lOMoARcPSD|26582732
HESI MED SURG EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) ANSWERS) ALREADY GRADED
A 2025
1. In assessing a client diagnosed with primary aldosteronism, the nurse expects the laboratory test
results to indicate a decreased serum level of which substance?
A. Sodium
B. Phosphate
C Potassiu
. m
D. Glucose
Rationale: Clients with primary aldosteronism exhibit a profound decline in serum levels of potassium;
hypokalemia; hypertension is the most prominent and universal sign. The serum sodium level is normal
or elevated, depending on the amount of water resorbed with the sodium. Option B is influenced by
parathyroid hormone (PTH). Option D is not affected by primary aldosteronism.
2. What is the most important nursing priority for a client who has been admitted for a possible
kidney stone?
A. Reducing dairy products in the diet
B. Straining all urine
C. Measuring intake and output
D. Increasing fluid intake
Rationale: Straining all urine is the most important nursing action to take in this case. Encouraging fluid
intake is important for any client who may have a kidney stone, but it is even more important to strain all
urine. Straining urine will enable the nurse to determine when the kidney stone has been passed and may
prevent the need for surgery. Option C is not the highest priority action. Option A is usually not
recommended until the stone is obtained and the content of the stone is determined. Even then, dietary
restrictions are controversial.
3. A client is being discharged following radioactive seed implantation for prostate cancer. What is
the most important information that the nurse should provide to this client’s family?
A. Follow exposure precautions
B. Encourage regular meals
C. Collect all urine
D. Avoid touching the client
Rationale: Clients being treated for prostate cancer with radioactive seed implants should be instructed
regarding the amount of time and distance needed to prevent excessive exposure that would pose a hazard
to others. Option B is a good suggestion to promote adequate nutrition but is not as important as option
A. Option C is unnecessary. Contact with the client is permitted but should be brief to limit radiation
exposure.
4. The nurse is assessing a client who presents with jaundice. Which assessment finding is most
important for the nurse to follow up?
Downloaded by NELSON KIIRU ()
, lOMoARcPSD|26582732
A. Urine specific gravity of 1.03
B. Frothy, tea-colored urine
C. Clay-colored stools
D. Elevated serum amylase and lipase levels
Rationale: Obstructive cholelithiasis and alcoholism are the two major causes of pancreatitis, and
elevated serum amylase and lipase levels indicate pancreatic injury. Option A is a normal finding.
Options B and C are expected findings related to jaundice.
5. The x-ray for the client in the emergency department (ED) reveals a right-sided rib fracture. What
information will the nurse include in the client’s discharge instructions? (Select all that apply.)
A. Splint your right side with your right arm
B. You may have to sleep sitting up for a while
C. Return to the ED if you develop difficulty breathing
D. Use shallow breaths until pain subsides
E. Use 2 L of oxygen by nasal cannula when you have shortness of breath
Rationale: Shallow breaths do not promote adequate oxygenation. The client should splint the area and
breathe as normally as possible to maintain adequate oxygenation. Shortness of breath should not occur
with a rib fracture and is a sign of a pneumothorax. The client will not be sent home with O 2 by nasal
cannula if the only health issue is a fractured rib.
6. The nurse is conducting an osteoporosis screening clinic at a health fair. What information should
the nurse provide to individuals who are at risk for osteoporosis? (Select all that apply.)
A. Encourage alcohol and smoking
cessation
B. Suggest supplementing diet with vitamin E
C. Promote regular weight-bearing exercises
D. Implement a home safety plan to prevent falls
E. Propose a regular sleep pattern of 8 hours nightly
Rationale: Options A, C, and D are factors that decrease the risk for developing osteoporosis. Vitamin D
and calcium are important supplements to aid in the decrease of bone loss. Regular sleep patterns are
important to overall health but are not identified with a decreasing risk for osteoporosis
7. Which consideration is most important when the nurse is assigning a room for a client being
admitted with progressive systemic sclerosis (scleroderma)?
A. Provide a room that can be kept warm
B. Make sure that the room can be kept dark
C. Keep the client close to the nursing unit
D. Select a room that is visible from the nurses’ desk
Rationale: Abnormal blood flow in response to cold (Raynaud phenomenon) is precipitated in clients
with scleroderma. Option B is not a significant factor. Stress can also precipitate the severe pain of
Raynaud phenomenon, so a quiet environment is preferred to option C, which is often very noisy. Option
D is not necessary.
