HESI RN MEDICAL-SURGICAL SET 2 EXAM
QUESTIONS WITH ANSWERS AND EXPLANATIONS
Question 1.
During prioritization, the nurse receives four handoffs; one involves a patient being treated
for postoperative venous thromboembolism prevention. Which patient should be assessed
first based on the change described?
A. A patient with postoperative venous thromboembolism prevention who now has sudden
dyspnea, pleuritic chest pain, syncope, hemoptysis, or new unilateral leg swelling
B. A patient with major thermal burn who is stable while being monitored for airway,
oxygenation, urine output, temperature, distal perfusion, pain, and wound evolution
C. A patient with hypovolemic shock who is stable while being monitored for mental status,
blood pressure, heart rate, urine output, peripheral perfusion, lactate, and hemoglobin
when relevant
D. A patient with acute pulmonary edema who is stable while being monitored for
oxygenation, respiratory effort, lung sounds, blood pressure, rhythm, urine output, and
diuretic response
Correct Answer: A. A patient with postoperative venous thromboembolism
prevention who now has sudden dyspnea, pleuritic chest pain, syncope,
hemoptysis, or new unilateral leg swelling
Explanation: The patient with sudden dyspnea, pleuritic chest pain, syncope,
hemoptysis, or new unilateral leg swelling requires immediate assessment because this
change can represent a life-threatening complication of postoperative venous
thromboembolism prevention. Priority decisions are based on threat to airway, breathing,
circulation, neurologic function, or rapidly worsening instability rather than diagnosis
alone. The other patients are described as stable and are already undergoing appropriate
monitoring. After addressing the unstable patient, the nurse should return to the
remaining patients according to acuity and scheduled needs.
Question 2.
The nurse is preparing discharge teaching for a 54-year-old adult recovering from
hypovolemic shock. Which instruction is most important to include?
A. seek prompt care for signs of infection with confusion, breathing difficulty, profound
weakness, or decreased urine output
B. follow bleeding precautions and seek urgent care for syncope, persistent dizziness,
bleeding, or reduced urine output
C. do not apply ice to major burns and follow wound, nutrition, rehabilitation, and
infection-prevention instructions
D. follow heart-failure or volume-management plans and report rapidly worsening
breathlessness or weight gain
Correct Answer: B. follow bleeding precautions and seek urgent care for
syncope, persistent dizziness, bleeding, or reduced urine output
,Explanation: Effective teaching for hypovolemic shock includes the instruction to follow
bleeding precautions and seek urgent care for syncope, persistent dizziness, bleeding, or
reduced urine output. This guidance targets recurrence prevention, early recognition of
deterioration, or safe self-management. The other statements may apply to different
disorders and should not replace condition-specific teaching. Teach-back should be used
so the nurse can confirm that the patient or caregiver can apply the plan correctly.
Question 3.
During prioritization, the nurse receives four handoffs; one involves a patient being treated
for thyroid storm. Which patient should be assessed first based on the change described?
A. A patient with adrenal crisis who is stable while being monitored for blood pressure,
glucose, sodium, potassium, fluid balance, and response to corticosteroid therapy
B. A patient with hyperosmolar hyperglycemic state who is stable while being monitored
for osmolality, sodium, glucose decline, potassium, neurologic status, renal function, and
fluid balance
C. A patient with thyroid storm who now has dysrhythmia, heart failure, hyperthermia,
seizure, or worsening delirium
D. A patient with myxedema coma who is stable while being monitored for temperature,
respiratory status, heart rate, sodium, glucose, and mental status
Correct Answer: C. A patient with thyroid storm who now has dysrhythmia, heart
failure, hyperthermia, seizure, or worsening delirium
Explanation: The patient with dysrhythmia, heart failure, hyperthermia, seizure, or
worsening delirium requires immediate assessment because this change can represent a
life-threatening complication of thyroid storm. Priority decisions are based on threat to
airway, breathing, circulation, neurologic function, or rapidly worsening instability rather
than diagnosis alone. The other patients are described as stable and are already
undergoing appropriate monitoring. After addressing the unstable patient, the nurse
should return to the remaining patients according to acuity and scheduled needs.
