The Ultimate HESI PN Med-Surg Exam
Prep: Practice Questions with Answers
& Rationales
1. A nurse is assisting in the care of a client who is receiving a
continuous tube feeding of 60 mL/hr at 1.2 cal/mL. How many calories
will the client receive in 12 hours? (Round to the nearest whole
number.)
Answer: 864 calories
Rationale: 1.2 cal × 60 mL × 12 hours = 864 calories .
2. A nurse is reinforcing teaching with a client who has diabetes
mellitus and a new prescription for regular and NPH insulin. Which
instruction should the nurse include?
a. Withdraw both types of insulin and then add 0.2 mL of air to the syringe
b. Gently shake the NPH insulin prior to withdrawing the dose
c. Withdraw the regular insulin before withdrawing the NPH insulin
d. Inject air into the NPH vial after withdrawing regular insulin
Answer: c. Withdraw the regular insulin before withdrawing the NPH
insulin
Rationale: The nurse should remind the client to withdraw regular insulin
before NPH insulin to prevent contamination of the regular insulin with
NPH insulin .
,3. A nurse is preparing to assist a client out of bed 4 hours following a
laparoscopic cholecystectomy. Which action should the nurse take
first?
a. Place the client in Fowler's position
b. Obtain the client's blood pressure
c. Dangle the client's legs at the bedside
d. Apply nonskid slippers
Answer: b. Obtain the client's blood pressure
Rationale: The greatest risk to the client is postural hypotension due to
decreased blood volume following surgery. The first action is to obtain a
baseline blood pressure to determine if it is safe for the client to get out of
bed .
4. A nurse is assisting with care for a client who has age-related
macular degeneration. Which finding should the nurse expect?
a. Seeing halos around artificial lights
b. Distorted central vision of the eyes
c. Colored spots before the visual fields
d. Spontaneous tearing of the eyes
Answer: b. Distorted central vision of the eyes
Rationale: Macular degeneration results in distortion and blurring of
central vision. The client might completely lose central vision and view a
dark spot in the center .
5. A nurse is reinforcing teaching with a client on a low-sodium diet
who asks about improving the taste of bland food. Which food should
the nurse recommend?
,a. Ketchup
b. Mayonnaise
c. Soy sauce
d. Lemon juice
Answer: d. Lemon juice
Rationale: Lemon juice is recommended because it is low in sodium and
can enhance food flavor without adding salt .
6. A nurse is preparing to assist with insertion of a double-lumen
gastric sump tube for a client with peptic ulcer disease and
gastrointestinal bleeding. Which feature is correct about this tube?
Answer: The clear portion allows aspiration of stomach contents; the blue
"pig tail" portion vents to the atmosphere, preventing tube lodgment
against the stomach wall .
7. A nurse is contributing to the plan of care for a client with
tuberculosis (TB). Which intervention should be included?
a. Place a "no visitors" sign on the client's door
b. Have the client wear an N95 respirator mask during transport
c. Initiate droplet precautions for the client
d. Place the client in a negative-pressure airflow room
Answer: d. Place the client in a negative-pressure airflow room
Rationale: Clients with TB require airborne precautions and should be
placed in a negative-pressure airflow room to filter the air and prevent
transmission of microorganisms .
, 8. A nurse is contributing to the plan of care for a client who had a
stroke. For which interprofessional team member should the nurse
recommend a referral prior to initiating oral intake?
a. Occupational therapist
b. Speech-language pathologist
c. Physical therapist
d. Case manager
Answer: b. Speech-language pathologist
Rationale: A speech-language pathologist should evaluate the client's
swallowing ability before oral intake is initiated to prevent aspiration .
9. To provide culturally competent care, what action must the practical
nurse do first?
Answer: Understand their own values and views to prevent those beliefs
from being imparted to others, in addition to understanding the client's
cultural views .
10. The nurse is reinforcing hygiene instructions to UAP who will be
bathing a client with pneumonia. What instruction is most important?
Answer: The client should have activities such as bathing alternated with
rest periods. The client should be allowed to rest before activities such as
bathing take place .
11. A client is admitted with a left tibia fracture and has a splint in
place. The client received analgesia 2 hours ago but now complains of
excruciating leg pain and demands stronger pain medication. What
initial action is most important?
