HESI MED SURG MARKING SCHEME EXAM 2025/2026
QUESTIONS WITH SOLUTIONS GRADED A+
✔✔A male client with chronic atrial fibrillation and a slow ventricular response is
scheduled for surgical placement of a permanent pacemaker. The client asks the nurse
how this device will help him. How should the nurse explain the action of a synchronous
pacemaker? - ✔✔An electrical stimulus is discharged when no ventricular response is
sensed.
Synchronous - impulse generated on demand or as needed according to patient
intrinsic rhythm
✔✔A man who smokes two packs of cigarettes a day wants to know if smoking is
contributing to the difficulty that he and his wife are having getting pregnant. What
information is best for the nurse to provide? - ✔✔Smoking can decrease quantity and
quality of sperm
The first semen analysis should be repeated to confirm sperm counts
Cessation of smoking improves general health and fertility
✔✔The nurse is providing postoperative instructions for a female client after a
mastectomy. Which information should the nurse include in the teaching plan? -
✔✔Report inflammation of the incision site or affected arm
Avoid lifting more than 4.5 kg (10lb) or reaching above head
✔✔A client in the preoperative holding area receives a prescription for midazolam
(Versed) IV. The nurse determines that the surgical consent form needs to be signed by
the client. Which action should the nurse implement? - ✔✔Withhold the drug until the
client validates understanding of the surgical procedure and signs the consent form.
The HCP should explain procedure to client before arriving to the preoperative area
✔✔A client with acute osteomyelitis has undergone surgical debridement of the
diseased bone and asks the nurse how long will antibiotics have to be administered.
Which information should the nurse communicate? - ✔✔Parenteral antibiotics for 4-8
weeks then oral antibiotics for 4-8 weeks.
✔✔The nurse is preparing an adult client for an upper GI series. Which information
should the nurse include in the teaching plan? - ✔✔Nothing by mouth is allowed for 6-8
hours before the study
✔✔The nurse is caring for a client scheduled to undergo insertion of a percutaneous
endoscopic gastrostomy (PEG) tube. The client asked the nurse to explain how a PEG
tube differs from a gastrostomy tube (GT). Which explanation best describes how they
are different? - ✔✔Method of insertion.
GT - incision in the wall of the abdomen and suturing the tube to the gastric wall.
,PEG - inserted with endoscopic visualization through the esophagus into the stomach
and then pulled through a stab wound in the abdominal wall.
✔✔The HCP prescribes high-protein, high-fat, low-carbohydrate diet with limited fluids
during meals for a client recovering from gastric surgery. The client asks the nurse what
the purpose is for this type of diet. Which rationale should be included in the nurse's
explanation to this client? - ✔✔This type of diet is slowly digested and is slow to leave
the stomach
✔✔The nurse is caring for a client with a small bowel obstruction. The client is vomiting
foul smelling fecal-like material. What action should the nurse implement? - ✔✔Give IV
fluids with electrolytes
✔✔What instruction should the nurse include in the discharge teaching for a client who
needs to perform self-catheterization technique at home? - ✔✔Catheterize every 3-4
hours.
