lOMoARcPSD|5422489
HESI MEDICAL SURGICAL EXAM TEST BANK 2027/ACTUAL
EXAM WITH CORRECT DETAILED AND VERIFIED ANSWERS/
MEDICAL SURGICAL HESI EXAM 2026-2027
A male client with sickle cell anemia, who has been hospitalized for another health problem, tells the
nurse he has had an erection for over 4 hours. What action should the nurse implement first?
Notify the client’s healthcare provider.
Document the Finding in the client record.
Prepare a warm enema solution for rectal instillation.
Obtain a large bore needle for aspiration of the corpora cavernosa.
Explanation
Priapism, a urologic emergency, is common during sickle cell crisis due to sickle cells clogging the
microcirculation in the penis, causing a reduction of blood ow and oxygenation to the penis, so the
healthcare provider should be rst noti ed immediately. The prescribed therapy may consist of
noninvasive measures such as applying ice to the penis, instilling a warm solution enema to
increase out ow in the corpora cavernosa and giving pain medications. If noninvasive measures
do not work, then needle aspiration of the corpora cavernosa is implemented by the healthcare
provider.
The nurse completes visual inspection of a client’s abdomen. What technique should the nurse perform next
in the abdominal examination?
Percussion.
Auscultation.
Deep palpation.
Light palpation.
Explanation
Auscultation of the client’s abdomen is performed next because manual manipulation of the
abdomen can stimulate peristalsis and create inaccurate assessment of bowel sounds heard
during auscultation.
, lOMoARcPSD|5422489
Which intervention should the nurse implement that best con rms placement of an endotracheal tube (ETT)?
Use an end-tital CO2 detector.
Ascultate for bilateral breath sounds.
Obtain pulse oximeter reading.
Check symmetrical chest movement.
Explanation
The end-tidal carbon dioxide detector indicates the prescence of CO2tidalby a color change or a
number indicated on the detector, which is supporting evidence that the ETT is in the trachea, not
the esophagus.
A female client with type 2 diabetes mellitus reports dysuria. Which assessment nding is most
important for the nurse to report to the healthcare provider?
Suprapublic pain and distention.
Bounding pulse at 100 beats/minute.
Fingerstick glucose of 300
mg/dl. Small vesicular
perineal lesions.
Explanation
Elevated ngerstick glucose levels needs to be reported tot he healthcare provider, so a plan of care
can be adjusted to treat the elevated glucose level. Also elevated glucose levels, spills into the
urine and provide a medium for bacterial growth.
A client with type II diabetes arrives at the clinic with a blood glucose of 50 mg/dL. The nurse provides
the client with 6 ounces of orange juice. In 15 minutes the client’s capillary glucose is 74 mg/dL. What
action should the nurse take?
Obtain a specimen for serum glucose level.
Administer insulin per sliding scale.
Provide cheese and bread to eat.
, lOMoARcPSD|5422489
Collect a glycosylated hemoglobin specimen.
Explanation
Once blood glucose is greater than 70 mg/dl, the client should eat a regularly scheduled meal or a snack
that contains protein and carbohydrates to help prevent hypoglycemia from recurring.
A 48-year-old client with endometrial cancer is being discharged after a total hysterectomy and bilateral
salpingo- oophorectomy.
Which client statement indicates that further teaching is needed?
"Well, I don’t have to worry about getting pregnant anymore."
"I can’t wait to go on the cruise that I have planned for this
summer." "I know I will miss having sexual intercourse with
my husband."
"I have asked my daughter to stay with me next week after I am discharged."
Explanation
Further teaching is needed in response to the client’s misunderstanding of not being able to have
sexual intercourse after a hysterectomy, needs to be addressed.
A client asks the nurse about the purpose of beginning chemotherapy (CT) because the tumor is still
very small. Which information supports the explanation that the nurse should provide?
Side eûects are less likely if therapy is started early.
Collateral circulation increases as the tumor grows.
Sensitivity of cancer cells to CT is based on cell cycle rate.
The cell count of the tumor reduces by half with each
dose. Explanation
Initiating chemotherapy while the tumor is small provides a better chance of eradicating all cancer
cells because 50% of cancer cells or tumor cells are killed with each dose.
A client in the preoperative holding area receives a prescription for midazolam (Versed) IV. The nurse
determines that the surgical consent form needs to be signed by the client. Which action should the
nurse implement?
Give the drug and allow the client to read and sign the consent form.
, lOMoARcPSD|5422489
Counter-sign the client’s initials on the consent form after giving the drug.
Withhold the drug until the client validates understanding of the surgical procedure and signs
the consent form.
Call the healthcare provider to explain the surgical procedure before the client signs the consent.
Explanation
Midazolam, a benzodiazepine sedative, is commonly used for conscious-sedation intraoperatively and
interferes with the client s cognition and level of consciousness, so the consent form should be
signed before the drug is administered.
Which client should the nurse assess rst?
A 27-year-old complaining of severe back pain.
A 63-year-old complaining of foot and ankle pain.
A 49-year-old with pancreatitis complaining of unrelenting abdominal pain.
A 55-year-old newly admitted client complaining of jaw pain and
indigestion. Explanation
The 55-year-old client should be assessed rst to rule out cardiac involvement because jaw pain and
indigestion are common descriptors of myocardial injury.
What is the primary nursing problem for a client with asymptomatic primary syphilis?
Acute pain.
Risk for injury.
Sexual dysfunction.
De cient
knowledge.
Explanation
An asymptomatic client with primary syphilis is most likely unaware of this disease, so to prevent
transmission to others and recurrence in the client, the priority nursing diagnosis is de cient
knowledge of the disease
pathophysiology.
