainage through the nasogastric tube in the correctly, which would then relieve the client's nausea. The least invasive
last 2 hours. Which action should the nurse take first? intervention, repositioning the client, should be attempted first, followed by
A. options A and C, unless either of these interventions is contraindicated. If these
Irrigate the nasogastric tube with sterile normal saline. measures are unsuccessful, the client may require option D.
B.
Reposition the client on her side.
C.
Advance the nasogastric tube 5 cm.
D.
Administer an intravenous antiemetic as prescribed.
The nurse is conducting an osteoporosis screening clinic A, C, D
at a health fair. What information should the nurse Rationale:Options A, C, and D are factors that decrease the risk for developing
provide to individuals who are at risk for osteoporosis? osteoporosis. Vitamin D and calcium are important supplements to aid in the
(Select all that apply.) decrease of bone loss. Regular sleep patterns are important to overall health but
A. are not identified with a decreasing risk for osteoporosis.
Encourage alcohol and smoking cessation.
B.
Suggest supplementing diet with vitamin E.
C.
Promote regular weight-bearing exercises.
D.
Implement a home safety plan to prevent falls.
E.
Propose a regular sleep pattern of 8 hours nightly.
Which nursing action would be appropriate for a client A
who is newly diagnosed with Cushing syndrome? Rationale:Cushing syndrome results from a hypersecretion of glucocorticoids in
A. the adrenal cortex. Clients with Cushing syndrome often develop diabetes
Monitor blood glucose levels daily. mellitus. Monitoring of serum glucose levels assesses for increased blood
B. glucose levels so that treatment can begin early. A common finding in Cushing
Increase intake of fluids high in potassium. syndrome is generalized edema. Although potassium is needed, it is generally
C. obtained from food intake, not by offering potassium-enhanced fluids. Fatigue is
Encourage adequate rest between activities. usually not an overwhelming factor in Cushing syndrome, so an emphasis on the
D. need for rest is not indicated. A low-calorie, low-carbohydrate, low-sodium diet is
Offer the client a sodium-enriched menu. not recommended.
, A 58-year-old client who has no health problems asks the B
nurse about receiving the pneumococcal vaccine. Which Rationale:It is usually recommended that persons older than 65 years and those
statement given by the nurse would offer the client with a history of chronic illness should receive the vaccine once in their lifetime.
accurate information about this vaccine? Some recommend receiving the vaccine at 50 years of age. The influenza vaccine
A. is given once a year. Although the vaccine might be given to a person traveling
The vaccine is given annually before the flu season to overseas, that is not the main rationale for administering the vaccine. The vaccine
those older than 50 years. is usually given once in a lifetime, but with immunosuppressed clients or clients
B. with a history of pneumonia, revaccination is sometimes required.
The immunization is administered once to older adults or
those at risk for illness.
C.
The vaccine is for all ages and is given primarily to those
persons traveling overseas to areas of infection.
D.
The vaccine will prevent the occurrence of
pneumococcal pneumonia for up to 5 years.
A client is admitted to the hospital with severe lower left A
abdominal pain, nausea, vomiting, fever, and chills. Which Rationale:A client is showing signs of acute severe diverticulitis and is at risk for
nursing action has the highest priority? peritonitis and intestinal obstruction. The nurse should make the client NPO to
A. reduce risk of intestinal rupture. Options B, C, and D are important but are less of
Place the client on NPO status. a priority than option A, which is implemented to prevent a severe complication.
B.
Assess the client's temperature.
C.
Obtain a stool specimen.
D.
Administer IV fluids.
A client on telemetry has a pattern of uncontrolled atrial B
fibrillation with a rapid ventricular response. Based on this Rationale:With uncontrolled atrial fibrillation, the treatment of choice is
finding, the nurse anticipates assisting the physician with synchronized cardioversion to convert the cardiac rhythm back to normal sinus
which treatment? rhythm. Option A is a medication used for ventricular dysrhythmias. Option C is
A. not for a client with atrial fibrillation; it is reserved for clients with life-threatening
Administer lidocaine, 75 mg intravenous push. dysrhythmias, such as ventricular fibrillation and unstable ventricular tachycardia.
B. Option D is the drug of choice in symptomatic sinus bradycardia, not atrial
Perform synchronized cardioversion. fibrillation.
C.
Defibrillate the client as soon as possible.
D.
Administer atropine, 0.4 mg intravenous push.
AND ANSWERS | COMPREHENSIVE
MEDICAL SURGICAL NURSING STUDY
GUIDE 2026 | GRADED A+ |
GUARANTEED SUCCESS
Updated 2026 Questions and Answers | 100% Verified
Exam Prep and Comprehensive Rationales Included
,In assessing a client diagnosed with primary C
aldosteronism, the nurse expects the laboratory test Rationale:Clients with primary aldosteronism exhibit a profound decline in serum
results to indicate a decreased serum level of which levels of potassium; hypokalemia; hypertension is the most prominent and
substance? universal sign. The serum sodium level is normal or elevated, depending on the
A. amount of water resorbed with the sodium. Option B is influenced by parathyroid
Sodium hormone (PTH). Option D is not affected by primary aldosteronism.
B.
Phosphate
C.
Potassium
D.
Glucose
The nurse is completing an admission interview for a C
client with Parkinson disease. Which question will provide Rationale:Clients with Parkinson disease frequently experience difficulty in
additional information about manifestations that the client initiating, maintaining, and performing motor activities. They may even experience
is likely to experience? being rooted to the spot and unable to move. Parkinson disease does not
A. typically cause option A, B, or D.
"Have you ever experienced any paralysis of your arms or
legs?"
B.
"Do you have frequent blackout spells?"
C.
"Have you ever been frozen in one spot, unable to
move?"