8. Zolpidem tartrate, 1.75 mg PRN at bedtime, is prescribed for rest. The scored tablets are labeled
3.5 mg per tablet. What dose should the nurse plan to administer?____________
0.5
9. A client with cirrhosis develops increasing pedal edema and ascites. Which dietary modification
is most important for the nurse to teach this client?
Downloaded by NELSON KIIRU ()
, lOMoARcPSD|26582732
A. Avoid high-carbohydrate foods
B. Decrease intake of fat-soluble vitamins
C. Decrease caloric intake
D. Restrict salt and fluid intake
Rationale: Salt and fluid restrictions are the first dietary modifications for a client who is retaining fluid
as manifested by edema and ascites. Options A, B, and C will not affect fluid retention.
10. The clinic nurse is providing post-operative teaching for a client scheduled for a myringoplasty.
Which client statements indicate to the nurse that the teaching has been effective? (Select all that
apply.)
A. “I can wash my hair in the shower when I get home.”
B. “I will avoid forceful and deep coughing until my post-op checkup.”
C. “I must lay flat on my non-operative side for the first 12 hours after surgery.”
D. “My hearing may be less or muffles until the packaging comes out.”
E. “I need to only take the first 2 doses of antibiotics and save the rest for another time.”
Rationale: The client must keep the ear bandage clean and dry until the packing is removed. Showering
and hair washing is discouraged. As with all prescriptions for antibiotics, the client must take the full
course of treatment. The remaining client statements do indicate effective teaching.
11. Which content about self-care should the nurse include in the teaching plan of a female client who
has genital herpes? (Select all that apply.)
A. Encourage annual physical and pap smear
B. Take antiviral medication as prescribed
C. Use condoms to avoid transmission to others
D. Warm sitz baths may relieve itching
E. Use Nystatin suppositories to control itching
F. Use a douche with weak vinegar solution to decrease itching.
Rationale: The nurse should include (A, B, C, and D) in the teaching plan of a female client with genital
herpes. (E) is specific for Candida infections, and option (F) is used to treat Trichomonas.
12. An 81-year-old client has emphysema. The client lives at home with a cat and manages self-care
with no difficulty. When making a home visit, the nurse notices that this client’s tongue is
somewhat cracked and his eyeballs appear sunken. Which nursing action is indicated?
A. Help the client determine ways to increase fluid intake
B. Obtain an appointment for the client to have an eye examination
C. Instruct the client to use oxygen at night and increase the humification
D. Schedule the client for the test to determine his sensitivity to cat hair
Rationale: Clients with COPD should ingest 3 L of fluids daily but may experience a fluid deficit
because of shortness of breath. The nurse should suggest creative methods to increase the intake of fluids,
such as having fruit juices in disposable containers readily available. Option B is not indicated.
Humidified oxygen will not effectively treat the client’s fluid deficit, and there is no indication that the
client needs supplemental oxygen at night. These symptoms are not indicative of option D and may
unnecessarily upset the client, who depends on his pet for socialization
13. A client on telemetry has a pattern of uncontrolled atrial fibrillation with a rapid ventricular
response. Based on this finding, the nurse anticipates assisting the physician with which
treatment?
A. Administer lidocaine, 75 mg IV push
B. Perform synchronized cardioversion
Downloaded by NELSON KIIRU ()
, lOMoARcPSD|26582732
C. Defibrillate the client as soon as possible
D. Administer atropine, 0.4 mg IV push
Rationale: With uncontrolled atrial fibrillation, the treatment of choice is synchronized cardioversion to
convert the cardiac rhythm back to normal sinus rhythm. Option A is a medication used for ventricular
dysrhythmias. Option C is not for a client with atrial fibrillation; it is reserved for clients with
lifethreatening dysrhythmias, such as ventricular fibrillation and unstable ventricular tachycardia. Option
D is the drug of choice in symptomatic sinus bradycardia, not atrial fibrillation.
14. A practical nurse (PN) tells the charge nurse in a long-term facility that she does not want to be
assigned to one particular resident. She reports that the male client keeps insisting that she is his
daughter and begs her to stay in his room. What is the best managerial decision?
