PN HESI MED SURG EXAM SCRIPT 2026
QUESTIONS AND SOLUTIONS
COMPREHENSIVE STUDY SHEET FULL
PRACTICE SET
◉ 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.
Answer: 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.
Answer: 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
Answer: 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 The catheter should be withdrawn 1 to 2 cm at a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)
Answer: 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
QUESTIONS AND SOLUTIONS
COMPREHENSIVE STUDY SHEET FULL
PRACTICE SET
◉ 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.
Answer: 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.
Answer: 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
Answer: 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)
Answer: 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
