HESI RN Med-Surg Exam | 200 Verified Questions &
Answers | Elsevier Evolve Clinical Judgment |
Instant Download
Q1. A client with Cushing syndrome has moon face, buffalo hump,
hypertension, hyperglycemia. What cause and care? (Variation 47 –
Clinical Judgment Scenario)
A. Excess cortisol – steroids or adrenal tumor – monitor glucose BP
electrolytes weight, taper steroids not abrupt, infection risk Var 47
[1]
B. Cushing is low cortisol Var 47 [1A]
C. Cushing causes hypotension hypoglycemia Var 47 [1C]
D. Give extra cortisol always Var 47 [1B]
Correct Answer: A. Excess cortisol – steroids or adrenal tumor –
monitor glucose BP electrolytes weight, taper steroids not abrupt,
infection risk Var 47 [1]
Rationale: CORRECT: Excess cortisol – steroids or adrenal tumor –
monitor glucose BP electrolytes weight, taper steroids not abrupt,
infection risk Var 47. WHY WRONG: Distractors violate HESI Med-Surg
clinical judgment – high-yield topics cardiovascular respiratory renal
endocrine neurological postoperative nursing care pathophysiology
pharmacology nursing interventions patient care management
prioritization ABCs critical thinking clinical judgment NGN style.
Rationale strengthens understanding.
Q2. A client with chronic kidney disease has BUN 45 creatinine 2.8 K+
6.0 peaked T waves. What intervention for hyperkalemia? (Variation 134
– Clinical Judgment Scenario)
A. No treatment hyperkalemia benign Var 134 [2B]
B. Calcium gluconate protects heart, insulin glucose shifts K+ into
cells, kayexalate, dialysis – monitor ECG hyperkalemia Var 134 [2]
C. Give extra potassium supplement Var 134 [2A]
D. Give calcium only increases K+ Var 134 [2C]
Correct Answer: B. Calcium gluconate protects heart, insulin glucose
shifts K+ into cells, kayexalate, dialysis – monitor ECG hyperkalemia
Var 134 [2]
Rationale: CORRECT: Calcium gluconate protects heart, insulin glucose
shifts K+ into cells, kayexalate, dialysis – monitor ECG hyperkalemia
Var 134. WHY WRONG: Distractors violate HESI Med-Surg clinical judgment
– high-yield topics cardiovascular respiratory renal endocrine
neurological postoperative nursing care pathophysiology pharmacology
nursing interventions patient care management prioritization ABCs
critical thinking clinical judgment NGN style. Rationale strengthens
understanding.
Page 1
,
Q3. A client with hypertension 180/110 headache blurred vision chest
pain. What is hypertensive emergency vs urgency? (Variation 94 –
Clinical Judgment Scenario)
A. 180/110 always normal Var 94 [3C]
B. Hypertensive emergency does not need treatment Var 94 [3B]
C. Emergency with target organ damage – chest pain neuro changes AKI
pulmonary edema – needs IV antihypertensives ICU, urgency no organ
damage oral meds Var 94 [3]
D. No difference emergency urgency same Var 94 [3A]
Correct Answer: C. Emergency with target organ damage – chest pain
neuro changes AKI pulmonary edema – needs IV antihypertensives ICU,
urgency no organ damage oral meds Var 94 [3]
Rationale: CORRECT: Emergency with target organ damage – chest pain
neuro changes AKI pulmonary edema – needs IV antihypertensives ICU,
urgency no organ damage oral meds Var 94. WHY WRONG: Distractors violate
HESI Med-Surg clinical judgment – high-yield topics cardiovascular
respiratory renal endocrine neurological postoperative nursing care
pathophysiology pharmacology nursing interventions patient care
management prioritization ABCs critical thinking clinical judgment NGN
style. Rationale strengthens understanding.
Q4. A client with hyperthyroidism has tachycardia 120, tremor, heat
intolerance, weight loss. What assessment priority? (Variation 73 –
Clinical Judgment Scenario)
A. Give thyroid hormone replacement Var 73 [4A]
B. Hyperthyroidism causes bradycardia Var 73 [4C]
C. Encourage heat exposure Var 73 [4B]
D. Thyroid storm risk – fever tachycardia agitation – beta-blockers
antithyroid meds iodine corticosteroids cool environment – monitor
vitals Var 73 [4]
Correct Answer: D. Thyroid storm risk – fever tachycardia agitation –
beta-blockers antithyroid meds iodine corticosteroids cool environment
– monitor vitals Var 73 [4]
Rationale: CORRECT: Thyroid storm risk – fever tachycardia agitation –
beta-blockers antithyroid meds iodine corticosteroids cool environment –
monitor vitals Var 73. WHY WRONG: Distractors violate HESI Med-Surg
clinical judgment – high-yield topics cardiovascular respiratory renal
endocrine neurological postoperative nursing care pathophysiology
pharmacology nursing interventions patient care management
prioritization ABCs critical thinking clinical judgment NGN style.
