MED SURGE HESI REAL EXAM 200 2026
COMPLETE HESI PREPARATION GUIDE WITH
CASE-BASED PRACTICE CONCEPTS
◉ Which nursing action would be appropriate for a client who is
newly diagnosed with Cushing syndrome?
A.
Monitor blood glucose levels daily.
B.
Increase intake of fluids high in potassium.
C.
Encourage adequate rest between activities.
D.
Offer the client a sodium-enriched menu.
Answer: A
Rationale:Cushing syndrome results from a hypersecretion of
glucocorticoids in the adrenal cortex. Clients with Cushing syndrome
often develop diabetes mellitus. Monitoring of serum glucose levels
assesses for increased blood glucose levels so that treatment can
begin early. A common finding in Cushing syndrome is generalized
edema. Although potassium is needed, it is generally obtained from
food intake, not by offering potassium-enhanced fluids. Fatigue is
usually not an overwhelming factor in Cushing syndrome, so an
,emphasis on the need for rest is not indicated. A low-calorie, low-
carbohydrate, low-sodium diet is not recommended.
◉ A 58-year-old client who has no health problems asks the nurse
about receiving the pneumococcal vaccine. Which statement given
by the nurse would offer the client accurate information about this
vaccine?
A.
The vaccine is given annually before the flu season to those older
than 50 years.
B.
The immunization is administered once to older adults or those at
risk for illness.
C.
The vaccine is for all ages and is given primarily to those persons
traveling overseas to areas of infection.
D.
The vaccine will prevent the occurrence of pneumococcal
pneumonia for up to 5 years.
Answer: B
Rationale:It is usually recommended that persons older than 65
years and those with a history of chronic illness should receive the
vaccine once in their lifetime. Some recommend receiving the
vaccine at 50 years of age. The influenza vaccine is given once a year.
Although the vaccine might be given to a person traveling overseas,
,that is not the main rationale for administering the vaccine. The
vaccine is usually given once in a lifetime, but with
immunosuppressed clients or clients with a history of pneumonia,
revaccination is sometimes required.
◉ A client is admitted to the hospital with severe lower left
abdominal pain, nausea, vomiting, fever, and chills. Which nursing
action has the highest priority?
A.
Place the client on NPO status.
B.
Assess the client's temperature.
C.
Obtain a stool specimen.
D.
Administer IV fluids.
Answer: A
Rationale:A client is showing signs of acute severe diverticulitis and
is at risk for peritonitis and intestinal obstruction. The nurse should
make the client NPO to reduce risk of intestinal rupture. Options B,
C, and D are important but are less of a priority than option A, which
is implemented to prevent a severe complication.
, ◉ A client on telemetry has a pattern of uncontrolled atrial
fibrillation with a rapid ventricular response. Based on this finding,
the nurse anticipates assisting the physician with which treatment?
A.
Administer lidocaine, 75 mg intravenous push.
B.
Perform synchronized cardioversion.
C.
Defibrillate the client as soon as possible.
D.
Administer atropine, 0.4 mg intravenous push.
Answer: B
Rationale:With uncontrolled atrial fibrillation, the treatment of
choice is synchronized cardioversion to convert the cardiac rhythm
back to normal sinus rhythm. Option A is a medication used for
ventricular dysrhythmias. Option C is not for a client with atrial
fibrillation; it is reserved for clients with life-threatening
dysrhythmias, such as ventricular fibrillation and unstable
ventricular tachycardia. Option D is the drug of choice in
symptomatic sinus bradycardia, not atrial fibrillation.
◉ 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.)
COMPLETE HESI PREPARATION GUIDE WITH
CASE-BASED PRACTICE CONCEPTS
◉ Which nursing action would be appropriate for a client who is
newly diagnosed with Cushing syndrome?
A.
Monitor blood glucose levels daily.
B.
Increase intake of fluids high in potassium.
C.
Encourage adequate rest between activities.
D.
Offer the client a sodium-enriched menu.
Answer: A
Rationale:Cushing syndrome results from a hypersecretion of
glucocorticoids in the adrenal cortex. Clients with Cushing syndrome
often develop diabetes mellitus. Monitoring of serum glucose levels
assesses for increased blood glucose levels so that treatment can
begin early. A common finding in Cushing syndrome is generalized
edema. Although potassium is needed, it is generally obtained from
food intake, not by offering potassium-enhanced fluids. Fatigue is
usually not an overwhelming factor in Cushing syndrome, so an
,emphasis on the need for rest is not indicated. A low-calorie, low-
carbohydrate, low-sodium diet is not recommended.
◉ A 58-year-old client who has no health problems asks the nurse
about receiving the pneumococcal vaccine. Which statement given
by the nurse would offer the client accurate information about this
vaccine?
A.
The vaccine is given annually before the flu season to those older
than 50 years.
B.
The immunization is administered once to older adults or those at
risk for illness.
C.
The vaccine is for all ages and is given primarily to those persons
traveling overseas to areas of infection.
D.
The vaccine will prevent the occurrence of pneumococcal
pneumonia for up to 5 years.
Answer: B
Rationale:It is usually recommended that persons older than 65
years and those with a history of chronic illness should receive the
vaccine once in their lifetime. Some recommend receiving the
vaccine at 50 years of age. The influenza vaccine is given once a year.
Although the vaccine might be given to a person traveling overseas,
,that is not the main rationale for administering the vaccine. The
vaccine is usually given once in a lifetime, but with
immunosuppressed clients or clients with a history of pneumonia,
revaccination is sometimes required.
◉ A client is admitted to the hospital with severe lower left
abdominal pain, nausea, vomiting, fever, and chills. Which nursing
action has the highest priority?
A.
Place the client on NPO status.
B.
Assess the client's temperature.
C.
Obtain a stool specimen.
D.
Administer IV fluids.
Answer: A
Rationale:A client is showing signs of acute severe diverticulitis and
is at risk for peritonitis and intestinal obstruction. The nurse should
make the client NPO to reduce risk of intestinal rupture. Options B,
C, and D are important but are less of a priority than option A, which
is implemented to prevent a severe complication.
, ◉ A client on telemetry has a pattern of uncontrolled atrial
fibrillation with a rapid ventricular response. Based on this finding,
the nurse anticipates assisting the physician with which treatment?
A.
Administer lidocaine, 75 mg intravenous push.
B.
Perform synchronized cardioversion.
C.
Defibrillate the client as soon as possible.
D.
Administer atropine, 0.4 mg intravenous push.
Answer: B
Rationale:With uncontrolled atrial fibrillation, the treatment of
choice is synchronized cardioversion to convert the cardiac rhythm
back to normal sinus rhythm. Option A is a medication used for
ventricular dysrhythmias. Option C is not for a client with atrial
fibrillation; it is reserved for clients with life-threatening
dysrhythmias, such as ventricular fibrillation and unstable
ventricular tachycardia. Option D is the drug of choice in
symptomatic sinus bradycardia, not atrial fibrillation.
◉ 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.)
