lOMoARcPSD|5422489
HESI MEDICAL SURGICAL EXAM TEST BANK 2026/ACTU
h h h h h h
AL EXAM WITH CORRECT DETAILED AND VERIFIED ANS
h h h h h h h
WERS/ MEDICAL SURGICAL HESI EXAM 2026-2027
h h h h h
Ahmalehclienthwithhsicklehcellhanemia,hwhohhashbeenhhospitalizedh forhanotherhhealthhproblem,htellshthehnursehhehhashh
h
adhanherectionh forhoverh4hhours.hWhathactionhshouldhthehnursehimplementhfirst?
h
h Notifyhthehclient’sh healthcarehprovider.
h DocumenththehFindinghinhthehclienthrecord.
Preparehahwarmhenemahsolutionh forhrectalh instillation.
Obtainhahlargehborehneedlehforhaspirationh ofhthehcorporahcavernosa.
Explanation
Priapism,hahurologichemergency,hishcommonhduringhsicklehcellhcrisishduehtohsicklehcellshclogginghthehmicrocirculation
h inhthehpenis,hcausinghahreductionh ofhbloodhowhandhoxygenationh tohthehpenis,hsohthe
healthcareh providerhshouldhbehrsthnotihedhimmediately.h Thehprescribedhtherapyhmayhconsisthofhnoninvasivehme
asuresh suchhashapplyinghicehtohthehpenis,hinstillingh ahwarmhsolutionh enemahtohincreasehouthowhinhthehcorporahca
vernosahandhgivinghpainhmedications.h Ifhnoninvasiveh measureshdohnothwork,hthenhneedlehaspirationhofhthehcorp
orahcavernosahishimplementedh byhthehhealthcarehprovider.
Thehnursehcompleteshvisualhinspectionh ofhahclient’shabdomen.hWhathtechniquehshouldhthehnursehperformhnexthinhthehabdom
inalhexamination?
h Percussion.
h Auscultation.
h
Deephpalpation.hLight
h palpation.
Explanation
Auscultationhofhthehclient’shabdomenhishperformedh nexthbecausehmanualhmanipulationh ofhthehabdomenhcanhstim
ulateh peristalsish andhcreatehinaccurateh assessmenthofhbowelhsoundshheardhduringhauscultation.
Whichhinterventionh shouldhthehnursehimplementh thathbesthconhrmshplacementh ofhanhendotrachealhtubeh(ETT)?
h h Usehanhend-titalh CO2hdetector.
h
h Ascultatehforhbilateralh breathhsounds.
, lOMoARcPSD|5422489
Obtainhpulsehoximeterh reading.
hCheckhsymmetricalh chesthmovement.
Explanation
Thehend-
tidalhcarbonhdioxidehdetectorhindicatesh thehprescencehofhCO2tidalbyhahcolorhchangehorhahnumberhindicatedh onht
hehdetector,hwhichhishsupportinghevidencehthaththehETThishinhthehtrachea,h noththehesophagus.
Ahfemalehclienthwithhtypeh2hdiabeteshmellitush reportshdysuria.hWhichhassessmenthndinghishmosthimportanthforhthehnurs
ehtohreporthtohthehhealthcareh provider?
h Suprapublichpainhandhdistention.
h Boundinghpulsehath100h beats/minute.
Fingerstickhglucosehofh300hmg/dl.h
Smallhvesicularhperinealhlesions.
Explanation
Elevatedhngerstickh glucosehlevelshneedshtohbehreportedhtothhehhealthcareh provider,hsohahplanhofhcarehcanhbehadju
stedhtohtreaththehelevatedhglucosehlevel.hAlsohelevatedhglucosehlevels,hspillshintohthehurinehandhprovidehahmediu
mhforhbacterialhgrowth.
AhclienthwithhtypehIIhdiabetesharrivesh aththehclinich withhahbloodhglucosehofh50hmg/dL.hThehnursehprovideshthehclienthwi
thh6hounceshofhorangehjuice.hInh15hminutesh thehclient’sh capillaryh glucosehish74hmg/dL.hWhathactionh shouldhthehnurseh
take?
h Obtainhahspecimenhforhserumhglucosehlevel.
h Administerhinsulinh perhslidingh scale.