D.
"Do you have headaches, especially ones with throbbing
pain?"
Client census is often used to determine staffing needs. C
Which method of obtaining census determination for a Rationale:An average daily census is determined by trend data and takes into
particular unit provides the best formula for determining account seasonal and daily fluctuations, so it is the best method for determining
long-range staffing patterns? staffing needs. Options A and B provide data at a certain point in time, and that
A. data could change quickly. It is unrealistic to expect to obtain an hourly census,
Midnight census and such data would only provide information about a certain point in time.
B.
Oncoming shift census
C.
Average daily census
D.
Hourly census
,A male client has just undergone a laryngectomy and has B
a cuffed tracheostomy tube in place. When initiating Rationale:The cuff should be inflated before the feeding to block the trachea and
bolus tube feedings postoperatively, when should the prevent food from entering if oral feedings are started while a cuffed
nurse inflate the cuff? tracheostomy tube is in place. It should remain inflated throughout the feeding to
A. prevent aspiration of food into the respiratory system. Options A and D place the
Immediately after feeding client at risk for aspiration. Option C places the client at risk for tracheal wall
B. necrosis.
Just prior to tube feeding
C.
Continuous inflation is required
D.
Inflation is not required
A client with a nasogastric tube attached to low suction B
states that she is nauseated. The nurse assesses that there Rationale:The immediate priority is to determine if the tube is functioning
has been no drainage through the nasogastric tube in the correctly, which would then relieve the client's nausea. The least invasive
last 2 hours. Which action should the nurse take first? intervention, repositioning the client, should be attempted first, followed by
A. options A and C, unless either of these interventions is contraindicated. If these
Irrigate the nasogastric tube with sterile normal saline. measures are unsuccessful, the client may require option D.
B.
Reposition the client on her side.
C.
Advance the nasogastric tube 5 cm.
D.
Administer an intravenous antiemetic as prescribed.
The nurse is conducting an osteoporosis screening clinic A, C, D
at a health fair. What information should the nurse Rationale:Options A, C, and D are factors that decrease the risk for developing
provide to individuals who are at risk for osteoporosis? osteoporosis. Vitamin D and calcium are important supplements to aid in the
(Select all that apply.) decrease of bone loss. Regular sleep patterns are important to overall health but
A. are not identified with a decreasing risk for osteoporosis.
Encourage alcohol and smoking cessation.
B.
Suggest supplementing diet with vitamin E.
C.
Promote regular weight-bearing exercises.
D.
Implement a home safety plan to prevent falls.
E.
Propose a regular sleep pattern of 8 hours nightly.
Which nursing action would be appropriate for a client A
who is newly diagnosed with Cushing syndrome? Rationale:Cushing syndrome results from a hypersecretion of glucocorticoids in
A. the adrenal cortex. Clients with Cushing syndrome often develop diabetes
Monitor blood glucose levels daily. mellitus. Monitoring of serum glucose levels assesses for increased blood
B. glucose levels so that treatment can begin early. A common finding in Cushing
Increase intake of fluids high in potassium. syndrome is generalized edema. Although potassium is needed, it is generally
C. obtained from food intake, not by offering potassium-enhanced fluids. Fatigue is
Encourage adequate rest between activities. usually not an overwhelming factor in Cushing syndrome, so an emphasis on the
D. need for rest is not indicated. A low-calorie, low-carbohydrate, low-sodium diet is
Offer the client a sodium-enriched menu. not recommended.
, A 58-year-old client who has no health problems asks the B
nurse about receiving the pneumococcal vaccine. Which Rationale:It is usually recommended that persons older than 65 years and those
statement given by the nurse would offer the client with a history of chronic illness should receive the vaccine once in their lifetime.
accurate information about this vaccine? Some recommend receiving the vaccine at 50 years of age. The influenza vaccine
A. is given once a year. Although the vaccine might be given to a person traveling
The vaccine is given annually before the flu season to overseas, that is not the main rationale for administering the vaccine. The vaccine
those older than 50 years. is usually given once in a lifetime, but with immunosuppressed clients or clients
B. with a history of pneumonia, revaccination is sometimes required.
The immunization is administered once to older adults or
those at risk for illness.
C.
The vaccine is for all ages and is given primarily to those
persons traveling overseas to areas of infection.
D.
The vaccine will prevent the occurrence of
pneumococcal pneumonia for up to 5 years.
A client is admitted to the hospital with severe lower left A
abdominal pain, nausea, vomiting, fever, and chills. Which Rationale:A client is showing signs of acute severe diverticulitis and is at risk for
nursing action has the highest priority? peritonitis and intestinal obstruction. The nurse should make the client NPO to
A. reduce risk of intestinal rupture. Options B, C, and D are important but are less of
Place the client on NPO status. a priority than option A, which is implemented to prevent a severe complication.
B.
Assess the client's temperature.
C.
Obtain a stool specimen.
D.
Administer IV fluids.
A client on telemetry has a pattern of uncontrolled atrial B
fibrillation with a rapid ventricular response. Based on this Rationale:With uncontrolled atrial fibrillation, the treatment of choice is
finding, the nurse anticipates assisting the physician with synchronized cardioversion to convert the cardiac rhythm back to normal sinus
which treatment? rhythm. Option A is a medication used for ventricular dysrhythmias. Option C is
A. not for a client with atrial fibrillation; it is reserved for clients with life-threatening
Administer lidocaine, 75 mg intravenous push. dysrhythmias, such as ventricular fibrillation and unstable ventricular tachycardia.
B. Option D is the drug of choice in symptomatic sinus bradycardia, not atrial
Perform synchronized cardioversion. fibrillation.
C.
Defibrillate the client as soon as possible.
D.
Administer atropine, 0.4 mg intravenous push.