A. Notify the family that the resident will have to be discharged if his behavior does not
improve.
B. Notify administration of the PN’s insubordination and need for counseling about her
statements.
C. Ask the PN what she has done to encourage the resident to believe that she is his
daughter.
D. Reassign the PN until the resident can be assessed more completely for reality
orientation. Rationale: Temporary reassignment is the best option until the resident can be examined
and his medications reviewed. He may have worsening cerebral dysfunction from an infection or
electrolyte imbalance. Option A is not the best option because the family cannot control the resident’s
actions. The administration may need to know about the situation, but not as a case of
insubordination. Implying that the PN is somehow creating the situation is inappropriate until a
further evaluation has been conducted.
15. Which condition should the nurse anticipate as a potential problem in a female client with a
neurogenic bladder? A. Stress incontinence
B. Infection
C. Painless gross hematuria
D. Peritonitis
Rationale: Infection is the major complication resulting from stasis of urine and subsequent
catheterization. Option A is the involuntary loss of urine through an intact urethra as a result of a sudden
increase in intra-abdominal pressure. Option C is the most common symptom of bladder cancer. Option
D is the most common and serious complication of peritoneal dialysis.
16. The nurse is caring for a client who is one day post-acute myocardial infarction. The client is
receiving oxygen at 2 L/min via nasal cannula and has a peripheral saline lock. The nurse notes
that the client is having eight premature ventricular contractions (pvcs) per minute. Which action
should the nurse take first?
A. Obtain and IV pump for antiarrhythmic infusion
B. Increase the client’s oxygen flow rate
C. Prepare for immediate countershock
D. Gather equipment for endotracheal intubation
Rationale: Increasing the oxygen flow rate provides more oxygen to the client’s myocardium and may
decrease myocardial irritability as manifested by the frequent pvcs. Option A can be delegated and is a
lower priority action than option B. Defibrillation may eventually be necessary, but option C is not the
immediate treatment for frequent pvcs. Option D may become necessary if the client stops breathing but
is not indicated at this time.
17. A client diagnosed with angina pectoris complains of chest pain while ambulating in the hallway.
Downloaded by NELSON KIIRU ()
HESI MED SURG EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) ANSWERS) ALREADY GRADED
A 2025
1. In assessing a client diagnosed with primary aldosteronism, the nurse expects the laboratory test
results to indicate a decreased serum level of which substance?
A. Sodium
B. Phosphate
C Potassiu
. m
D. Glucose
Rationale: Clients with primary aldosteronism exhibit a profound decline in serum levels of potassium;
hypokalemia; hypertension is the most prominent and universal sign. The serum sodium level is normal
or elevated, depending on the amount of water resorbed with the sodium. Option B is influenced by
parathyroid hormone (PTH). Option D is not affected by primary aldosteronism.
2. What is the most important nursing priority for a client who has been admitted for a possible
kidney stone?
A. Reducing dairy products in the diet
B. Straining all urine
C. Measuring intake and output
D. Increasing fluid intake
Rationale: Straining all urine is the most important nursing action to take in this case. Encouraging fluid
intake is important for any client who may have a kidney stone, but it is even more important to strain all
urine. Straining urine will enable the nurse to determine when the kidney stone has been passed and may
prevent the need for surgery. Option C is not the highest priority action. Option A is usually not
recommended until the stone is obtained and the content of the stone is determined. Even then, dietary
restrictions are controversial.
3. A client is being discharged following radioactive seed implantation for prostate cancer. What is
the most important information that the nurse should provide to this client’s family?
A. Follow exposure precautions
B. Encourage regular meals
C. Collect all urine
D. Avoid touching the client
Rationale: Clients being treated for prostate cancer with radioactive seed implants should be instructed
regarding the amount of time and distance needed to prevent excessive exposure that would pose a hazard
to others. Option B is a good suggestion to promote adequate nutrition but is not as important as option
A. Option C is unnecessary. Contact with the client is permitted but should be brief to limit radiation
exposure.
4. The nurse is assessing a client who presents with jaundice. Which assessment finding is most
important for the nurse to follow up?