Question 4.
Which statement by a patient or caregiver after teaching about sickle cell vaso-occlusive
crisis best shows correct understanding?
A. report burning, stinging, pain, swelling, or redness immediately during vesicant infusion
B. report any delayed fever, dark urine, jaundice, rash, or dyspnea after discharge when
instructed
C. avoid sick contacts and report fever immediately rather than taking antipyretics and
waiting
D. maintain hydration, avoid known triggers, adhere to disease-modifying therapy, and
seek care for fever or chest symptoms
Correct Answer: D. maintain hydration, avoid known triggers, adhere to
disease-modifying therapy, and seek care for fever or chest symptoms
Explanation: Effective teaching for sickle cell vaso-occlusive crisis includes the
instruction to maintain hydration, avoid known triggers, adhere to disease-modifying
,therapy, and seek care for fever or chest symptoms. This guidance targets recurrence
prevention, early recognition of deterioration, or safe self-management. The other
statements may apply to different disorders and should not replace condition-specific
teaching. Teach-back should be used so the nurse can confirm that the patient or
caregiver can apply the plan correctly.
Question 5.
During prioritization, the nurse receives four handoffs; one involves a patient being treated
for adrenal crisis. Which patient should be assessed first based on the change described?
A. A patient with adrenal crisis who now has refractory hypotension, severe hypoglycemia,
hyperkalemic dysrhythmia, or rapidly worsening weakness
B. A patient with thyroid storm who is stable while being monitored for temperature,
rhythm, blood pressure, mental status, glucose, and signs of heart failure
C. A patient with severe hypoglycemia who is stable while being monitored for repeat
glucose after treatment, mental status, recurrence risk, and the cause of the low glucose
D. A patient with myxedema coma who is stable while being monitored for temperature,
respiratory status, heart rate, sodium, glucose, and mental status
Correct Answer: A. A patient with adrenal crisis who now has refractory
hypotension, severe hypoglycemia, hyperkalemic dysrhythmia, or rapidly
worsening weakness
Explanation: The patient with refractory hypotension, severe hypoglycemia,
hyperkalemic dysrhythmia, or rapidly worsening weakness requires immediate
assessment because this change can represent a life-threatening complication of adrenal
crisis. Priority decisions are based on threat to airway, breathing, circulation, neurologic
function, or rapidly worsening instability rather than diagnosis alone. The other patients
are described as stable and are already undergoing appropriate monitoring. After
addressing the unstable patient, the nurse should return to the remaining patients
according to acuity and scheduled needs.
Question 6.
The nurse is preparing discharge teaching for a 76-year-old woman recovering from severe
hyperkalemia. Which instruction is most important to include?
A. complete the antibiotic course and seek care for fever, worsening flank pain, or inability
to hydrate
B. avoid unapproved potassium supplements or salt substitutes when restricted and follow
laboratory monitoring
C. avoid nonprescribed nephrotoxic drugs and follow fluid, diet, and follow-up instructions
D. protect the access, follow fluid and dietary limits, and keep every dialysis treatment
Correct Answer: B. avoid unapproved potassium supplements or salt substitutes
when restricted and follow laboratory monitoring
Explanation: Effective teaching for severe hyperkalemia includes the instruction to avoid
unapproved potassium supplements or salt substitutes when restricted and follow
laboratory monitoring. This guidance targets recurrence prevention, early recognition of
, deterioration, or safe self-management. The other statements may apply to different
disorders and should not replace condition-specific teaching. Teach-back should be used
so the nurse can confirm that the patient or caregiver can apply the plan correctly.
Question 7.
During prioritization, the nurse receives four handoffs; one involves a patient being treated
for diabetic ketoacidosis. Which patient should be assessed first based on the change
described?
