HESI-RN MEDSURG EXAM 2026/2027
QUESTIONS AND CORRECT ANSWERS GRADED
A+
The nurse is preparing a client for discharge after a right total knee replacement.
Which client statements about use of a walker indicate to the nurse the teaching
was effective? (Select all that apply.)
A."I will walk in the middle of the walker."
B."I will make sure all four feet of the walker are on the floor before I use the hand
pieces."
C"I will move my right foot forward into the walker, and then my left foot."
D."I will collapse the walker and put it in the chair opposite the bed at night."
E."I will use a silicone-based cleaning product to clean the hand pieces and rubber
tips."
A, B, C
Rationale:The nurse is teaching about use of a walker. Having the walker collapsed
at night does not help with nighttime ambulation to the restroom. The client is at
risk for falling. Silicone is a slippery material and placing silicone on the rubber
tips of the walker places the client at risk for falling. The remaining client
statements about use of a walker are correct.
A resident in a long-term care facility is diagnosed with hepatitis B. Which action
should the nurse take with the staff caring for this client?
A.Determine if all employees have had the hepatitis B vaccine series.
B.Explain that this type of hepatitis can be transmitted when feeding the client.
C.Assure the employees that they cannot contract hepatitis B when providing
direct care.
,D.Tell the employees that wearing gloves and a gown are required when providing
all care.
A
Rationale:Hepatitis B vaccine should be administered to all health care providers.
Hepatitis A (not hepatitis B) can be transmitted by fecal-oral contamination. There
is a chance that staff could contract hepatitis B if exposed to the client's blood
and/or body fluids; therefore, option C is incorrect. There is no need to wear gloves
and gowns except with blood or body fluid contact.
The nurse is providing care to a client admitted to the emergency room with a
blood glucose level of 40 mg/dL and is semiconscious. What are the nurse's next
actions? (Select all that apply.)
A.
Place 4 sugar cubes under the tongue.
B.
Place 1 tablespoon of honey in the client's cheek.
C.
Start an IV of Normal Saline.
D.
Obtain a 50% dextrose solution.
E.
Administer glucagon as per the standing order.
F.
Turn the client to the side.
C, D, E, F
Rationale:Oral carbohydrates, such as sugar and honey, should never be given to
the semiconscious or unconscious clients with low blood sugar levels, for concern
,for aspiration. Glucagon can be administered immediately, followed by starting an
IV. Await the orders for the 50% dextrose solution. Place the client in a side lying
position as there is a risk for vomiting and aspiration with these clients.
A family member was taught to suction a client's tracheostomy prior to the client's
discharge from the hospital. Which observation by the nurse indicates that the
family member is capable of correctly performing the suctioning technique?
A.
Turns on the continuous wall suction to 190 mm Hg
B.
Inserts the catheter until resistance or coughing occurs
C.
Withdraws the catheter while maintaining suctioning
D.
Reclears the tracheostomy after suctioning the mouth
B
Rationale:Option B indicates correct technique for performing suctioning. Suction
pressure should be between 80 and 120 mm Hg, not 190 mm Hg. The catheter
should be withdrawn 1 to 2 cm at a time with intermittent, not continuous, suction.
Option D introduces pathogens unnecessarily into the tracheobronchial tree.
Which change in laboratory values indicates to the nurse that a client with
rheumatoid arthritis may be experiencing an adverse effect of methotrexate
therapy?
A.
Increase in rheumatoid factor
, B.
Decrease in hemoglobin level
C.
Increase in blood glucose level
D.
Decrease in erythrocyte sedimentation rate (ESR; sed rate)
B
Rationale:Methotrexate is an immunosuppressant. A common side effect is bone
marrow depression, which would be reflected by a decrease in the hemoglobin
level. Option A indicates disease progression but is not a side effect of the
medication. Option C is not related to methotrexate. Option D indicates that
inflammation associated with the disease has diminished.
A client with alcohol-related liver disease is admitted to the unit. Which
prescription should the nurse call the health care provider about for reverification
for this client?
A.
Vitamin K1, 5 mg IM daily
B.
High-calorie, low-sodium diet
C.
Fluid restriction to 1500 mL/day
D.