Providehcheesehandhbreadhtoheat.
hCollecthahglycosylatedh hemoglobinh specimen.
Explanation
Oncehbloodhglucosehishgreaterhthanh70hmg/dl,hthehclienthshouldheathahregularlyh scheduledhmealhorhahsnackhthathcontain
shproteinhandhcarbohydrateshtohhelphpreventhhypoglycemiahfromhrecurring.
Ah48-year-oldhclienthwithhendometrialh cancerhishbeinghdischargedhafterhahtotalhhysterectomyh andhbilateralhsalpingo-
hoophorectomy.
Whichhclienthstatementh indicateshthathfurtherhteachinghishneeded?
h "Well,hIhdon’thhavehtohworryhabouthgettinghpregnanthanymore."
h "Ihcan’thwaithtohgohonhthehcruisehthathIhhavehplannedhforhthishsummer."h
, lOMoARcPSD|5422489
"IhknowhIhwillhmisshhavinghsexualhintercourseh withhmyhhusband."
"Ihhavehaskedh myhdaughterhtohstayh withh mehnexthweekhafterhIhamhdischarged."
Explanation
Furtherhteachinghishneededhinhresponsehtohthehclient’shmisunderstandingh ofhnothbeinghablehtohhavehsexualhinterco
ursehafterhahhysterectomy,h needshtohbehaddressed.
Ahclienthaskshthehnursehabouththehpurposehofhbeginninghchemotherapyh (CT)hbecausehthehtumorhishstillhveryhsmall.hWhi
chhinformationhsupportshthehexplanationhthaththehnursehshouldhprovide?
h Sideheûectsh arehlesshlikelyh ifhtherapyhishstartedh early.
h Collateralhcirculationh increaseshashthehtumorhgrows.
Sensitivityh ofhcancerhcellshtohCThishbasedhonhcellhcyclehrate.
Thehcellhcounthofhthehtumorh reduceshbyhhalfhwithheachhdose.h
Explanation
Initiatingh chemotherapyhwhilehthehtumorhishsmallhprovideshahbetterhchancehofheradicatingh allhcancerhcellshbecaus
eh50%hofhcancerhcellshorhtumorhcellsharehkilledhwithheachhdose.
Ahclienthinhthehpreoperativehholdinghareahreceiveshahprescriptionh forhmidazolamh (Versed)hIV.hThehnursehdetermineshth
aththehsurgicalhconsenthformhneedshtohbehsignedhbyhthehclient.h Whichhactionhshouldhthehnursehimplement?
h h Givehtheh drughandhallowh thehclienth tohreadh andhsignh thehconsenthform.
h Counter-signhthehclient’sh initialsh onhthehconsenthformhafterh givinghthehdrug.
Withholdhthehdrughuntilhthehclienthvalidateshunderstandinghofhthehsurgicalhprocedurehandhsignshthehcons
enthform.
hCallhthehhealthcareh providerhtohexplainhthehsurgicalh procedurehbeforehthehclienth signshthehconsent.
Explanation
Midazolam,hahbenzodiazepinehsedative,hishcommonlyhusedhforhconscious-sedationh intraoperativelyh and
interfereshwithhthehclienthshcognitionh andhlevelhofhconsciousness,h sohthehconsenthformhshouldhbehsignedhbeforehth
ehdrughishadministered.
Whichhclienthshouldhthehnursehassesshrst?
h Ah27-year-oldhcomplainingh ofhseverehbackhpain.
h Ah63-year-oldhcomplainingh ofhfoothandhanklehpain.
Ah49-year-oldhwithhpancreatitish complainingh ofhunrelentingh abdominalhpain.