Sterile technique used at hospital but clean technique used at home
✔✔A client's prostate-specific antigen (PSA) exam result showed a PSA density of 0.13
ng/ml. Which conclusion regarding this lab data is accurate? - ✔✔Low risk for prostate
cancer
PSA density <0.15 ng/mL = low risk
✔✔The nurse is caring for a client after transurethral resection of the prostate and
determines the client's urinary catheter is not draining. What should the nurse
implement? - ✔✔Irrigate the catheter because blood clots after TURPs commonly
cause obstruction of urinary flow
✔✔A male client with a prostatic stent is preparing for discharge. What should the nurse
ensure the client understands? - ✔✔The client should not be catheterized through the
stent for at least 3 months
✔✔When teaching a client with breast cancer about the prescribed radiation therapy for
treatment, what information is important to include? - ✔✔Dry, itchy skin changes may
occur
Side effects from breast cancer radiation most often include temporary skin changes:
dryness, tenderness, redness, swelling, pruritis
✔✔The nurse is caring for a client receiving tamoxifen (Nolvadex) for treatment of
breast cancer. Which action should the nurse include in the client's plan of care? -
✔✔Assist client in coping with hot flashes because tamoxifen (estrogen receptor
blocking agent) can cause hot flashes
, ✔✔The nurse is assessing a middle-aged male client for risk factors related to chronic
illness. Which finding should the nurse assess further? - ✔✔Increase in abdominal fat
deposits because this may be indicative of metabolic syndrome which places client at
risk for cardiac disease
✔✔What is the priority nursing action while caring for a client on a ventilator when an
electrical fire occurs in the intensive care unit? - ✔✔Use a bag-valve-mask resuscitator
while removing the client from the area
Unplugging the patient and moving them away from oxygen sources during a fire
promotes client safety
✔✔In planning care for a client with an acute stroke resulting in right-sided hemiplegia,
which positioning should the nurse use to maintain optimal functioning? - ✔✔Left lateral,
supine, brief periods on the right side, and prone
✔✔A client with a recent history of blood in his stools is scheduled for a
proctosigmoidoscopy. The nurse should implement which protocols to prepare the client
for this procedure? - ✔✔Obtain consent
Begin fast the morning of procedure
Administer enema before the procedure
Provide a clear-liquid diet 48 hours before procedure
✔✔The nurse is assessing a client admitted from the emergency room with GI bleeding
related to peptic ulcer disease (PUD). Which physiological factors can produce
ulceration? - ✔✔Vagal stimulation
Decreased duodenal inhibition
Hypersecretion of hydrochloric acid
An increased number of parietal cells
✔✔When caring for a client with percutaneous endoscopic gastrostomy (PEG) tube,
what protocols should the nurse implement for intermittent feedings? - ✔✔Keep HOB 30
degrees
Change enteral-feeding bag every 24 hours
Checking placement of tube by means of gastric aspiration
Flushing tube with 50 mL of normal saline solution after each feeding
✔✔A client with a chronic infection of Hepatitis C virus (HCV) is scheduled for liver
biopsy. Which intervention should the nurse perform after the procedure? - ✔✔Assess
for signs of bleeding and hypovolemia. because internal bleeding is the greatest risk
following liver biopsy
Place client in a right lateral position which would apply pressure at the site
✔✔A nurse is preparing a teaching plan for a client who is post-menopausal. Which
measure is most important for the nurse to include to prevent osteoporosis? -
QUESTIONS WITH SOLUTIONS GRADED A+
✔✔A male client with chronic atrial fibrillation and a slow ventricular response is
scheduled for surgical placement of a permanent pacemaker. The client asks the nurse
how this device will help him. How should the nurse explain the action of a synchronous
pacemaker? - ✔✔An electrical stimulus is discharged when no ventricular response is
sensed.
Synchronous - impulse generated on demand or as needed according to patient
intrinsic rhythm
✔✔A man who smokes two packs of cigarettes a day wants to know if smoking is
contributing to the difficulty that he and his wife are having getting pregnant. What
information is best for the nurse to provide? - ✔✔Smoking can decrease quantity and
quality of sperm
The first semen analysis should be repeated to confirm sperm counts
Cessation of smoking improves general health and fertility
✔✔The nurse is providing postoperative instructions for a female client after a
mastectomy. Which information should the nurse include in the teaching plan? -
✔✔Report inflammation of the incision site or affected arm
Avoid lifting more than 4.5 kg (10lb) or reaching above head
✔✔A client in the preoperative holding area receives a prescription for midazolam
(Versed) IV. The nurse determines that the surgical consent form needs to be signed by
the client. Which action should the nurse implement? - ✔✔Withhold the drug until the
client validates understanding of the surgical procedure and signs the consent form.
