Med-Surg HESI Test Questions
2022/2023 Verified Answers Graded A+
A female client with a nasogastric tube attached to low suction states that she is nauseated. The
nurse assesses that there has been no drainage through the nasogastric tube in the last 2 hours.
Which action should the nurse take first? - CORRECT ANSWER Reposition the client on her side. The
priority is to determined if the tube is functioning correctly, which would relieve the client's nausea.
The least invasive intervention is to reposition the client (B), should be attempted first, followed by
(A & C) if these are unsuccessful then (D).
When assigning clients on a medical-surgical floor to a RN and a LPN, it is best for the charge nurse
to assign which client to the LPN?
A. A child with bacterial meningitis with recent seizures.
B. An older adult client with pneumonia and viral meningitis.
C. A female client in isolation wiht meningococcal meningitis.
D. A male client 1 day post-op after drainage of a brain abscess. - CORRECT ANSWER B. Is the most
stable. A, C, D have an increased risk for elevated ICP.
Which description of symptoms is characteristic of a client diagnosed with trigeminal neuralgia (tic
douloureux)?
A. Tinnitus, vertigo, and hearing difficulties.
B. Sudden, stabbing, severe pain over the lip and chin.
C. Unilateral facial weakness and paralysis.
D. Difficulty in talking, chewing, and swallowing. - CORRECT ANSWER B. Trigeminal neuralgia is
characterized by paroxysms of pain, similar to an electric shock, in the area innervated by one or
more branches of the trigeminal nerve.
A. Characteristic of Meniere's
C. Characteristic of Bell palsey
D. Characteristic of disorders of the hypoglossal (12th cranial nerve)
Which abnormal lab finding indicates that a client with diabetes needs further evaluation for
diabetic nephropathy?
A. Hypokalemia
B. Microalbuminauria
C. Elevated serum lipids
D. Ketonuria - CORRECT ANSWER B. Microalbuminuria is the earliest sign of nephropathy and
indicates the need for follow-up evaluation. Hyperkalemia (A) is associated with end stage renal
disease caused by diabetic nephropathy. (C) may be elevated in end stage renal disease. (D) may
signal the onset of DKA.
An older male client comes to the geriatric screening clinic complaining of pain in his left calf. The
nurse notices a reddened area on the calf of his right leg that is warm to touch and the nurse
suspects that the client may have thrombophlebitis. Which addition assessment is most important
for the nurse to perform?
A. Measure calf circumference.
B. Auscultate the client's breath sounds.
C. Observe for ecchymosis and petechiae.
,D. Obtain the client's blood pressure. - CORRECT ANSWER B. Since the client may have a pulmonary
embolus secondary to the thrombophlebitis.
A. Would support the nurses assessment.
C. Least helpful since bruising is not associated with thrombophlebitis.
D. Less important then auscultation.
The nurse know that a client taking diuretics must be assessed for the development of hypokalemia,
and that hypokalemia will create changes in the client's normal ECG tracing. Which ECG change
would be an expected finding in the client with hypokalemia?
A. Tall, spiked T waves
B. A prolonged QT interval
C. A widening QRS complex
D. Presence of a U wave - CORRECT ANSWER D. A U wave is a positive deflection following the T wave
and is often present with hypokalemia. A, B, C indicate hyperkalemia.
An older client is admitted with a diagnosis of bacterial pneumonia. The nurse's assessment of the
client will most likely reveal which S/SX?
A. Leukocytosis and febrile.
B. Polycythemia and crackles.
C. Pharyngitis and sputum production.
D. Confusion and tachycardia. - CORRECT ANSWER D. The onset of pneumonia is the older may be
signaled by general deterioration, confusion, increased heart rate or increased respiratory rate.
(A, B, C) are often absent in the older with bacterial pneumonia.
The nurse observes ventricular fibrillation on telemetry and upon entering the clients bathroom
finds the client unconscious on the floor. What intervention should the nurse implement first?
A. Administer an antidysrhythmic medication.
B. Start cardiopulmonary resuscitation.
C. Defibrillate the client at 200 joules.
D. Assess the client's pulse oximetry. - CORRECT ANSWER B. Ventricular fibrillation is a life-threatening
dysrhythmia and CPR should be started immediately. A & C are appropriate but B is the priority. D
does not address the seriousness of the situation.
An older female client with dementia is transferred from a long term care unit to an acute care unit.