A. A patient with severe hypoglycemia who is stable while being monitored for repeat
glucose after treatment, mental status, recurrence risk, and the cause of the low glucose
B. A patient with hyperosmolar hyperglycemic state who is stable while being monitored
for osmolality, sodium, glucose decline, potassium, neurologic status, renal function, and
fluid balance
C. A patient with SIADH who is stable while being monitored for serum sodium, neurologic
status, fluid balance, weight, serum osmolality, and urine concentration
D. A patient with diabetic ketoacidosis who now has declining consciousness, severe
hypokalemia, shock, or signs of cerebral edema during treatment
Correct Answer: D. A patient with diabetic ketoacidosis who now has declining
consciousness, severe hypokalemia, shock, or signs of cerebral edema during
treatment
Explanation: The patient with declining consciousness, severe hypokalemia, shock, or
signs of cerebral edema during treatment requires immediate assessment because this
change can represent a life-threatening complication of diabetic ketoacidosis. Priority
decisions are based on threat to airway, breathing, circulation, neurologic function, or
rapidly worsening instability rather than diagnosis alone. The other patients are described
as stable and are already undergoing appropriate monitoring. After addressing the
unstable patient, the nurse should return to the remaining patients according to acuity and
scheduled needs.
Question 8.
Which statement by a patient or caregiver after teaching about osteoporosis best shows
correct understanding?
A. do not remove or rest traction weights unless specifically directed and perform
prescribed exercises
B. report escalating pain or numbness immediately after fracture, casting, or limb injury
C. use weight-bearing and resistance exercise, avoid smoking, and follow medication
administration instructions
D. use prescribed positioning devices and avoid prohibited hip movements according to
surgical approach
Correct Answer: C. use weight-bearing and resistance exercise, avoid smoking,
and follow medication administration instructions
Explanation: Effective teaching for osteoporosis includes the instruction to use
weight-bearing and resistance exercise, avoid smoking, and follow medication
QUESTIONS WITH ANSWERS AND EXPLANATIONS
Question 1.
During prioritization, the nurse receives four handoffs; one involves a patient being treated
for postoperative venous thromboembolism prevention. Which patient should be assessed
first based on the change described?
A. A patient with postoperative venous thromboembolism prevention who now has sudden
dyspnea, pleuritic chest pain, syncope, hemoptysis, or new unilateral leg swelling
B. A patient with major thermal burn who is stable while being monitored for airway,
oxygenation, urine output, temperature, distal perfusion, pain, and wound evolution
C. A patient with hypovolemic shock who is stable while being monitored for mental status,
blood pressure, heart rate, urine output, peripheral perfusion, lactate, and hemoglobin
when relevant
D. A patient with acute pulmonary edema who is stable while being monitored for
oxygenation, respiratory effort, lung sounds, blood pressure, rhythm, urine output, and
diuretic response
Correct Answer: A. A patient with postoperative venous thromboembolism
prevention who now has sudden dyspnea, pleuritic chest pain, syncope,
hemoptysis, or new unilateral leg swelling
Explanation: The patient with sudden dyspnea, pleuritic chest pain, syncope,
hemoptysis, or new unilateral leg swelling requires immediate assessment because this
change can represent a life-threatening complication of postoperative venous
thromboembolism prevention. Priority decisions are based on threat to airway, breathing,
circulation, neurologic function, or rapidly worsening instability rather than diagnosis
alone. The other patients are described as stable and are already undergoing appropriate
monitoring. After addressing the unstable patient, the nurse should return to the
remaining patients according to acuity and scheduled needs.
Question 2.
The nurse is preparing discharge teaching for a 54-year-old adult recovering from
hypovolemic shock. Which instruction is most important to include?