Rationale strengthens understanding.
Page 2
,
Q5. A client with diabetic ketoacidosis has glucose 450, K+ 5.2, pH
7.20, ketones positive. What is priority fluid and insulin management?
A. 0.9% NS bolus then 0.45% NS, regular insulin drip 0.1 unit/kg/hr,
monitor K+ glucose hourly, replace K+ when <5.2, assess LOC [5]
B. Give oral hypoglycemics [5C]
C. Give D5W immediately [5A]
D. Hold fluids give insulin bolus only [5B]
Correct Answer: A. 0.9% NS bolus then 0.45% NS, regular insulin drip
0.1 unit/kg/hr, monitor K+ glucose hourly, replace K+ when <5.2,
assess LOC [5]
Rationale: CORRECT: 0.9% NS bolus then 0.45% NS, regular insulin drip
0.1 unit/kg/hr, monitor K+ glucose hourly, replace K+ when <5.2, assess
LOC. WHY WRONG: Distractors violate HESI Med-Surg clinical judgment –
high-yield topics cardiovascular respiratory renal endocrine
neurological postoperative nursing care pathophysiology pharmacology
nursing interventions patient care management prioritization ABCs
critical thinking clinical judgment NGN style. Rationale strengthens
understanding.
Q6. A client with pneumonia has fever 101.5, productive cough,
crackles, WBC 14k. What nursing intervention? (Variation 125 –
Clinical Judgment Scenario)
A. Restrict fluids Var 125 [6B]
B. Encourage cough deep breathe incentive spirometry, increase fluids
2-3 L if not contraindicated, antibiotics, O2, rest Var 125 [6]
C. No antibiotics viral only Var 125 [6C]
D. Suppress cough completely Var 125 [6A]
Correct Answer: B. Encourage cough deep breathe incentive spirometry,
increase fluids 2-3 L if not contraindicated, antibiotics, O2, rest
Var 125 [6]
Rationale: CORRECT: Encourage cough deep breathe incentive spirometry,
increase fluids 2-3 L if not contraindicated, antibiotics, O2, rest Var
125. WHY WRONG: Distractors violate HESI Med-Surg clinical judgment –
high-yield topics cardiovascular respiratory renal endocrine
neurological postoperative nursing care pathophysiology pharmacology
nursing interventions patient care management prioritization ABCs
critical thinking clinical judgment NGN style. Rationale strengthens
understanding.
Page 3
,
Q7. A client post thyroidectomy has tingling around mouth, positive
Chvostek Trousseau, muscle cramps. What indicates?
A. Hypocalcemia is expected no treatment [7C]
B. Normal post-op findings [7B]
C. Hypocalcemia from parathyroid injury – give calcium gluconate, check
calcium levels, assess airway laryngospasm [7]
D. Hypercalcemia [7A]
Correct Answer: C. Hypocalcemia from parathyroid injury – give calcium
gluconate, check calcium levels, assess airway laryngospasm [7]
Rationale: CORRECT: Hypocalcemia from parathyroid injury – give calcium
gluconate, check calcium levels, assess airway laryngospasm. WHY WRONG:
Distractors violate HESI Med-Surg clinical judgment – high-yield topics
cardiovascular respiratory renal endocrine neurological postoperative
nursing care pathophysiology pharmacology nursing interventions patient
care management prioritization ABCs critical thinking clinical judgment
NGN style. Rationale strengthens understanding.
Q8. A client with chronic kidney disease has BUN 45 creatinine 2.8 K+
6.0 peaked T waves. What intervention for hyperkalemia? (Variation 166
– Clinical Judgment Scenario)
A. No treatment hyperkalemia benign Var 166 [8B]
B. Give calcium only increases K+ Var 166 [8C]
C. Give extra potassium supplement Var 166 [8A]
D. Calcium gluconate protects heart, insulin glucose shifts K+ into
cells, kayexalate, dialysis – monitor ECG hyperkalemia Var 166 [8]
Correct Answer: D. Calcium gluconate protects heart, insulin glucose
shifts K+ into cells, kayexalate, dialysis – monitor ECG hyperkalemia
Var 166 [8]
Rationale: CORRECT: Calcium gluconate protects heart, insulin glucose
shifts K+ into cells, kayexalate, dialysis – monitor ECG hyperkalemia
Var 166. WHY WRONG: Distractors violate HESI Med-Surg clinical judgment
– high-yield topics cardiovascular respiratory renal endocrine
neurological postoperative nursing care pathophysiology pharmacology
nursing interventions patient care management prioritization ABCs
critical thinking clinical judgment NGN style. Rationale strengthens
understanding.