, lOMoARcPSD|5422489
Ah55-year-
oldhnewlyhadmittedhclienthcomplaininghofhjawhpainhandhindigestion.hExplanation
Theh55-year-
oldhclienthshouldhbehassessedhrsthtohrulehouthcardiachinvolvementhbecausehjawhpainhandhindigestionharehcommonhdes
criptorshofhmyocardialhinjury.
Whathishthehprimaryh nursinghproblemhforhahclienthwithhasymptomatich primaryhsyphilis?
h Acutehpain.
h Riskhforhinjury.
Sexualhdysfunction.h
Dehcienthknowledge.
Explanation
Anhasymptomatichclienthwithhprimaryhsyphilishishmosthlikelyhunawarehofhthishdisease,hsohtohpreventhtransmissionhtoh
othershandhrecurrencehinhthehclient,h thehpriorityh nursinghdiagnosishishdehcienthknowledgehofhthehdisease
pathophysiology.
Anh85-year-
oldhmalehclienthcomeshtohthehclinich forhhishannualhphysicalhexamhandhrenewalhofhantihypertensivehmedicationhprescri
ptions.h Thehclient’shradialhpulsehratehish104hbeats/minute.hWhichhadditionalhassessmenthshouldhthehnursehcomplete?
h Palpatehthehpedalhpulsehvolume.
hCounththehbrachialhpulsehrate.hM
easurehthehbloodhpressure.
Assesshforhahcarotidh bruit.
Explanation
Elderlyhclientshwhohtakehantihypertensiveh medicationshoftenhexperiencehsideheûects,h suchhashhypotension,h whichhc
auseshtachycardia,hahcompensatoryhmechanismhtohmaintainhadequatehcardiachoutput,hsohthehclient’shbloodhpressure
hshouldhbehmeasured.
Thehnursehassesseshahlong-
termhresidenthofhahnursinghhomehandhndshthehclienthhashahfungalhinfectionh (candidiasis)hbeneathhbothhbreasts.hTohpre
venthnosocomialhinfection,h whichhprotocolhshouldhthehnursehreviewhwithhthehresthofhthehstaû?
Followhcontacthisolationhprocedures.
HESI MEDICAL SURGICAL EXAM TEST BANK 2026/ACTU
h h h h h h
AL EXAM WITH CORRECT DETAILED AND VERIFIED ANS
h h h h h h h
WERS/ MEDICAL SURGICAL HESI EXAM 2026-2027
h h h h h
Ahmalehclienthwithhsicklehcellhanemia,hwhohhashbeenhhospitalizedh forhanotherhhealthhproblem,htellshthehnursehhehhashh
h
adhanherectionh forhoverh4hhours.hWhathactionhshouldhthehnursehimplementhfirst?
h
h Notifyhthehclient’sh healthcarehprovider.
h DocumenththehFindinghinhthehclienthrecord.
Preparehahwarmhenemahsolutionh forhrectalh instillation.
Obtainhahlargehborehneedlehforhaspirationh ofhthehcorporahcavernosa.
Explanation
Priapism,hahurologichemergency,hishcommonhduringhsicklehcellhcrisishduehtohsicklehcellshclogginghthehmicrocirculation
h inhthehpenis,hcausinghahreductionh ofhbloodhowhandhoxygenationh tohthehpenis,hsohthe
healthcareh providerhshouldhbehrsthnotihedhimmediately.h Thehprescribedhtherapyhmayhconsisthofhnoninvasivehme
asuresh suchhashapplyinghicehtohthehpenis,hinstillingh ahwarmhsolutionh enemahtohincreasehouthowhinhthehcorporahca
vernosahandhgivinghpainhmedications.h Ifhnoninvasiveh measureshdohnothwork,hthenhneedlehaspirationhofhthehcorp
orahcavernosahishimplementedh byhthehhealthcarehprovider.
Thehnursehcompleteshvisualhinspectionh ofhahclient’shabdomen.hWhathtechniquehshouldhthehnursehperformhnexthinhthehabdom
inalhexamination?
h Percussion.
h Auscultation.
h
Deephpalpation.hLight
h palpation.