A. seek prompt care for signs of infection with confusion, breathing difficulty, profound
weakness, or decreased urine output
B. follow bleeding precautions and seek urgent care for syncope, persistent dizziness,
bleeding, or reduced urine output
C. do not apply ice to major burns and follow wound, nutrition, rehabilitation, and
infection-prevention instructions
D. follow heart-failure or volume-management plans and report rapidly worsening
breathlessness or weight gain
Correct Answer: B. follow bleeding precautions and seek urgent care for
syncope, persistent dizziness, bleeding, or reduced urine output
,Explanation: Effective teaching for hypovolemic shock includes the instruction to follow
bleeding precautions and seek urgent care for syncope, persistent dizziness, bleeding, or
reduced urine output. This guidance targets recurrence prevention, early recognition of
deterioration, or safe self-management. The other statements may apply to different
disorders and should not replace condition-specific teaching. Teach-back should be used
so the nurse can confirm that the patient or caregiver can apply the plan correctly.
Question 3.
During prioritization, the nurse receives four handoffs; one involves a patient being treated
for thyroid storm. Which patient should be assessed first based on the change described?
A. A patient with adrenal crisis who is stable while being monitored for blood pressure,
glucose, sodium, potassium, fluid balance, and response to corticosteroid therapy
B. A patient with hyperosmolar hyperglycemic state who is stable while being monitored
for osmolality, sodium, glucose decline, potassium, neurologic status, renal function, and
fluid balance
C. A patient with thyroid storm who now has dysrhythmia, heart failure, hyperthermia,
seizure, or worsening delirium
D. A patient with myxedema coma who is stable while being monitored for temperature,
respiratory status, heart rate, sodium, glucose, and mental status
Correct Answer: C. A patient with thyroid storm who now has dysrhythmia, heart
failure, hyperthermia, seizure, or worsening delirium
Explanation: The patient with dysrhythmia, heart failure, hyperthermia, seizure, or
worsening delirium requires immediate assessment because this change can represent a
life-threatening complication of thyroid storm. Priority decisions are based on threat to
airway, breathing, circulation, neurologic function, or rapidly worsening instability rather
than diagnosis alone. The other patients are described as stable and are already
undergoing appropriate monitoring. After addressing the unstable patient, the nurse
should return to the remaining patients according to acuity and scheduled needs.
Question 4.
Which statement by a patient or caregiver after teaching about sickle cell vaso-occlusive
crisis best shows correct understanding?
A. report burning, stinging, pain, swelling, or redness immediately during vesicant infusion
B. report any delayed fever, dark urine, jaundice, rash, or dyspnea after discharge when
instructed
C. avoid sick contacts and report fever immediately rather than taking antipyretics and
waiting
D. maintain hydration, avoid known triggers, adhere to disease-modifying therapy, and
seek care for fever or chest symptoms
Correct Answer: D. maintain hydration, avoid known triggers, adhere to
disease-modifying therapy, and seek care for fever or chest symptoms
Explanation: Effective teaching for sickle cell vaso-occlusive crisis includes the
instruction to maintain hydration, avoid known triggers, adhere to disease-modifying
,therapy, and seek care for fever or chest symptoms. This guidance targets recurrence
prevention, early recognition of deterioration, or safe self-management. The other
statements may apply to different disorders and should not replace condition-specific
teaching. Teach-back should be used so the nurse can confirm that the patient or
caregiver can apply the plan correctly.
Question 5.
During prioritization, the nurse receives four handoffs; one involves a patient being treated
for adrenal crisis. Which patient should be assessed first based on the change described?