Answer: Measure the pulse strength and capillary refill distal to the fracture
Prep: Practice Questions with Answers
& Rationales
1. A nurse is assisting in the care of a client who is receiving a
continuous tube feeding of 60 mL/hr at 1.2 cal/mL. How many calories
will the client receive in 12 hours? (Round to the nearest whole
number.)
Answer: 864 calories
Rationale: 1.2 cal × 60 mL × 12 hours = 864 calories .
2. A nurse is reinforcing teaching with a client who has diabetes
mellitus and a new prescription for regular and NPH insulin. Which
instruction should the nurse include?
a. Withdraw both types of insulin and then add 0.2 mL of air to the syringe
b. Gently shake the NPH insulin prior to withdrawing the dose
c. Withdraw the regular insulin before withdrawing the NPH insulin
d. Inject air into the NPH vial after withdrawing regular insulin
Answer: c. Withdraw the regular insulin before withdrawing the NPH
insulin
Rationale: The nurse should remind the client to withdraw regular insulin
before NPH insulin to prevent contamination of the regular insulin with
NPH insulin .
,3. A nurse is preparing to assist a client out of bed 4 hours following a
laparoscopic cholecystectomy. Which action should the nurse take
first?
a. Place the client in Fowler's position
b. Obtain the client's blood pressure
c. Dangle the client's legs at the bedside
d. Apply nonskid slippers
Answer: b. Obtain the client's blood pressure
Rationale: The greatest risk to the client is postural hypotension due to
decreased blood volume following surgery. The first action is to obtain a
baseline blood pressure to determine if it is safe for the client to get out of
bed .
4. A nurse is assisting with care for a client who has age-related
macular degeneration. Which finding should the nurse expect?
a. Seeing halos around artificial lights
b. Distorted central vision of the eyes
c. Colored spots before the visual fields
d. Spontaneous tearing of the eyes
Answer: b. Distorted central vision of the eyes
Rationale: Macular degeneration results in distortion and blurring of
central vision. The client might completely lose central vision and view a
dark spot in the center .
5. A nurse is reinforcing teaching with a client on a low-sodium diet
who asks about improving the taste of bland food. Which food should
the nurse recommend?
,a. Ketchup
b. Mayonnaise
c. Soy sauce
d. Lemon juice
Answer: d. Lemon juice
Rationale: Lemon juice is recommended because it is low in sodium and
can enhance food flavor without adding salt .
6. A nurse is preparing to assist with insertion of a double-lumen
gastric sump tube for a client with peptic ulcer disease and
gastrointestinal bleeding. Which feature is correct about this tube?
Answer: The clear portion allows aspiration of stomach contents; the blue
"pig tail" portion vents to the atmosphere, preventing tube lodgment
against the stomach wall .
7. A nurse is contributing to the plan of care for a client with
tuberculosis (TB). Which intervention should be included?
a. Place a "no visitors" sign on the client's door
b. Have the client wear an N95 respirator mask during transport
c. Initiate droplet precautions for the client
d. Place the client in a negative-pressure airflow room
Answer: d. Place the client in a negative-pressure airflow room
Rationale: Clients with TB require airborne precautions and should be
placed in a negative-pressure airflow room to filter the air and prevent
transmission of microorganisms .
, 8. A nurse is contributing to the plan of care for a client who had a
stroke. For which interprofessional team member should the nurse
recommend a referral prior to initiating oral intake?
a. Occupational therapist
b. Speech-language pathologist
c. Physical therapist
d. Case manager
Answer: b. Speech-language pathologist
Rationale: A speech-language pathologist should evaluate the client's
swallowing ability before oral intake is initiated to prevent aspiration .
9. To provide culturally competent care, what action must the practical
nurse do first?
Answer: Understand their own values and views to prevent those beliefs
from being imparted to others, in addition to understanding the client's
cultural views .
10. The nurse is reinforcing hygiene instructions to UAP who will be
bathing a client with pneumonia. What instruction is most important?
Answer: The client should have activities such as bathing alternated with
rest periods. The client should be allowed to rest before activities such as
bathing take place .
11. A client is admitted with a left tibia fracture and has a splint in
place. The client received analgesia 2 hours ago but now complains of
excruciating leg pain and demands stronger pain medication. What
initial action is most important?
Answer: Measure the pulse strength and capillary refill distal to the fracture
