Med Surg HESI Study Guide |
Medical-Surgical Nursing Practice
Questions & Exam Prep 2026/2027
,Which statement made by a client with chronic To prevent exacerbations of chronic pancreatitis, clients should be instructed to
pancreatitis indicates that further education is avoid nicotine entirely. Additional teaching includes avoiding caffeinated beverages,
needed? resting frequently as needed, and eating a bland diet low fat and high in protein.
I will cut back on smoking cigarettes daily. Correct
I will avoid drinking caffeinated beverages.
I will rest frequently and avoid vigorous exercise. Incorrect
I will eat a bland, low-fat, high-protein diet.
How should the nurse position the electrodes for In MCL I monitoring, the positive electrode is placed on the client's mid-chest to the
modified chest lead one (MCL I) telemetry monitoring? right of the sternum, and the negative electrode is placed on the upper left part of
Negative polarity left shoulder, positive polarity right chest the chest. The ground may be placed anywhere, but is usually placed on the lower
nipple line, ground left chest nipple line. Correct left portion of the chest.
In preparing to administer intravenous albumin to a Albumin should be infused within four hours because it does not contain any
client following surgery, which are the priority nursing preservatives. Any fluid remaining after four hours should be discarded. A large
interventions? (Select all that apply.) gauge catheter allows for fast infusion rate, which may be necessary. Hemodilution
Set the infusion pump to infuse the albumin within four may decrease hemoglobin (HgB) and hematocrit (HCT) levels, so the HgB and HCT
hours. Correct levels should be monitored while monitoring for bleeding because of the increased
Compare the client's blood type with the label on the blood volume and blood pressure.
albumin.
Assign a UAP to monitor blood pressure q15 minutes.
Administer through a large gauge catheter. Correct
Monitor hemoglobin and hematocrit levels. Correct
Assess for increased bleeding after
administration. Correct
A client who has heart failure is admitted with a serum Hypokalemia (normal 3.5 to 5 mEq/L [3.5 to 5 mmol/L]) causes changes in
potassium level of 2.9 mEq/L (2.9 mmol/L). Which myocardial irritability and ECG waveform, so it is most important for the nurse to
action is most important for the nurse to implement? initiate continuous cardiac monitoring to identify ventricular ectopy or other life-
Give 20 mEq of potassium chloride. threatening dysrhythmias. After cardiac monitoring is initiated, then the potassium
Initiate continuous cardiac monitoring. Correct chloride should be given so that the effects of potassium replacement on the
Arrange a consultation with the dietician. cardiac rhythm can be monitored.
Teach about the side effects of diuretics.
After checking the urinary drainage system for kinks After surgery, an adult who weighs 132 pounds (60 kg) should produce about 60 mL
in the tubing, the nurse determines that a client who of urine hourly (1 mL/kg/hour). Dark, concentrated, and low volume of urine output
has returned from the post-anesthesia care has a dark, should be reported to the surgeon.
concentrated urinary output of 54 mL for the last 2
hours. Which priority nursing action should be
implemented?
Report the findings to the surgeon. Correct
Irrigate the indwelling urinary catheter.
Apply manual pressure to the bladder.
Increase the IV flow rate for 15 minutes. Incorrect
Two days postoperative, a male client reports aching For a client exhibiting symptoms of deep vein thrombosis (DVT), a complication of
pain in his left leg. The nurse assesses redness and immobility, the initial care includes bedrest and elevation of the extremity.
warmth on the lower left calf. Which intervention
would be most helpful to this client?
Apply sequential compression devices (SCDs) bilaterally.
Assess for a positive Homan's sign in each leg. Incorrect
Pad all bony prominences on the affected leg.
Advise the client to remain in bed with the leg
elevated. Correct
Which description of pain is consistent with a Rheumatoid arthritis (RA) is an autoimmune disease that causes joint pain and
diagnosis of rheumatoid arthritis? swelling. RA is characterized by pain that is worse when arising and involves
Joint pain is worse in the morning and involves symmetric symmetric joints.
joints. Correct
Joint pain is better in the morning and worsens throughout
the day.
Joint pain is consistent throughout the day and is relieved
by pain medication. Incorrect
Joint pain is worse during the day and involves unilateral
joints.
, A client’s susceptibility to ulcerative colitis is most Ulcerative colitis is 4 to 5 times more common among individuals of Jewish
likely due to which aspect in the client’s history? European or Ashkenazi ancestry.
Jewish European ancestry. Correct
H. pylori bowel infection.
Family history of irritable bowel syndrome.
Age between 25 and 55 years.
While working in the emergency room, the nurse is A tuberculin skin test is effective 4 to 6 weeks after an exposure, so the individual
exposed to a client with active tuberculosis. When with a known exposure should wait 4 to 6 weeks before having a tuberculin skin
should the nurse plan to obtain a tuberculin skin test? test.
Immediately after the exposure.
Within one week of the exposure.
Four to six weeks after the exposure. Correct
Three months after the exposure.