Page 4
Answers | Elsevier Evolve Clinical Judgment |
Instant Download
Q1. A client with Cushing syndrome has moon face, buffalo hump,
hypertension, hyperglycemia. What cause and care? (Variation 47 –
Clinical Judgment Scenario)
A. Excess cortisol – steroids or adrenal tumor – monitor glucose BP
electrolytes weight, taper steroids not abrupt, infection risk Var 47
[1]
B. Cushing is low cortisol Var 47 [1A]
C. Cushing causes hypotension hypoglycemia Var 47 [1C]
D. Give extra cortisol always Var 47 [1B]
Correct Answer: A. Excess cortisol – steroids or adrenal tumor –
monitor glucose BP electrolytes weight, taper steroids not abrupt,
infection risk Var 47 [1]
Rationale: CORRECT: Excess cortisol – steroids or adrenal tumor –
monitor glucose BP electrolytes weight, taper steroids not abrupt,
infection risk Var 47. WHY WRONG: Distractors violate HESI Med-Surg
clinical judgment – high-yield topics cardiovascular respiratory renal
endocrine neurological postoperative nursing care pathophysiology
pharmacology nursing interventions patient care management
prioritization ABCs critical thinking clinical judgment NGN style.
Rationale strengthens understanding.
Q2. A client with chronic kidney disease has BUN 45 creatinine 2.8 K+
6.0 peaked T waves. What intervention for hyperkalemia? (Variation 134
– Clinical Judgment Scenario)
A. No treatment hyperkalemia benign Var 134 [2B]
B. Calcium gluconate protects heart, insulin glucose shifts K+ into
cells, kayexalate, dialysis – monitor ECG hyperkalemia Var 134 [2]
C. Give extra potassium supplement Var 134 [2A]
D. Give calcium only increases K+ Var 134 [2C]
Correct Answer: B. Calcium gluconate protects heart, insulin glucose
shifts K+ into cells, kayexalate, dialysis – monitor ECG hyperkalemia
Var 134 [2]
Rationale: CORRECT: Calcium gluconate protects heart, insulin glucose
shifts K+ into cells, kayexalate, dialysis – monitor ECG hyperkalemia
Var 134. WHY WRONG: Distractors violate HESI Med-Surg clinical judgment
– high-yield topics cardiovascular respiratory renal endocrine
neurological postoperative nursing care pathophysiology pharmacology
nursing interventions patient care management prioritization ABCs
critical thinking clinical judgment NGN style. Rationale strengthens
understanding.
Page 1
,
Q3. A client with hypertension 180/110 headache blurred vision chest
pain. What is hypertensive emergency vs urgency? (Variation 94 –
Clinical Judgment Scenario)
A. 180/110 always normal Var 94 [3C]
B. Hypertensive emergency does not need treatment Var 94 [3B]
C. Emergency with target organ damage – chest pain neuro changes AKI
pulmonary edema – needs IV antihypertensives ICU, urgency no organ
damage oral meds Var 94 [3]
D. No difference emergency urgency same Var 94 [3A]
Correct Answer: C. Emergency with target organ damage – chest pain
neuro changes AKI pulmonary edema – needs IV antihypertensives ICU,
urgency no organ damage oral meds Var 94 [3]
Rationale: CORRECT: Emergency with target organ damage – chest pain
neuro changes AKI pulmonary edema – needs IV antihypertensives ICU,
urgency no organ damage oral meds Var 94. WHY WRONG: Distractors violate
HESI Med-Surg clinical judgment – high-yield topics cardiovascular
respiratory renal endocrine neurological postoperative nursing care
pathophysiology pharmacology nursing interventions patient care
management prioritization ABCs critical thinking clinical judgment NGN
style. Rationale strengthens understanding.
Q4. A client with hyperthyroidism has tachycardia 120, tremor, heat
intolerance, weight loss. What assessment priority? (Variation 73 –
Clinical Judgment Scenario)
A. Give thyroid hormone replacement Var 73 [4A]
B. Hyperthyroidism causes bradycardia Var 73 [4C]
C. Encourage heat exposure Var 73 [4B]
D. Thyroid storm risk – fever tachycardia agitation – beta-blockers
antithyroid meds iodine corticosteroids cool environment – monitor
vitals Var 73 [4]
Correct Answer: D. Thyroid storm risk – fever tachycardia agitation –
beta-blockers antithyroid meds iodine corticosteroids cool environment
– monitor vitals Var 73 [4]
Rationale: CORRECT: Thyroid storm risk – fever tachycardia agitation –
beta-blockers antithyroid meds iodine corticosteroids cool environment –
monitor vitals Var 73. WHY WRONG: Distractors violate HESI Med-Surg
clinical judgment – high-yield topics cardiovascular respiratory renal
endocrine neurological postoperative nursing care pathophysiology
pharmacology nursing interventions patient care management
prioritization ABCs critical thinking clinical judgment NGN style.