A. A patient with adrenal crisis who now has refractory hypotension, severe hypoglycemia,
hyperkalemic dysrhythmia, or rapidly worsening weakness
B. A patient with thyroid storm who is stable while being monitored for temperature,
rhythm, blood pressure, mental status, glucose, and signs of heart failure
C. A patient with severe hypoglycemia who is stable while being monitored for repeat
glucose after treatment, mental status, recurrence risk, and the cause of the low glucose
D. A patient with myxedema coma who is stable while being monitored for temperature,
respiratory status, heart rate, sodium, glucose, and mental status
Correct Answer: A. A patient with adrenal crisis who now has refractory
hypotension, severe hypoglycemia, hyperkalemic dysrhythmia, or rapidly
worsening weakness
Explanation: The patient with refractory hypotension, severe hypoglycemia,
hyperkalemic dysrhythmia, or rapidly worsening weakness requires immediate
assessment because this change can represent a life-threatening complication of adrenal
crisis. Priority decisions are based on threat to airway, breathing, circulation, neurologic
function, or rapidly worsening instability rather than diagnosis alone. The other patients
are described as stable and are already undergoing appropriate monitoring. After
addressing the unstable patient, the nurse should return to the remaining patients
according to acuity and scheduled needs.
Question 6.
The nurse is preparing discharge teaching for a 76-year-old woman recovering from severe
hyperkalemia. Which instruction is most important to include?
A. complete the antibiotic course and seek care for fever, worsening flank pain, or inability
to hydrate
B. avoid unapproved potassium supplements or salt substitutes when restricted and follow
laboratory monitoring
C. avoid nonprescribed nephrotoxic drugs and follow fluid, diet, and follow-up instructions
D. protect the access, follow fluid and dietary limits, and keep every dialysis treatment
Correct Answer: B. avoid unapproved potassium supplements or salt substitutes
when restricted and follow laboratory monitoring
Explanation: Effective teaching for severe hyperkalemia includes the instruction to avoid
unapproved potassium supplements or salt substitutes when restricted and follow
laboratory monitoring. This guidance targets recurrence prevention, early recognition of
, deterioration, or safe self-management. The other statements may apply to different
disorders and should not replace condition-specific teaching. Teach-back should be used
so the nurse can confirm that the patient or caregiver can apply the plan correctly.
Question 7.
During prioritization, the nurse receives four handoffs; one involves a patient being treated
for diabetic ketoacidosis. Which patient should be assessed first based on the change
described?
A. A patient with severe hypoglycemia who is stable while being monitored for repeat
glucose after treatment, mental status, recurrence risk, and the cause of the low glucose
B. A patient with hyperosmolar hyperglycemic state who is stable while being monitored
for osmolality, sodium, glucose decline, potassium, neurologic status, renal function, and
fluid balance
C. A patient with SIADH who is stable while being monitored for serum sodium, neurologic
status, fluid balance, weight, serum osmolality, and urine concentration
D. A patient with diabetic ketoacidosis who now has declining consciousness, severe
hypokalemia, shock, or signs of cerebral edema during treatment
Correct Answer: D. A patient with diabetic ketoacidosis who now has declining
consciousness, severe hypokalemia, shock, or signs of cerebral edema during
treatment
Explanation: The patient with declining consciousness, severe hypokalemia, shock, or
signs of cerebral edema during treatment requires immediate assessment because this
change can represent a life-threatening complication of diabetic ketoacidosis. Priority
decisions are based on threat to airway, breathing, circulation, neurologic function, or
rapidly worsening instability rather than diagnosis alone. The other patients are described
as stable and are already undergoing appropriate monitoring. After addressing the
unstable patient, the nurse should return to the remaining patients according to acuity and
scheduled needs.
Question 8.
Which statement by a patient or caregiver after teaching about osteoporosis best shows
correct understanding?
A. do not remove or rest traction weights unless specifically directed and perform
prescribed exercises
B. report escalating pain or numbness immediately after fracture, casting, or limb injury
C. use weight-bearing and resistance exercise, avoid smoking, and follow medication
administration instructions
D. use prescribed positioning devices and avoid prohibited hip movements according to
surgical approach
Correct Answer: C. use weight-bearing and resistance exercise, avoid smoking,
and follow medication administration instructions
Explanation: Effective teaching for osteoporosis includes the instruction to use
weight-bearing and resistance exercise, avoid smoking, and follow medication