The nurse knows that lab values sometimes vary for As older adults age, the protein found in urine slightly rises as a result of kidney
the older client. Which data would the nurse expect to changes, and the serum glucose increases slightly, also due to changes in the
find when reviewing laboratory values of an 80-year- kidney.
old male?
Increased WBC, decreased RBC.
Increased serum bilirubin, slightly increased liver
enzymes.
Increased protein in the urine, slightly increased
serum glucose levels. Correct
Decreased serum sodium, an increased urine specific
gravity.
The nurse is assessing a client's laboratory values Tumor lysis symdrome (TLS) results in hyperkalemia, hypocalcemia, hyperuricemia,
following administration of chemotherapy. Which lab and hyperphosphatemia. A serum calcium level of 5, which is low, is an indicator of
value leads the nurse to suspect that the client is possible tumor lysis syndrome.
experiencing tumor lysis syndrome (TLS)?
Serum PTT of 10 seconds.
Serum calcium of 5 mg/dL. Correct
Oxygen saturation of 90%.
Hemoglobin of 10 g/dL.
Which intervention should the nurse plan to A large tourniquet should be placed in plain sight at the client's bedside, in the event
implement when caring for a client who has just severe bleeding occurs. The purpose is to have the tourniquet available to apply to
undergone a right above-the-knee amputation? the residual limb to control bleeding if hemorrhaging was to occur.
Maintain the residual limb on three pillows at all
times. Incorrect
Place a large tourniquet at the client's
bedside. Correct
Apply constant, direct pressure to the residual limb.
Do not allow the client to lie in the prone position.
Creatinine More SPECIFIC THAN BUN.
An elevated creatinine strongly indicates nephron loss, reducing filtration.
Which nail color alteration should the nurse expect to Fingernails and toenails can be affected by chronic kidney disease. This condition
observe in a client with chronic kidney disease? may cause horizontal white lines or bands (leukonychia) to appear on the nails.
Horizontal white banding. Correct
Diffuse blue discoloration.
Diffuse brown discoloration.
Thin, dark red vertical lines.
The nurse is providing dietary instructions to a 68- To reduce risk factors associated with coronary heart disease, the daily intake of
year-old client who is at high risk for development of soluble fiber should be increased to between 10 and 25 grams per day. According to
coronary heart disease (CHD). Which information the American Heart Association, soluble fibers helps reduce LDL cholesterol levels.
should the nurse include?
Limit dietary selection of cholesterol to 300 mg per day.
Increase intake of soluble fiber to 10 to 25 grams per
day. Correct
Decrease plant stanols and sterols to less than 2
grams/day.
Ensure saturated fat is less than 30% of total caloric
intake.
Medical-Surgical Nursing Practice
Questions & Exam Prep 2026/2027
,Which statement made by a client with chronic To prevent exacerbations of chronic pancreatitis, clients should be instructed to
pancreatitis indicates that further education is avoid nicotine entirely. Additional teaching includes avoiding caffeinated beverages,
needed? resting frequently as needed, and eating a bland diet low fat and high in protein.
I will cut back on smoking cigarettes daily. Correct
I will avoid drinking caffeinated beverages.
I will rest frequently and avoid vigorous exercise. Incorrect
I will eat a bland, low-fat, high-protein diet.
How should the nurse position the electrodes for In MCL I monitoring, the positive electrode is placed on the client's mid-chest to the
modified chest lead one (MCL I) telemetry monitoring? right of the sternum, and the negative electrode is placed on the upper left part of
Negative polarity left shoulder, positive polarity right chest the chest. The ground may be placed anywhere, but is usually placed on the lower
nipple line, ground left chest nipple line. Correct left portion of the chest.
In preparing to administer intravenous albumin to a Albumin should be infused within four hours because it does not contain any
client following surgery, which are the priority nursing preservatives. Any fluid remaining after four hours should be discarded. A large
interventions? (Select all that apply.) gauge catheter allows for fast infusion rate, which may be necessary. Hemodilution
Set the infusion pump to infuse the albumin within four may decrease hemoglobin (HgB) and hematocrit (HCT) levels, so the HgB and HCT
hours. Correct levels should be monitored while monitoring for bleeding because of the increased
Compare the client's blood type with the label on the blood volume and blood pressure.
albumin.
Assign a UAP to monitor blood pressure q15 minutes.
Administer through a large gauge catheter. Correct
Monitor hemoglobin and hematocrit levels. Correct
Assess for increased bleeding after
administration. Correct
A client who has heart failure is admitted with a serum Hypokalemia (normal 3.5 to 5 mEq/L [3.5 to 5 mmol/L]) causes changes in
potassium level of 2.9 mEq/L (2.9 mmol/L). Which myocardial irritability and ECG waveform, so it is most important for the nurse to
action is most important for the nurse to implement? initiate continuous cardiac monitoring to identify ventricular ectopy or other life-
Give 20 mEq of potassium chloride. threatening dysrhythmias. After cardiac monitoring is initiated, then the potassium
Initiate continuous cardiac monitoring. Correct chloride should be given so that the effects of potassium replacement on the
Arrange a consultation with the dietician. cardiac rhythm can be monitored.