The client's children express concern that their mother's confusion is worsening. How should the
nurse respond?
A. "It is to be expected that older people will experience progressive confusion."
B. "Confusion in an older person often follows relocation to new surroundings."
C. "The dementia is progressing rapidly, but we will do everything we can to keep your mother safe."
D. "The acute care staff is not as experienced as the long-term care staff at dealing with dementia." -
CORRECT ANSWER B. Relocation often results in confusion among older clients and is stressful to
clients of all ages. (A) is an inaccurate stereotype. (C) is most likely false there are many factors that
cause increased temporary confusion. (D) may be true but does not offer the family a sense of
security about the care.
The nurse plCORRECT ANSWER to help an 18-year-old developmentally disabled female client
ambulate on the first postoperative day. When the nurse tells her it is time to get out of bed, the
,client becomes angry and yells at the nurse. "Get out of here! I'll get up when I'm ready." Which
response should the nurse provide?
A. "Your healthcare provider has prescribed ambulation on the first postoperative day."
B. "You must ambulate to avoid serious complications that are much more painful."
C. "I know how you feel; you're angry about having to do this, but it is required."
D. "I'll be back in 30 minutes to help you get out of bed and walk around the room." - CORRECT
ANSWER D. Returning in 30 minutes provides a cooling off period, is firm, direct, nonthreatening, and
avoids argument with the client. B is threatening. C. assumes what the client is feeling. A. avoids the
nurse's responsibility to ambulate the client.
The nurse is performing hourly neurological check for a client with a head injury. Which new
assessment finding warrants the most immediate intervention by the nurse?
A. A unilateral pupil that is dilated and nonreactive to light.
B. Client cries out when awakened by a verbal stimulus.
C. Client demonstrates a loss of memory to the events leading up to the injury.
D. Onset of nausea, headache, and vertigo. - CORRECT ANSWER A. Any changes in pupil size and
reactivity is an indication of increasing ICP and should be reported immediately. (B) is normal for
being awakened. (C & D) are common manifestations of head injury and less of an immediacy than
(A).
A male client with arterial peripheral vascular disease (PVD) complains of pain in his feet. Which
instruction should the nurse give to the UPA to quickly relieve the client's pain?
A. Help the client to dangle his legs.
B. Apply compression stockings.
C. Assist with passive leg exercises.
D. Ambulate three times daily. - CORRECT ANSWER A. A client who has arterial PVD may benefit from
a dependent position which can be achieved by dangling by improving blood flow and relieving pain.
(B) is indicated for venous insufficiency and (C) is indicated for bed rest. (D) is indicated to facilitate
collateral circulation and may improve long term complaints of pain.
A 58-year-old client, who has no health problems, asks the nurse about taking the pneumococcal
vaccine (Pneumovax). Which statement give by the nurse would offer the client accurate
information about this vaccine?
A. "The vaccine is given annually before the flue season to those over 50 years of age."
B. "The immunization is administered once to older adults or persons with a history of chronic
illness."
C. "The vaccine is for all ages and is given primarily to those person traveling overseas to infected
areas."
D. "The vaccine will prevent the occurrence of pneumococcal pneumonia for up to 5 years." -
CORRECT ANSWER B. It is usually recommended that persons over 65 years of age and those with a
history of chronic illness should receive the vaccine once in a lifetime. (A) the influenza vaccine is
given annually. (C) travel is not the main rationale for the vaccine. (D) The vaccine is usually given
once in a lifetime.
A client with hypertension has been receiving ramipril (Altace) 5 mg PO daily for 2 weeks and is
scheduled to receive a dose at 0900. At 0830 the client's blood pressure is 120/70. Which action
should the nurse take?
, A. Administer the dose as prescribed.
B. Hold the dose and contact the healthcare provider.
C. Hold the dose and recheck the blood pressure in 1 hour.
D. Check the healthcare provider's prescription to clarify the dose. - CORRECT ANSWER A. The BP is
WNL and indicates that the medication is working. (B & C) would be indicated if the BP was low
(systole below 100). (D) is not required because the dose is within manufacture's recommendations.
The nurse know that normal lab values expected for an adult may vary in an older client. Which data
would the nurse expect to find when reviewing laboratory values of an 80-year-old man who is in
good overall health.