Explanation
Auscultationhofhthehclient’shabdomenhishperformedh nexthbecausehmanualhmanipulationh ofhthehabdomenhcanhstim
ulateh peristalsish andhcreatehinaccurateh assessmenthofhbowelhsoundshheardhduringhauscultation.
Whichhinterventionh shouldhthehnursehimplementh thathbesthconhrmshplacementh ofhanhendotrachealhtubeh(ETT)?
h h Usehanhend-titalh CO2hdetector.
h
h Ascultatehforhbilateralh breathhsounds.
, lOMoARcPSD|5422489
Obtainhpulsehoximeterh reading.
hCheckhsymmetricalh chesthmovement.
Explanation
Thehend-
tidalhcarbonhdioxidehdetectorhindicatesh thehprescencehofhCO2tidalbyhahcolorhchangehorhahnumberhindicatedh onht
hehdetector,hwhichhishsupportinghevidencehthaththehETThishinhthehtrachea,h noththehesophagus.
Ahfemalehclienthwithhtypeh2hdiabeteshmellitush reportshdysuria.hWhichhassessmenthndinghishmosthimportanthforhthehnurs
ehtohreporthtohthehhealthcareh provider?
h Suprapublichpainhandhdistention.
h Boundinghpulsehath100h beats/minute.
Fingerstickhglucosehofh300hmg/dl.h
Smallhvesicularhperinealhlesions.
Explanation
Elevatedhngerstickh glucosehlevelshneedshtohbehreportedhtothhehhealthcareh provider,hsohahplanhofhcarehcanhbehadju
stedhtohtreaththehelevatedhglucosehlevel.hAlsohelevatedhglucosehlevels,hspillshintohthehurinehandhprovidehahmediu
mhforhbacterialhgrowth.
AhclienthwithhtypehIIhdiabetesharrivesh aththehclinich withhahbloodhglucosehofh50hmg/dL.hThehnursehprovideshthehclienthwi
thh6hounceshofhorangehjuice.hInh15hminutesh thehclient’sh capillaryh glucosehish74hmg/dL.hWhathactionh shouldhthehnurseh
take?
h Obtainhahspecimenhforhserumhglucosehlevel.
h Administerhinsulinh perhslidingh scale.
Providehcheesehandhbreadhtoheat.
hCollecthahglycosylatedh hemoglobinh specimen.
Explanation
Oncehbloodhglucosehishgreaterhthanh70hmg/dl,hthehclienthshouldheathahregularlyh scheduledhmealhorhahsnackhthathcontain
shproteinhandhcarbohydrateshtohhelphpreventhhypoglycemiahfromhrecurring.
Ah48-year-oldhclienthwithhendometrialh cancerhishbeinghdischargedhafterhahtotalhhysterectomyh andhbilateralhsalpingo-
hoophorectomy.
Whichhclienthstatementh indicateshthathfurtherhteachinghishneeded?
h "Well,hIhdon’thhavehtohworryhabouthgettinghpregnanthanymore."
h "Ihcan’thwaithtohgohonhthehcruisehthathIhhavehplannedhforhthishsummer."h
, lOMoARcPSD|5422489
"IhknowhIhwillhmisshhavinghsexualhintercourseh withhmyhhusband."
"Ihhavehaskedh myhdaughterhtohstayh withh mehnexthweekhafterhIhamhdischarged."
Explanation
Furtherhteachinghishneededhinhresponsehtohthehclient’shmisunderstandingh ofhnothbeinghablehtohhavehsexualhinterco
ursehafterhahhysterectomy,h needshtohbehaddressed.
Ahclienthaskshthehnursehabouththehpurposehofhbeginninghchemotherapyh (CT)hbecausehthehtumorhishstillhveryhsmall.hWhi
chhinformationhsupportshthehexplanationhthaththehnursehshouldhprovide?
h Sideheûectsh arehlesshlikelyh ifhtherapyhishstartedh early.
h Collateralhcirculationh increaseshashthehtumorhgrows.