Downloaded by NELSON KIIRU ()
, lOMoARcPSD|26582732
A. Urine specific gravity of 1.03
B. Frothy, tea-colored urine
C. Clay-colored stools
D. Elevated serum amylase and lipase levels
Rationale: Obstructive cholelithiasis and alcoholism are the two major causes of pancreatitis, and
elevated serum amylase and lipase levels indicate pancreatic injury. Option A is a normal finding.
Options B and C are expected findings related to jaundice.
5. The x-ray for the client in the emergency department (ED) reveals a right-sided rib fracture. What
information will the nurse include in the client’s discharge instructions? (Select all that apply.)
A. Splint your right side with your right arm
B. You may have to sleep sitting up for a while
C. Return to the ED if you develop difficulty breathing
D. Use shallow breaths until pain subsides
E. Use 2 L of oxygen by nasal cannula when you have shortness of breath
Rationale: Shallow breaths do not promote adequate oxygenation. The client should splint the area and
breathe as normally as possible to maintain adequate oxygenation. Shortness of breath should not occur
with a rib fracture and is a sign of a pneumothorax. The client will not be sent home with O 2 by nasal
cannula if the only health issue is a fractured rib.
6. The nurse is conducting an osteoporosis screening clinic at a health fair. What information should
the nurse provide to individuals who are at risk for osteoporosis? (Select all that apply.)
A. Encourage alcohol and smoking
cessation
B. Suggest supplementing diet with vitamin E
C. Promote regular weight-bearing exercises
D. Implement a home safety plan to prevent falls
E. Propose a regular sleep pattern of 8 hours nightly
Rationale: Options A, C, and D are factors that decrease the risk for developing osteoporosis. Vitamin D
and calcium are important supplements to aid in the decrease of bone loss. Regular sleep patterns are
important to overall health but are not identified with a decreasing risk for osteoporosis
7. Which consideration is most important when the nurse is assigning a room for a client being
admitted with progressive systemic sclerosis (scleroderma)?
A. Provide a room that can be kept warm
B. Make sure that the room can be kept dark
C. Keep the client close to the nursing unit
D. Select a room that is visible from the nurses’ desk
Rationale: Abnormal blood flow in response to cold (Raynaud phenomenon) is precipitated in clients
with scleroderma. Option B is not a significant factor. Stress can also precipitate the severe pain of
Raynaud phenomenon, so a quiet environment is preferred to option C, which is often very noisy. Option
D is not necessary.
8. Zolpidem tartrate, 1.75 mg PRN at bedtime, is prescribed for rest. The scored tablets are labeled
3.5 mg per tablet. What dose should the nurse plan to administer?____________
0.5
9. A client with cirrhosis develops increasing pedal edema and ascites. Which dietary modification
is most important for the nurse to teach this client?
Downloaded by NELSON KIIRU ()
, lOMoARcPSD|26582732
A. Avoid high-carbohydrate foods
B. Decrease intake of fat-soluble vitamins
C. Decrease caloric intake
D. Restrict salt and fluid intake
Rationale: Salt and fluid restrictions are the first dietary modifications for a client who is retaining fluid
as manifested by edema and ascites. Options A, B, and C will not affect fluid retention.
10. The clinic nurse is providing post-operative teaching for a client scheduled for a myringoplasty.
Which client statements indicate to the nurse that the teaching has been effective? (Select all that
apply.)
A. “I can wash my hair in the shower when I get home.”
B. “I will avoid forceful and deep coughing until my post-op checkup.”
C. “I must lay flat on my non-operative side for the first 12 hours after surgery.”
D. “My hearing may be less or muffles until the packaging comes out.”
E. “I need to only take the first 2 doses of antibiotics and save the rest for another time.”
Rationale: The client must keep the ear bandage clean and dry until the packing is removed. Showering
and hair washing is discouraged. As with all prescriptions for antibiotics, the client must take the full
course of treatment. The remaining client statements do indicate effective teaching.
11. Which content about self-care should the nurse include in the teaching plan of a female client who
has genital herpes? (Select all that apply.)
A. Encourage annual physical and pap smear
B. Take antiviral medication as prescribed
C. Use condoms to avoid transmission to others
D. Warm sitz baths may relieve itching
E. Use Nystatin suppositories to control itching
F. Use a douche with weak vinegar solution to decrease itching.
Rationale: The nurse should include (A, B, C, and D) in the teaching plan of a female client with genital
herpes. (E) is specific for Candida infections, and option (F) is used to treat Trichomonas.