HESI MEDICAL SURGICAL EXAM TEST BANK 2027/ACTUAL
EXAM WITH CORRECT DETAILED AND VERIFIED ANSWERS/
MEDICAL SURGICAL HESI EXAM 2026-2027
A male client with sickle cell anemia, who has been hospitalized for another health problem, tells the
nurse he has had an erection for over 4 hours. What action should the nurse implement first?
Notify the client’s healthcare provider.
Document the Finding in the client record.
Prepare a warm enema solution for rectal instillation.
Obtain a large bore needle for aspiration of the corpora cavernosa.
Explanation
Priapism, a urologic emergency, is common during sickle cell crisis due to sickle cells clogging the
microcirculation in the penis, causing a reduction of blood ow and oxygenation to the penis, so the
healthcare provider should be rst noti ed immediately. The prescribed therapy may consist of
noninvasive measures such as applying ice to the penis, instilling a warm solution enema to
increase out ow in the corpora cavernosa and giving pain medications. If noninvasive measures
do not work, then needle aspiration of the corpora cavernosa is implemented by the healthcare
provider.
The nurse completes visual inspection of a client’s abdomen. What technique should the nurse perform next
in the abdominal examination?
Percussion.
Auscultation.
Deep palpation.
Light palpation.
Explanation
Auscultation of the client’s abdomen is performed next because manual manipulation of the
abdomen can stimulate peristalsis and create inaccurate assessment of bowel sounds heard
during auscultation.
, lOMoARcPSD|5422489
Which intervention should the nurse implement that best con rms placement of an endotracheal tube (ETT)?
Use an end-tital CO2 detector.
Ascultate for bilateral breath sounds.
Obtain pulse oximeter reading.
Check symmetrical chest movement.
Explanation
The end-tidal carbon dioxide detector indicates the prescence of CO2tidalby a color change or a
number indicated on the detector, which is supporting evidence that the ETT is in the trachea, not
the esophagus.
A female client with type 2 diabetes mellitus reports dysuria. Which assessment nding is most
important for the nurse to report to the healthcare provider?
Suprapublic pain and distention.
Bounding pulse at 100 beats/minute.
Fingerstick glucose of 300
mg/dl. Small vesicular
perineal lesions.
Explanation
Elevated ngerstick glucose levels needs to be reported tot he healthcare provider, so a plan of care
can be adjusted to treat the elevated glucose level. Also elevated glucose levels, spills into the
urine and provide a medium for bacterial growth.
A client with type II diabetes arrives at the clinic with a blood glucose of 50 mg/dL. The nurse provides
the client with 6 ounces of orange juice. In 15 minutes the client’s capillary glucose is 74 mg/dL. What
action should the nurse take?
Obtain a specimen for serum glucose level.
Administer insulin per sliding scale.
Provide cheese and bread to eat.
, lOMoARcPSD|5422489
Collect a glycosylated hemoglobin specimen.
Explanation
Once blood glucose is greater than 70 mg/dl, the client should eat a regularly scheduled meal or a snack
that contains protein and carbohydrates to help prevent hypoglycemia from recurring.
A 48-year-old client with endometrial cancer is being discharged after a total hysterectomy and bilateral
salpingo- oophorectomy.
Which client statement indicates that further teaching is needed?
"Well, I don’t have to worry about getting pregnant anymore."
"I can’t wait to go on the cruise that I have planned for this
summer." "I know I will miss having sexual intercourse with
my husband."
"I have asked my daughter to stay with me next week after I am discharged."
Explanation
Further teaching is needed in response to the client’s misunderstanding of not being able to have
sexual intercourse after a hysterectomy, needs to be addressed.
A client asks the nurse about the purpose of beginning chemotherapy (CT) because the tumor is still
very small. Which information supports the explanation that the nurse should provide?
Side eûects are less likely if therapy is started early.
Collateral circulation increases as the tumor grows.
Sensitivity of cancer cells to CT is based on cell cycle rate.
The cell count of the tumor reduces by half with each
dose. Explanation
Initiating chemotherapy while the tumor is small provides a better chance of eradicating all cancer
cells because 50% of cancer cells or tumor cells are killed with each dose.
A client in the preoperative holding area receives a prescription for midazolam (Versed) IV. The nurse
determines that the surgical consent form needs to be signed by the client. Which action should the
nurse implement?
Give the drug and allow the client to read and sign the consent form.
, lOMoARcPSD|5422489
Counter-sign the client’s initials on the consent form after giving the drug.
Withhold the drug until the client validates understanding of the surgical procedure and signs
the consent form.
Call the healthcare provider to explain the surgical procedure before the client signs the consent.
Explanation
Midazolam, a benzodiazepine sedative, is commonly used for conscious-sedation intraoperatively and
interferes with the client s cognition and level of consciousness, so the consent form should be
signed before the drug is administered.
Which client should the nurse assess rst?
A 27-year-old complaining of severe back pain.
A 63-year-old complaining of foot and ankle pain.
A 49-year-old with pancreatitis complaining of unrelenting abdominal pain.
A 55-year-old newly admitted client complaining of jaw pain and
indigestion. Explanation
The 55-year-old client should be assessed rst to rule out cardiac involvement because jaw pain and
indigestion are common descriptors of myocardial injury.
What is the primary nursing problem for a client with asymptomatic primary syphilis?
Acute pain.
Risk for injury.
Sexual dysfunction.
De cient
knowledge.
Explanation
An asymptomatic client with primary syphilis is most likely unaware of this disease, so to prevent
transmission to others and recurrence in the client, the priority nursing diagnosis is de cient
knowledge of the disease
pathophysiology.