Rationale strengthens understanding.
Page 2
,
Q5. A client with diabetic ketoacidosis has glucose 450, K+ 5.2, pH
7.20, ketones positive. What is priority fluid and insulin management?
A. 0.9% NS bolus then 0.45% NS, regular insulin drip 0.1 unit/kg/hr,
monitor K+ glucose hourly, replace K+ when <5.2, assess LOC [5]
B. Give oral hypoglycemics [5C]
C. Give D5W immediately [5A]
D. Hold fluids give insulin bolus only [5B]
Correct Answer: A. 0.9% NS bolus then 0.45% NS, regular insulin drip
0.1 unit/kg/hr, monitor K+ glucose hourly, replace K+ when <5.2,
assess LOC [5]
Rationale: CORRECT: 0.9% NS bolus then 0.45% NS, regular insulin drip
0.1 unit/kg/hr, monitor K+ glucose hourly, replace K+ when <5.2, assess
LOC. WHY WRONG: Distractors violate HESI Med-Surg clinical judgment –
high-yield topics cardiovascular respiratory renal endocrine
neurological postoperative nursing care pathophysiology pharmacology
nursing interventions patient care management prioritization ABCs
critical thinking clinical judgment NGN style. Rationale strengthens
understanding.
Q6. A client with pneumonia has fever 101.5, productive cough,
crackles, WBC 14k. What nursing intervention? (Variation 125 –
Clinical Judgment Scenario)
A. Restrict fluids Var 125 [6B]
B. Encourage cough deep breathe incentive spirometry, increase fluids
2-3 L if not contraindicated, antibiotics, O2, rest Var 125 [6]
C. No antibiotics viral only Var 125 [6C]
D. Suppress cough completely Var 125 [6A]
Correct Answer: B. Encourage cough deep breathe incentive spirometry,
increase fluids 2-3 L if not contraindicated, antibiotics, O2, rest
Var 125 [6]
Rationale: CORRECT: Encourage cough deep breathe incentive spirometry,
increase fluids 2-3 L if not contraindicated, antibiotics, O2, rest Var
125. WHY WRONG: Distractors violate HESI Med-Surg clinical judgment –
high-yield topics cardiovascular respiratory renal endocrine
neurological postoperative nursing care pathophysiology pharmacology
nursing interventions patient care management prioritization ABCs
critical thinking clinical judgment NGN style. Rationale strengthens
understanding.
Page 3
,
Q7. A client post thyroidectomy has tingling around mouth, positive
Chvostek Trousseau, muscle cramps. What indicates?
A. Hypocalcemia is expected no treatment [7C]
B. Normal post-op findings [7B]
C. Hypocalcemia from parathyroid injury – give calcium gluconate, check
calcium levels, assess airway laryngospasm [7]
D. Hypercalcemia [7A]
Correct Answer: C. Hypocalcemia from parathyroid injury – give calcium
gluconate, check calcium levels, assess airway laryngospasm [7]
Rationale: CORRECT: Hypocalcemia from parathyroid injury – give calcium
gluconate, check calcium levels, assess airway laryngospasm. WHY WRONG:
Distractors violate HESI Med-Surg clinical judgment – high-yield topics
cardiovascular respiratory renal endocrine neurological postoperative
nursing care pathophysiology pharmacology nursing interventions patient
care management prioritization ABCs critical thinking clinical judgment
NGN style. Rationale strengthens understanding.
Q8. A client with chronic kidney disease has BUN 45 creatinine 2.8 K+
6.0 peaked T waves. What intervention for hyperkalemia? (Variation 166
– Clinical Judgment Scenario)
A. No treatment hyperkalemia benign Var 166 [8B]
B. Give calcium only increases K+ Var 166 [8C]
C. Give extra potassium supplement Var 166 [8A]
D. Calcium gluconate protects heart, insulin glucose shifts K+ into
cells, kayexalate, dialysis – monitor ECG hyperkalemia Var 166 [8]
Correct Answer: D. Calcium gluconate protects heart, insulin glucose
shifts K+ into cells, kayexalate, dialysis – monitor ECG hyperkalemia
Var 166 [8]
Rationale: CORRECT: Calcium gluconate protects heart, insulin glucose
shifts K+ into cells, kayexalate, dialysis – monitor ECG hyperkalemia
Var 166. WHY WRONG: Distractors violate HESI Med-Surg clinical judgment
– high-yield topics cardiovascular respiratory renal endocrine
neurological postoperative nursing care pathophysiology pharmacology
nursing interventions patient care management prioritization ABCs
critical thinking clinical judgment NGN style. Rationale strengthens
understanding.
Page 4