Nembutal sodium at bedtime for rest
D
Rationale:Sedatives such as pentobarbital are contraindicated for clients with liver
damage and can have dangerous consequences. Option A is often prescribed
QUESTIONS AND CORRECT ANSWERS GRADED
A+
The nurse is preparing a client for discharge after a right total knee replacement.
Which client statements about use of a walker indicate to the nurse the teaching
was effective? (Select all that apply.)
A."I will walk in the middle of the walker."
B."I will make sure all four feet of the walker are on the floor before I use the hand
pieces."
C"I will move my right foot forward into the walker, and then my left foot."
D."I will collapse the walker and put it in the chair opposite the bed at night."
E."I will use a silicone-based cleaning product to clean the hand pieces and rubber
tips."
A, B, C
Rationale:The nurse is teaching about use of a walker. Having the walker collapsed
at night does not help with nighttime ambulation to the restroom. The client is at
risk for falling. Silicone is a slippery material and placing silicone on the rubber
tips of the walker places the client at risk for falling. The remaining client
statements about use of a walker are correct.
A resident in a long-term care facility is diagnosed with hepatitis B. Which action
should the nurse take with the staff caring for this client?
A.Determine if all employees have had the hepatitis B vaccine series.
B.Explain that this type of hepatitis can be transmitted when feeding the client.
C.Assure the employees that they cannot contract hepatitis B when providing
direct care.
,D.Tell the employees that wearing gloves and a gown are required when providing
all care.
A
Rationale:Hepatitis B vaccine should be administered to all health care providers.
Hepatitis A (not hepatitis B) can be transmitted by fecal-oral contamination. There
is a chance that staff could contract hepatitis B if exposed to the client's blood
and/or body fluids; therefore, option C is incorrect. There is no need to wear gloves
and gowns except with blood or body fluid contact.
The nurse is providing care to a client admitted to the emergency room with a
blood glucose level of 40 mg/dL and is semiconscious. What are the nurse's next
actions? (Select all that apply.)
A.
Place 4 sugar cubes under the tongue.
B.
Place 1 tablespoon of honey in the client's cheek.
C.
Start an IV of Normal Saline.
D.
Obtain a 50% dextrose solution.
E.
Administer glucagon as per the standing order.
F.
Turn the client to the side.
C, D, E, F
Rationale:Oral carbohydrates, such as sugar and honey, should never be given to
the semiconscious or unconscious clients with low blood sugar levels, for concern
,for aspiration. Glucagon can be administered immediately, followed by starting an
IV. Await the orders for the 50% dextrose solution. Place the client in a side lying
position as there is a risk for vomiting and aspiration with these clients.
A family member was taught to suction a client's tracheostomy prior to the client's
discharge from the hospital. Which observation by the nurse indicates that the
family member is capable of correctly performing the suctioning technique?
A.
Turns on the continuous wall suction to 190 mm Hg
B.
Inserts the catheter until resistance or coughing occurs
C.
Withdraws the catheter while maintaining suctioning
D.
Reclears the tracheostomy after suctioning the mouth
B
Rationale:Option B indicates correct technique for performing suctioning. Suction
pressure should be between 80 and 120 mm Hg, not 190 mm Hg. The catheter
should be withdrawn 1 to 2 cm at a time with intermittent, not continuous, suction.
Option D introduces pathogens unnecessarily into the tracheobronchial tree.
Which change in laboratory values indicates to the nurse that a client with
rheumatoid arthritis may be experiencing an adverse effect of methotrexate
therapy?
A.
Increase in rheumatoid factor
, B.
Decrease in hemoglobin level
C.
Increase in blood glucose level
D.
Decrease in erythrocyte sedimentation rate (ESR; sed rate)
B
Rationale:Methotrexate is an immunosuppressant. A common side effect is bone
marrow depression, which would be reflected by a decrease in the hemoglobin
level. Option A indicates disease progression but is not a side effect of the
medication. Option C is not related to methotrexate. Option D indicates that
inflammation associated with the disease has diminished.
A client with alcohol-related liver disease is admitted to the unit. Which
prescription should the nurse call the health care provider about for reverification
for this client?
A.
Vitamin K1, 5 mg IM daily
B.
High-calorie, low-sodium diet
C.
Fluid restriction to 1500 mL/day
D.
Nembutal sodium at bedtime for rest
D
Rationale:Sedatives such as pentobarbital are contraindicated for clients with liver
damage and can have dangerous consequences. Option A is often prescribed
