HESI RN MED SURG TEST Questions With
Complete Solutions Newest Version
Updated.
1. The nurse is assessing a client with acute pancreatitis. Which finding
requires the most immediate intervention by the nurse?
A. The client's amylase level is three times higher than the normal level
B. The client has a carpal spasm when taking a blood pressure
C. On a 1 to 10 scale, the client tells the nurse that her epigastric pain is at
7
D. The client states that she will continue to drink alcohol after going home
Answer B. The client has a carpal spasm when taking a blood pressure
Rationale: This is a positive Trousseau sign, indicating hypocalcemia - a
common and serious complication of acute pancreatitis due to fat necrosis
and calcium sequestration. Hypocalcemia can cause tetany, seizures, and
cardiac dysrhythmias and requires immediate intervention. Elevated
amylase [A] and severe epigastric pain [C] are expected findings in
pancreatitis. Alcohol cessation teaching [D] is important but not an
immediate priority.
,2. A 55-year-old male client has been admitted to the hospital with a
medical diagnosis of chronic obstructive pulmonary disease [COPD]. Which
risk factor is the most significant in the development of this client's COPD?
A. The client's father was diagnosed with COPD in his 50s
B. A close family member contracted tuberculosis last year
C. The client smokes one to two packs of cigarettes per day
D. The client has been 40 pounds overweight for 15 years
Answer C. The client smokes one to two packs of cigarettes per day
Rationale: Cigarette smoking is the number one modifiable risk factor for
COPD, responsible for 80-90% of cases. While genetics may play a role, it is
not as significant as smoking. Tuberculosis [B] and obesity [D] are not
primary risk factors for COPD.
3. In assessing a client diagnosed with primary aldosteronism, the nurse
expects the laboratory test results to indicate a decreased serum level of
which substance?
A. Sodium
B. Phosphate
C. Potassium
D. Glucose
,Answer C. Potassium
Rationale: Primary aldosteronism causes excess aldosterone secretion,
which leads to sodium and water retention [causing hypertension] and
excessive potassium excretion by the kidneys, resulting in hypokalemia.
Sodium will be normal or elevated. Phosphate is regulated by parathyroid
hormone, and glucose is not affected.
4. The nurse is completing an admission interview for a client with
Parkinson's disease. Which question will provide additional information
about manifestations that the client is likely to experience?
A. "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?"
Answer C. "Have you ever been frozen in one spot, unable to move?"
Rationale: Parkinson's disease causes bradykinesia, rigidity, and akinesia.
Freezing episodes - being temporarily unable to initiate movement - are a
classic manifestation. Paralysis [A], blackouts/syncope [B], and throbbing
,headaches [D] are not characteristic of Parkinson's disease.
5. Client census is often used to determine staffing needs. Which method of
obtaining census determination for a particular unit provides the best
formula for determining long-range staffing patterns?
A. Midnight census
B. Oncoming shift census
C. Average daily census
D. Hourly census
Answer C. Average daily census
Rationale: The Average Daily Census [ADC] uses trend data over time and
accounts for seasonal and daily fluctuations, making it the most accurate for
long-range staffing planning. Midnight [A], oncoming shift [B], and hourly
[D] censuses only provide a snapshot at a single point in time.
6. A male client has just undergone a laryngectomy and has a cuffed tra-
cheostomy tube in place. When initiating bolus tube feedings
postoperatively, when should the nurse inflate the cuff?
A.
Immediately after
feeding B.
Complete Solutions Newest Version
Updated.
1. The nurse is assessing a client with acute pancreatitis. Which finding
requires the most immediate intervention by the nurse?
A. The client's amylase level is three times higher than the normal level
B. The client has a carpal spasm when taking a blood pressure
C. On a 1 to 10 scale, the client tells the nurse that her epigastric pain is at
7
D. The client states that she will continue to drink alcohol after going home
Answer B. The client has a carpal spasm when taking a blood pressure
Rationale: This is a positive Trousseau sign, indicating hypocalcemia - a
common and serious complication of acute pancreatitis due to fat necrosis
and calcium sequestration. Hypocalcemia can cause tetany, seizures, and
cardiac dysrhythmias and requires immediate intervention. Elevated
amylase [A] and severe epigastric pain [C] are expected findings in
pancreatitis. Alcohol cessation teaching [D] is important but not an
immediate priority.
,2. A 55-year-old male client has been admitted to the hospital with a
medical diagnosis of chronic obstructive pulmonary disease [COPD]. Which
risk factor is the most significant in the development of this client's COPD?
A. The client's father was diagnosed with COPD in his 50s
B. A close family member contracted tuberculosis last year
C. The client smokes one to two packs of cigarettes per day
D. The client has been 40 pounds overweight for 15 years
Answer C. The client smokes one to two packs of cigarettes per day
Rationale: Cigarette smoking is the number one modifiable risk factor for
COPD, responsible for 80-90% of cases. While genetics may play a role, it is
not as significant as smoking. Tuberculosis [B] and obesity [D] are not
primary risk factors for COPD.
3. In assessing a client diagnosed with primary aldosteronism, the nurse
expects the laboratory test results to indicate a decreased serum level of
which substance?
A. Sodium
B. Phosphate
C. Potassium
D. Glucose
,Answer C. Potassium
Rationale: Primary aldosteronism causes excess aldosterone secretion,
which leads to sodium and water retention [causing hypertension] and
excessive potassium excretion by the kidneys, resulting in hypokalemia.
Sodium will be normal or elevated. Phosphate is regulated by parathyroid
hormone, and glucose is not affected.
4. The nurse is completing an admission interview for a client with
Parkinson's disease. Which question will provide additional information
about manifestations that the client is likely to experience?
A. "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?"
Answer C. "Have you ever been frozen in one spot, unable to move?"
Rationale: Parkinson's disease causes bradykinesia, rigidity, and akinesia.
Freezing episodes - being temporarily unable to initiate movement - are a
classic manifestation. Paralysis [A], blackouts/syncope [B], and throbbing
,headaches [D] are not characteristic of Parkinson's disease.
5. Client census is often used to determine staffing needs. Which method of
obtaining census determination for a particular unit provides the best
formula for determining long-range staffing patterns?
A. Midnight census
B. Oncoming shift census
C. Average daily census
D. Hourly census
Answer C. Average daily census
Rationale: The Average Daily Census [ADC] uses trend data over time and
accounts for seasonal and daily fluctuations, making it the most accurate for
long-range staffing planning. Midnight [A], oncoming shift [B], and hourly
[D] censuses only provide a snapshot at a single point in time.
6. A male client has just undergone a laryngectomy and has a cuffed tra-
cheostomy tube in place. When initiating bolus tube feedings
postoperatively, when should the nurse inflate the cuff?
A.
Immediately after
feeding B.