A. Complet blood count reveals increased WBC and decreased RBC counts.
B. Chemistries reveal an increased serum bilirubin with slightly increased liver enzymes.
C. Urinalysis reveals slight protein in the urine and bacteriuria with pyuria.
D. Serum electrolytes reveal a decreased sodium level with an increased potassium level. - CORRECT
ANSWER C. In older adults the protein found in urine is slightly risen as a result of kidney changes or
subclinical UTIs and the client frequently experiences asymptomatic bacteriuria and pyuria as a
result of incomplete bladder emptying. (A, B, D) are not normal findings.
The nurse is completing an admission inter for a client with Parkinson disease. Which question will
provide addition information about manifestations the client is likely to experience?
A. "Have you ever experienced and paralysis of your arms or legs?"
B. " Do you have frequent blackout spells?"
C. "Have you ever been 'frozen' in one spot, unable to move?"
D. "Do you have headaches, especially ones with throbbing pain?" - CORRECT ANSWER C. Parkinson
clients frequently experience difficulty in initiating, maintaining, and performing motor activities.
They may even experience being rooted, unable to move. (A, B, D) Does not typically occur in
Parkinson.
During the change of shift report, the charge nurse reviews the infusions being received by the
clients on the oncology unit. The client receiving which infusion should be seen first? - CORRECT
ANSWER C. Has the highest risk for respiratory depression and therefor should be seen first. (A) Risk
of hypotension. (B) Lowest risk. (D) Risk of nephrotoxicity and phlebitis.
The home health nurse is assessing a male client being treated for Parkinson disease with levodopa-
carbidopa (Sinemet). The nurse observes that he does not demonstrate any apparent emotions
when speaking and rarely blinks. Which intervention should the nurse implement?
A. Perform a complete cranial nerve assessment.
B. Instruct the client that he may be experiencing medication toxicity.
C. Document the presence of these assessment findings.
D. Advise the client to seek immediate medical evaluation. - CORRECT ANSWER C. A mask-like
expression and infrequent blinking are common clinical features of Parkinsonism. The nurse should
document the findings. (A & D) are not necessary. Signs of toxicity (B) are dyskinesia, hallucinations,
and psychosis.
A client is placed on a mechanical ventilator following a cerebral hemorrhage, and vecuronium
bromide (Norcuron) 0.04 mg/kg every 12 hours IV is prescribed. What is the priority nursing
diagnosis for this client?
2022/2023 Verified Answers Graded A+
A female client with a nasogastric tube attached to low suction states that she is nauseated. The
nurse assesses that there has been no drainage through the nasogastric tube in the last 2 hours.
Which action should the nurse take first? - CORRECT ANSWER Reposition the client on her side. The
priority is to determined if the tube is functioning correctly, which would relieve the client's nausea.
The least invasive intervention is to reposition the client (B), should be attempted first, followed by
(A & C) if these are unsuccessful then (D).
When assigning clients on a medical-surgical floor to a RN and a LPN, it is best for the charge nurse
to assign which client to the LPN?
A. A child with bacterial meningitis with recent seizures.
B. An older adult client with pneumonia and viral meningitis.
C. A female client in isolation wiht meningococcal meningitis.
D. A male client 1 day post-op after drainage of a brain abscess. - CORRECT ANSWER B. Is the most
stable. A, C, D have an increased risk for elevated ICP.
Which description of symptoms is characteristic of a client diagnosed with trigeminal neuralgia (tic
douloureux)?
A. Tinnitus, vertigo, and hearing difficulties.
B. Sudden, stabbing, severe pain over the lip and chin.
C. Unilateral facial weakness and paralysis.
D. Difficulty in talking, chewing, and swallowing. - CORRECT ANSWER B. Trigeminal neuralgia is
characterized by paroxysms of pain, similar to an electric shock, in the area innervated by one or
more branches of the trigeminal nerve.
A. Characteristic of Meniere's
C. Characteristic of Bell palsey
D. Characteristic of disorders of the hypoglossal (12th cranial nerve)
Which abnormal lab finding indicates that a client with diabetes needs further evaluation for
diabetic nephropathy?
A. Hypokalemia
B. Microalbuminauria
C. Elevated serum lipids
D. Ketonuria - CORRECT ANSWER B. Microalbuminuria is the earliest sign of nephropathy and
indicates the need for follow-up evaluation. Hyperkalemia (A) is associated with end stage renal
disease caused by diabetic nephropathy. (C) may be elevated in end stage renal disease. (D) may
signal the onset of DKA.