Sensitivityh ofhcancerhcellshtohCThishbasedhonhcellhcyclehrate.
Thehcellhcounthofhthehtumorh reduceshbyhhalfhwithheachhdose.h
Explanation
Initiatingh chemotherapyhwhilehthehtumorhishsmallhprovideshahbetterhchancehofheradicatingh allhcancerhcellshbecaus
eh50%hofhcancerhcellshorhtumorhcellsharehkilledhwithheachhdose.
Ahclienthinhthehpreoperativehholdinghareahreceiveshahprescriptionh forhmidazolamh (Versed)hIV.hThehnursehdetermineshth
aththehsurgicalhconsenthformhneedshtohbehsignedhbyhthehclient.h Whichhactionhshouldhthehnursehimplement?
h h Givehtheh drughandhallowh thehclienth tohreadh andhsignh thehconsenthform.
h Counter-signhthehclient’sh initialsh onhthehconsenthformhafterh givinghthehdrug.
Withholdhthehdrughuntilhthehclienthvalidateshunderstandinghofhthehsurgicalhprocedurehandhsignshthehcons
enthform.
hCallhthehhealthcareh providerhtohexplainhthehsurgicalh procedurehbeforehthehclienth signshthehconsent.
Explanation
Midazolam,hahbenzodiazepinehsedative,hishcommonlyhusedhforhconscious-sedationh intraoperativelyh and
interfereshwithhthehclienthshcognitionh andhlevelhofhconsciousness,h sohthehconsenthformhshouldhbehsignedhbeforehth
ehdrughishadministered.
Whichhclienthshouldhthehnursehassesshrst?
h Ah27-year-oldhcomplainingh ofhseverehbackhpain.
h Ah63-year-oldhcomplainingh ofhfoothandhanklehpain.
Ah49-year-oldhwithhpancreatitish complainingh ofhunrelentingh abdominalhpain.
, lOMoARcPSD|5422489
Ah55-year-
oldhnewlyhadmittedhclienthcomplaininghofhjawhpainhandhindigestion.hExplanation
Theh55-year-
oldhclienthshouldhbehassessedhrsthtohrulehouthcardiachinvolvementhbecausehjawhpainhandhindigestionharehcommonhdes
criptorshofhmyocardialhinjury.
Whathishthehprimaryh nursinghproblemhforhahclienthwithhasymptomatich primaryhsyphilis?
h Acutehpain.
h Riskhforhinjury.
Sexualhdysfunction.h
Dehcienthknowledge.
Explanation
Anhasymptomatichclienthwithhprimaryhsyphilishishmosthlikelyhunawarehofhthishdisease,hsohtohpreventhtransmissionhtoh
othershandhrecurrencehinhthehclient,h thehpriorityh nursinghdiagnosishishdehcienthknowledgehofhthehdisease
pathophysiology.
Anh85-year-
oldhmalehclienthcomeshtohthehclinich forhhishannualhphysicalhexamhandhrenewalhofhantihypertensivehmedicationhprescri
ptions.h Thehclient’shradialhpulsehratehish104hbeats/minute.hWhichhadditionalhassessmenthshouldhthehnursehcomplete?
h Palpatehthehpedalhpulsehvolume.
hCounththehbrachialhpulsehrate.hM
easurehthehbloodhpressure.
Assesshforhahcarotidh bruit.
Explanation
Elderlyhclientshwhohtakehantihypertensiveh medicationshoftenhexperiencehsideheûects,h suchhashhypotension,h whichhc
auseshtachycardia,hahcompensatoryhmechanismhtohmaintainhadequatehcardiachoutput,hsohthehclient’shbloodhpressure
hshouldhbehmeasured.
Thehnursehassesseshahlong-
termhresidenthofhahnursinghhomehandhndshthehclienthhashahfungalhinfectionh (candidiasis)hbeneathhbothhbreasts.hTohpre
venthnosocomialhinfection,h whichhprotocolhshouldhthehnursehreviewhwithhthehresthofhthehstaû?
Followhcontacthisolationhprocedures.