12. An 81-year-old client has emphysema. The client lives at home with a cat and manages self-care
with no difficulty. When making a home visit, the nurse notices that this client’s tongue is
somewhat cracked and his eyeballs appear sunken. Which nursing action is indicated?
A. Help the client determine ways to increase fluid intake
B. Obtain an appointment for the client to have an eye examination
C. Instruct the client to use oxygen at night and increase the humification
D. Schedule the client for the test to determine his sensitivity to cat hair
Rationale: Clients with COPD should ingest 3 L of fluids daily but may experience a fluid deficit
because of shortness of breath. The nurse should suggest creative methods to increase the intake of fluids,
such as having fruit juices in disposable containers readily available. Option B is not indicated.
Humidified oxygen will not effectively treat the client’s fluid deficit, and there is no indication that the
client needs supplemental oxygen at night. These symptoms are not indicative of option D and may
unnecessarily upset the client, who depends on his pet for socialization
13. A client on telemetry has a pattern of uncontrolled atrial fibrillation with a rapid ventricular
response. Based on this finding, the nurse anticipates assisting the physician with which
treatment?
A. Administer lidocaine, 75 mg IV push
B. Perform synchronized cardioversion
Downloaded by NELSON KIIRU ()
, lOMoARcPSD|26582732
C. Defibrillate the client as soon as possible
D. Administer atropine, 0.4 mg IV push
Rationale: With uncontrolled atrial fibrillation, the treatment of choice is synchronized cardioversion to
convert the cardiac rhythm back to normal sinus rhythm. Option A is a medication used for ventricular
dysrhythmias. Option C is not for a client with atrial fibrillation; it is reserved for clients with
lifethreatening dysrhythmias, such as ventricular fibrillation and unstable ventricular tachycardia. Option
D is the drug of choice in symptomatic sinus bradycardia, not atrial fibrillation.
14. A practical nurse (PN) tells the charge nurse in a long-term facility that she does not want to be
assigned to one particular resident. She reports that the male client keeps insisting that she is his
daughter and begs her to stay in his room. What is the best managerial decision?
A. Notify the family that the resident will have to be discharged if his behavior does not
improve.
B. Notify administration of the PN’s insubordination and need for counseling about her
statements.
C. Ask the PN what she has done to encourage the resident to believe that she is his
daughter.
D. Reassign the PN until the resident can be assessed more completely for reality
orientation. Rationale: Temporary reassignment is the best option until the resident can be examined
and his medications reviewed. He may have worsening cerebral dysfunction from an infection or
electrolyte imbalance. Option A is not the best option because the family cannot control the resident’s
actions. The administration may need to know about the situation, but not as a case of
insubordination. Implying that the PN is somehow creating the situation is inappropriate until a
further evaluation has been conducted.
15. Which condition should the nurse anticipate as a potential problem in a female client with a
neurogenic bladder? A. Stress incontinence
B. Infection
C. Painless gross hematuria
D. Peritonitis
Rationale: Infection is the major complication resulting from stasis of urine and subsequent
catheterization. Option A is the involuntary loss of urine through an intact urethra as a result of a sudden
increase in intra-abdominal pressure. Option C is the most common symptom of bladder cancer. Option
D is the most common and serious complication of peritoneal dialysis.
16. The nurse is caring for a client who is one day post-acute myocardial infarction. The client is
receiving oxygen at 2 L/min via nasal cannula and has a peripheral saline lock. The nurse notes
that the client is having eight premature ventricular contractions (pvcs) per minute. Which action
should the nurse take first?
A. Obtain and IV pump for antiarrhythmic infusion
B. Increase the client’s oxygen flow rate
C. Prepare for immediate countershock
D. Gather equipment for endotracheal intubation
Rationale: Increasing the oxygen flow rate provides more oxygen to the client’s myocardium and may
decrease myocardial irritability as manifested by the frequent pvcs. Option A can be delegated and is a
lower priority action than option B. Defibrillation may eventually be necessary, but option C is not the
immediate treatment for frequent pvcs. Option D may become necessary if the client stops breathing but
is not indicated at this time.
17. A client diagnosed with angina pectoris complains of chest pain while ambulating in the hallway.
Downloaded by NELSON KIIRU ()