An older male client comes to the geriatric screening clinic complaining of pain in his left calf. The
nurse notices a reddened area on the calf of his right leg that is warm to touch and the nurse
suspects that the client may have thrombophlebitis. Which addition assessment is most important
for the nurse to perform?
A. Measure calf circumference.
B. Auscultate the client's breath sounds.
C. Observe for ecchymosis and petechiae.
,D. Obtain the client's blood pressure. - CORRECT ANSWER B. Since the client may have a pulmonary
embolus secondary to the thrombophlebitis.
A. Would support the nurses assessment.
C. Least helpful since bruising is not associated with thrombophlebitis.
D. Less important then auscultation.
The nurse know that a client taking diuretics must be assessed for the development of hypokalemia,
and that hypokalemia will create changes in the client's normal ECG tracing. Which ECG change
would be an expected finding in the client with hypokalemia?
A. Tall, spiked T waves
B. A prolonged QT interval
C. A widening QRS complex
D. Presence of a U wave - CORRECT ANSWER D. A U wave is a positive deflection following the T wave
and is often present with hypokalemia. A, B, C indicate hyperkalemia.
An older client is admitted with a diagnosis of bacterial pneumonia. The nurse's assessment of the
client will most likely reveal which S/SX?
A. Leukocytosis and febrile.
B. Polycythemia and crackles.
C. Pharyngitis and sputum production.
D. Confusion and tachycardia. - CORRECT ANSWER D. The onset of pneumonia is the older may be
signaled by general deterioration, confusion, increased heart rate or increased respiratory rate.
(A, B, C) are often absent in the older with bacterial pneumonia.
The nurse observes ventricular fibrillation on telemetry and upon entering the clients bathroom
finds the client unconscious on the floor. What intervention should the nurse implement first?
A. Administer an antidysrhythmic medication.
B. Start cardiopulmonary resuscitation.
C. Defibrillate the client at 200 joules.
D. Assess the client's pulse oximetry. - CORRECT ANSWER B. Ventricular fibrillation is a life-threatening
dysrhythmia and CPR should be started immediately. A & C are appropriate but B is the priority. D
does not address the seriousness of the situation.
An older female client with dementia is transferred from a long term care unit to an acute care unit.
The client's children express concern that their mother's confusion is worsening. How should the
nurse respond?
A. "It is to be expected that older people will experience progressive confusion."
B. "Confusion in an older person often follows relocation to new surroundings."
C. "The dementia is progressing rapidly, but we will do everything we can to keep your mother safe."
D. "The acute care staff is not as experienced as the long-term care staff at dealing with dementia." -
CORRECT ANSWER B. Relocation often results in confusion among older clients and is stressful to
clients of all ages. (A) is an inaccurate stereotype. (C) is most likely false there are many factors that
cause increased temporary confusion. (D) may be true but does not offer the family a sense of
security about the care.
The nurse plCORRECT ANSWER to help an 18-year-old developmentally disabled female client
ambulate on the first postoperative day. When the nurse tells her it is time to get out of bed, the
,client becomes angry and yells at the nurse. "Get out of here! I'll get up when I'm ready." Which
response should the nurse provide?
A. "Your healthcare provider has prescribed ambulation on the first postoperative day."
B. "You must ambulate to avoid serious complications that are much more painful."
C. "I know how you feel; you're angry about having to do this, but it is required."
D. "I'll be back in 30 minutes to help you get out of bed and walk around the room." - CORRECT
ANSWER D. Returning in 30 minutes provides a cooling off period, is firm, direct, nonthreatening, and
avoids argument with the client. B is threatening. C. assumes what the client is feeling. A. avoids the
nurse's responsibility to ambulate the client.
The nurse is performing hourly neurological check for a client with a head injury. Which new
assessment finding warrants the most immediate intervention by the nurse?
A. A unilateral pupil that is dilated and nonreactive to light.
B. Client cries out when awakened by a verbal stimulus.
C. Client demonstrates a loss of memory to the events leading up to the injury.
D. Onset of nausea, headache, and vertigo. - CORRECT ANSWER A. Any changes in pupil size and
reactivity is an indication of increasing ICP and should be reported immediately. (B) is normal for
being awakened. (C & D) are common manifestations of head injury and less of an immediacy than
(A).
A male client with arterial peripheral vascular disease (PVD) complains of pain in his feet. Which
instruction should the nurse give to the UPA to quickly relieve the client's pain?
