Page 1 of 23
HESI MEDICAL SURGICAL EXAM ALL ACTUAL EXAM QUESTIONS WITH
ANSWERS
The nurse is providing dietary instructions to a 68-year-old client who is at high risk for
development of coronary heart disease (CHD). Which information should the nurse
include?
Limit dietary selection of cholesterol to 300 mg per day.
Increase intake of soluble fiber to 10 to 25 grams per day.
Decrease plant stanols and sterols to less than 2 grams/day. Ensure saturated
fat is less than 30% of total caloric intake.
Rationale
To reduce risk factors associated with coronary heart disease, the daily intake of soluble
fiber should be increased to between 10 and 25 gm. According to the American Heart
Association, soluble fibers helps reduce the LDL cholesterol levels.
Despite several eye surgeries, a 78-year-old client who lives alone has persistent vision
problems. The visiting nurse is discussing home safety hazards with the client. The nurse
suggests that the edges of the steps be painted which color?
White.
Light green.
Medium yellow.
Black.
Rationale
The color yellow is the easiest for a person with failing vision to see.
A client receiving cholestyramine (Questran) for hyperlipidemia should be evaluated for
what vitamin deficiency?
K.
B12.
B6.
C.
Rationale
This drug is administered to help lower the triglycerides levels. One of the side effects
clients should be monitored for an increased prothrombin time and prolonged bleeding
times which would alert the nurse to a vitamin K deficiency. These drugs reduce absorption
of the fat soluble (lipid) vitamins A, D, E, and K.
The nurse is caring for a client with a stroke resulting in right-sided paresis and aphasia.
The client attempts to use the left hand for feeding and other self-care activities. The spouse
, lOMoARcPSD|5422489
becomes frustrated and insists on doing everything for the client. Based on this data, which
nursing diagnosis should the nurse document for this client?
Situational low self-esteem related to functional impairment and change in role function.
Disabled family coping related to dissonant coping style of significant person.
Interrupted family processes related to shift in health status of family member.
Risk for ineffective therapeutic regimen management related to complexity of care.
Rationale
A stroke affects the whole family and in this case the spouse probably thinks that she is
helping and needs to feel that she is contributing to the client's care. Her help is noted as
being incongruent with attempts of self-care by the client thereby disabling family coping.
The nurse is interviewing a male client with hypertension. Which additional medical
diagnosis in the client's history presents the greatest risk for developing a cerebral vascular
accident (CVA)?
Diabetes mellitus.
Hypothyroidism.
Parkinson's disease.
Recurring pneumonia.
Rationale
According to the National Stroke Association (2013), history of diabetes mellitus poses the
greatest risk for developing a CVA, 2-4Xs more than those who do not have diabetes
mellitus. The reason for this occurrence is related to the excess glucose circulating
throughout the body not being utilizing by the cells of the body, leading to the increased
fatty deposits or clots inside the blood vessels in the brain or neck, eventually causing a
stroke.
In assessing a client diagnosed with primary hyperaldosteronism, the nurse expects the
laboratory test results to indicate a decreased serum level of which substance?
Sodium.
Antidiuretic hormone.
Potassium.
Glucose.
Rationale
Clients with primary hyperaldosteronism exhibit a profound decline in the serum levels of
potassium (hypokalemia). Hypertension, along with the hypokalemia are the most
prominent and universal signs for this condition. If both of these findings are present, there
is 50% likelihood the client to be diagnosed with hyperaldosteronism.
Which intervention should the nurse implement for a female client diagnosed with pelvic
relaxation disorder?
, Page 3 of 23
Describe proper administration of vaginal suppositories and cream.
Encourage the client to perform Kegel exercises 10 times daily.
Explain the importance of using condoms when having sexual intercourse.
Discuss the importance of keeping a diary of daily temperature and menstrual cycle events.
Rationale
Pelvic relaxation disorders are structural disorders resulting from weakening support
tissues of the pelvis. Kegel exercises helps strengthen the surrounding muscles.
A splint is prescribed for nighttime use by a client with rheumatoid arthritis. Which
statement by the nurse provides the most accurate explanation for use of the splints?
Prevention of deformities.
Avoidance of joint trauma.
Relief of joint inflammation.
Improvement in joint strength.
Rationale
Splints may be used at night by clients with rheumatoid arthritis to prevent deformities
caused by muscle spasms and contractures.
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.)
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.
Rationale
The diaphragm needs to remain against the cervix for 6 to 8 hours to prevent pregnancy
but should not remain for longer than 8 hours to avoid the risk of TSS.
The diaphragm should be replaced every 3 months to maintain integrity.
A client has a staging procedure for cancer of the breast and ask the nurse which type of
breast cancer has the poorest prognosis. Which information should the nurse offer the
client?
Stage II.
Invasive infiltrating ductal carcinoma.
T1N0M0.
Inflammatory with peau d'orange.