Teach about the side effects of diuretics.
After checking the urinary drainage system for kinks After surgery, an adult who weighs 132 pounds (60 kg) should produce about 60 mL
in the tubing, the nurse determines that a client who of urine hourly (1 mL/kg/hour). Dark, concentrated, and low volume of urine output
has returned from the post-anesthesia care has a dark, should be reported to the surgeon.
concentrated urinary output of 54 mL for the last 2
hours. Which priority nursing action should be
implemented?
Report the findings to the surgeon. Correct
Irrigate the indwelling urinary catheter.
Apply manual pressure to the bladder.
Increase the IV flow rate for 15 minutes. Incorrect
Two days postoperative, a male client reports aching For a client exhibiting symptoms of deep vein thrombosis (DVT), a complication of
pain in his left leg. The nurse assesses redness and immobility, the initial care includes bedrest and elevation of the extremity.
warmth on the lower left calf. Which intervention
would be most helpful to this client?
Apply sequential compression devices (SCDs) bilaterally.
Assess for a positive Homan's sign in each leg. Incorrect
Pad all bony prominences on the affected leg.
Advise the client to remain in bed with the leg
elevated. Correct
Which description of pain is consistent with a Rheumatoid arthritis (RA) is an autoimmune disease that causes joint pain and
diagnosis of rheumatoid arthritis? swelling. RA is characterized by pain that is worse when arising and involves
Joint pain is worse in the morning and involves symmetric symmetric joints.
joints. Correct
Joint pain is better in the morning and worsens throughout
the day.
Joint pain is consistent throughout the day and is relieved
by pain medication. Incorrect
Joint pain is worse during the day and involves unilateral
joints.
, A client’s susceptibility to ulcerative colitis is most Ulcerative colitis is 4 to 5 times more common among individuals of Jewish
likely due to which aspect in the client’s history? European or Ashkenazi ancestry.
Jewish European ancestry. Correct
H. pylori bowel infection.
Family history of irritable bowel syndrome.
Age between 25 and 55 years.
While working in the emergency room, the nurse is A tuberculin skin test is effective 4 to 6 weeks after an exposure, so the individual
exposed to a client with active tuberculosis. When with a known exposure should wait 4 to 6 weeks before having a tuberculin skin
should the nurse plan to obtain a tuberculin skin test? test.
Immediately after the exposure.
Within one week of the exposure.
Four to six weeks after the exposure. Correct
Three months after the exposure.
The nurse knows that lab values sometimes vary for As older adults age, the protein found in urine slightly rises as a result of kidney
the older client. Which data would the nurse expect to changes, and the serum glucose increases slightly, also due to changes in the
find when reviewing laboratory values of an 80-year- kidney.
old male?
Increased WBC, decreased RBC.
Increased serum bilirubin, slightly increased liver
enzymes.
Increased protein in the urine, slightly increased
serum glucose levels. Correct
Decreased serum sodium, an increased urine specific
gravity.
The nurse is assessing a client's laboratory values Tumor lysis symdrome (TLS) results in hyperkalemia, hypocalcemia, hyperuricemia,
following administration of chemotherapy. Which lab and hyperphosphatemia. A serum calcium level of 5, which is low, is an indicator of
value leads the nurse to suspect that the client is possible tumor lysis syndrome.
experiencing tumor lysis syndrome (TLS)?
Serum PTT of 10 seconds.
Serum calcium of 5 mg/dL. Correct
Oxygen saturation of 90%.
Hemoglobin of 10 g/dL.
Which intervention should the nurse plan to A large tourniquet should be placed in plain sight at the client's bedside, in the event
implement when caring for a client who has just severe bleeding occurs. The purpose is to have the tourniquet available to apply to
undergone a right above-the-knee amputation? the residual limb to control bleeding if hemorrhaging was to occur.
Maintain the residual limb on three pillows at all
times. Incorrect
Place a large tourniquet at the client's
bedside. Correct
Apply constant, direct pressure to the residual limb.
Do not allow the client to lie in the prone position.
Creatinine More SPECIFIC THAN BUN.
An elevated creatinine strongly indicates nephron loss, reducing filtration.
Which nail color alteration should the nurse expect to Fingernails and toenails can be affected by chronic kidney disease. This condition
observe in a client with chronic kidney disease? may cause horizontal white lines or bands (leukonychia) to appear on the nails.
Horizontal white banding. Correct
Diffuse blue discoloration.
Diffuse brown discoloration.
Thin, dark red vertical lines.
The nurse is providing dietary instructions to a 68- To reduce risk factors associated with coronary heart disease, the daily intake of
year-old client who is at high risk for development of soluble fiber should be increased to between 10 and 25 grams per day. According to
coronary heart disease (CHD). Which information the American Heart Association, soluble fibers helps reduce LDL cholesterol levels.
should the nurse include?
Limit dietary selection of cholesterol to 300 mg per day.
Increase intake of soluble fiber to 10 to 25 grams per
day. Correct
Decrease plant stanols and sterols to less than 2
grams/day.
Ensure saturated fat is less than 30% of total caloric
intake.