A. Help the client to dangle his legs.
B. Apply compression stockings.
C. Assist with passive leg exercises.
D. Ambulate three times daily. - CORRECT ANSWER A. A client who has arterial PVD may benefit from
a dependent position which can be achieved by dangling by improving blood flow and relieving pain.
(B) is indicated for venous insufficiency and (C) is indicated for bed rest. (D) is indicated to facilitate
collateral circulation and may improve long term complaints of pain.
A 58-year-old client, who has no health problems, asks the nurse about taking the pneumococcal
vaccine (Pneumovax). Which statement give by the nurse would offer the client accurate
information about this vaccine?
A. "The vaccine is given annually before the flue season to those over 50 years of age."
B. "The immunization is administered once to older adults or persons with a history of chronic
illness."
C. "The vaccine is for all ages and is given primarily to those person traveling overseas to infected
areas."
D. "The vaccine will prevent the occurrence of pneumococcal pneumonia for up to 5 years." -
CORRECT ANSWER B. It is usually recommended that persons over 65 years of age and those with a
history of chronic illness should receive the vaccine once in a lifetime. (A) the influenza vaccine is
given annually. (C) travel is not the main rationale for the vaccine. (D) The vaccine is usually given
once in a lifetime.
A client with hypertension has been receiving ramipril (Altace) 5 mg PO daily for 2 weeks and is
scheduled to receive a dose at 0900. At 0830 the client's blood pressure is 120/70. Which action
should the nurse take?
, A. Administer the dose as prescribed.
B. Hold the dose and contact the healthcare provider.
C. Hold the dose and recheck the blood pressure in 1 hour.
D. Check the healthcare provider's prescription to clarify the dose. - CORRECT ANSWER A. The BP is
WNL and indicates that the medication is working. (B & C) would be indicated if the BP was low
(systole below 100). (D) is not required because the dose is within manufacture's recommendations.
The nurse know that normal lab values expected for an adult may vary in an older client. Which data
would the nurse expect to find when reviewing laboratory values of an 80-year-old man who is in
good overall health.
A. Complet blood count reveals increased WBC and decreased RBC counts.
B. Chemistries reveal an increased serum bilirubin with slightly increased liver enzymes.
C. Urinalysis reveals slight protein in the urine and bacteriuria with pyuria.
D. Serum electrolytes reveal a decreased sodium level with an increased potassium level. - CORRECT
ANSWER C. In older adults the protein found in urine is slightly risen as a result of kidney changes or
subclinical UTIs and the client frequently experiences asymptomatic bacteriuria and pyuria as a
result of incomplete bladder emptying. (A, B, D) are not normal findings.
The nurse is completing an admission inter for a client with Parkinson disease. Which question will
provide addition information about manifestations the client is likely to experience?
A. "Have you ever experienced and paralysis of your arms or legs?"
B. " Do you have frequent blackout spells?"
C. "Have you ever been 'frozen' in one spot, unable to move?"
D. "Do you have headaches, especially ones with throbbing pain?" - CORRECT ANSWER C. Parkinson
clients frequently experience difficulty in initiating, maintaining, and performing motor activities.
They may even experience being rooted, unable to move. (A, B, D) Does not typically occur in
Parkinson.
During the change of shift report, the charge nurse reviews the infusions being received by the
clients on the oncology unit. The client receiving which infusion should be seen first? - CORRECT
ANSWER C. Has the highest risk for respiratory depression and therefor should be seen first. (A) Risk
of hypotension. (B) Lowest risk. (D) Risk of nephrotoxicity and phlebitis.
The home health nurse is assessing a male client being treated for Parkinson disease with levodopa-
carbidopa (Sinemet). The nurse observes that he does not demonstrate any apparent emotions
when speaking and rarely blinks. Which intervention should the nurse implement?
A. Perform a complete cranial nerve assessment.
B. Instruct the client that he may be experiencing medication toxicity.
C. Document the presence of these assessment findings.
D. Advise the client to seek immediate medical evaluation. - CORRECT ANSWER C. A mask-like
expression and infrequent blinking are common clinical features of Parkinsonism. The nurse should
document the findings. (A & D) are not necessary. Signs of toxicity (B) are dyskinesia, hallucinations,
and psychosis.
A client is placed on a mechanical ventilator following a cerebral hemorrhage, and vecuronium
bromide (Norcuron) 0.04 mg/kg every 12 hours IV is prescribed. What is the priority nursing
diagnosis for this client?