HESI MEDICAL SURGICAL EXAM ALL ACTUAL EXAM QUESTIONS WITH
ANSWERS
The nurse is providing dietary instructions to a 68-year-old client who is at high risk for
development of coronary heart disease (CHD). Which information should the nurse
include?
Limit dietary selection of cholesterol to 300 mg per day.
Increase intake of soluble fiber to 10 to 25 grams per day.
Decrease plant stanols and sterols to less than 2 grams/day. Ensure saturated
fat is less than 30% of total caloric intake.
Rationale
To reduce risk factors associated with coronary heart disease, the daily intake of soluble
fiber should be increased to between 10 and 25 gm. According to the American Heart
Association, soluble fibers helps reduce the LDL cholesterol levels.
Despite several eye surgeries, a 78-year-old client who lives alone has persistent vision
problems. The visiting nurse is discussing home safety hazards with the client. The nurse
suggests that the edges of the steps be painted which color?
White.
Light green.
Medium yellow.
Black.
Rationale
The color yellow is the easiest for a person with failing vision to see.
A client receiving cholestyramine (Questran) for hyperlipidemia should be evaluated for
what vitamin deficiency?
K.
B12.
B6.
C.
Rationale
This drug is administered to help lower the triglycerides levels. One of the side effects
clients should be monitored for an increased prothrombin time and prolonged bleeding
times which would alert the nurse to a vitamin K deficiency. These drugs reduce absorption
of the fat soluble (lipid) vitamins A, D, E, and K.
The nurse is caring for a client with a stroke resulting in right-sided paresis and aphasia.
The client attempts to use the left hand for feeding and other self-care activities. The spouse
, lOMoARcPSD|5422489
becomes frustrated and insists on doing everything for the client. Based on this data, which
nursing diagnosis should the nurse document for this client?
Situational low self-esteem related to functional impairment and change in role function.
Disabled family coping related to dissonant coping style of significant person.
Interrupted family processes related to shift in health status of family member.
Risk for ineffective therapeutic regimen management related to complexity of care.
Rationale
A stroke affects the whole family and in this case the spouse probably thinks that she is
helping and needs to feel that she is contributing to the client's care. Her help is noted as
being incongruent with attempts of self-care by the client thereby disabling family coping.
The nurse is interviewing a male client with hypertension. Which additional medical
diagnosis in the client's history presents the greatest risk for developing a cerebral vascular
accident (CVA)?
Diabetes mellitus.
Hypothyroidism.
Parkinson's disease.
Recurring pneumonia.
Rationale
According to the National Stroke Association (2013), history of diabetes mellitus poses the
greatest risk for developing a CVA, 2-4Xs more than those who do not have diabetes
mellitus. The reason for this occurrence is related to the excess glucose circulating
throughout the body not being utilizing by the cells of the body, leading to the increased
fatty deposits or clots inside the blood vessels in the brain or neck, eventually causing a
stroke.
In assessing a client diagnosed with primary hyperaldosteronism, the nurse expects the
laboratory test results to indicate a decreased serum level of which substance?
Sodium.
Antidiuretic hormone.
Potassium.
Glucose.
Rationale
Clients with primary hyperaldosteronism exhibit a profound decline in the serum levels of
potassium (hypokalemia). Hypertension, along with the hypokalemia are the most
prominent and universal signs for this condition. If both of these findings are present, there
is 50% likelihood the client to be diagnosed with hyperaldosteronism.
Which intervention should the nurse implement for a female client diagnosed with pelvic
relaxation disorder?
, Page 3 of 23
Describe proper administration of vaginal suppositories and cream.
Encourage the client to perform Kegel exercises 10 times daily.
Explain the importance of using condoms when having sexual intercourse.
Discuss the importance of keeping a diary of daily temperature and menstrual cycle events.
Rationale
Pelvic relaxation disorders are structural disorders resulting from weakening support
tissues of the pelvis. Kegel exercises helps strengthen the surrounding muscles.
A splint is prescribed for nighttime use by a client with rheumatoid arthritis. Which
statement by the nurse provides the most accurate explanation for use of the splints?
Prevention of deformities.
Avoidance of joint trauma.
Relief of joint inflammation.
Improvement in joint strength.
Rationale
Splints may be used at night by clients with rheumatoid arthritis to prevent deformities
caused by muscle spasms and contractures.
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.)
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.
Rationale
The diaphragm needs to remain against the cervix for 6 to 8 hours to prevent pregnancy
but should not remain for longer than 8 hours to avoid the risk of TSS.
The diaphragm should be replaced every 3 months to maintain integrity.
A client has a staging procedure for cancer of the breast and ask the nurse which type of
breast cancer has the poorest prognosis. Which information should the nurse offer the
client?
Stage II.
Invasive infiltrating ductal carcinoma.
T1N0M0.
Inflammatory with peau d'orange.