The HCP should explain procedure to client before arriving to the preoperative area
✔✔A client with acute osteomyelitis has undergone surgical debridement of the
diseased bone and asks the nurse how long will antibiotics have to be administered.
Which information should the nurse communicate? - ✔✔Parenteral antibiotics for 4-8
weeks then oral antibiotics for 4-8 weeks.
✔✔The nurse is preparing an adult client for an upper GI series. Which information
should the nurse include in the teaching plan? - ✔✔Nothing by mouth is allowed for 6-8
hours before the study
✔✔The nurse is caring for a client scheduled to undergo insertion of a percutaneous
endoscopic gastrostomy (PEG) tube. The client asked the nurse to explain how a PEG
tube differs from a gastrostomy tube (GT). Which explanation best describes how they
are different? - ✔✔Method of insertion.
GT - incision in the wall of the abdomen and suturing the tube to the gastric wall.
,PEG - inserted with endoscopic visualization through the esophagus into the stomach
and then pulled through a stab wound in the abdominal wall.
✔✔The HCP prescribes high-protein, high-fat, low-carbohydrate diet with limited fluids
during meals for a client recovering from gastric surgery. The client asks the nurse what
the purpose is for this type of diet. Which rationale should be included in the nurse's
explanation to this client? - ✔✔This type of diet is slowly digested and is slow to leave
the stomach
✔✔The nurse is caring for a client with a small bowel obstruction. The client is vomiting
foul smelling fecal-like material. What action should the nurse implement? - ✔✔Give IV
fluids with electrolytes
✔✔What instruction should the nurse include in the discharge teaching for a client who
needs to perform self-catheterization technique at home? - ✔✔Catheterize every 3-4
hours.
Sterile technique used at hospital but clean technique used at home
✔✔A client's prostate-specific antigen (PSA) exam result showed a PSA density of 0.13
ng/ml. Which conclusion regarding this lab data is accurate? - ✔✔Low risk for prostate
cancer
PSA density <0.15 ng/mL = low risk
✔✔The nurse is caring for a client after transurethral resection of the prostate and
determines the client's urinary catheter is not draining. What should the nurse
implement? - ✔✔Irrigate the catheter because blood clots after TURPs commonly
cause obstruction of urinary flow
✔✔A male client with a prostatic stent is preparing for discharge. What should the nurse
ensure the client understands? - ✔✔The client should not be catheterized through the
stent for at least 3 months
✔✔When teaching a client with breast cancer about the prescribed radiation therapy for
treatment, what information is important to include? - ✔✔Dry, itchy skin changes may
occur
Side effects from breast cancer radiation most often include temporary skin changes:
dryness, tenderness, redness, swelling, pruritis
✔✔The nurse is caring for a client receiving tamoxifen (Nolvadex) for treatment of
breast cancer. Which action should the nurse include in the client's plan of care? -
✔✔Assist client in coping with hot flashes because tamoxifen (estrogen receptor
blocking agent) can cause hot flashes
, ✔✔The nurse is assessing a middle-aged male client for risk factors related to chronic
illness. Which finding should the nurse assess further? - ✔✔Increase in abdominal fat
deposits because this may be indicative of metabolic syndrome which places client at
risk for cardiac disease
✔✔What is the priority nursing action while caring for a client on a ventilator when an
electrical fire occurs in the intensive care unit? - ✔✔Use a bag-valve-mask resuscitator
while removing the client from the area
Unplugging the patient and moving them away from oxygen sources during a fire
promotes client safety
✔✔In planning care for a client with an acute stroke resulting in right-sided hemiplegia,
which positioning should the nurse use to maintain optimal functioning? - ✔✔Left lateral,
supine, brief periods on the right side, and prone
✔✔A client with a recent history of blood in his stools is scheduled for a
proctosigmoidoscopy. The nurse should implement which protocols to prepare the client
for this procedure? - ✔✔Obtain consent
Begin fast the morning of procedure
Administer enema before the procedure
Provide a clear-liquid diet 48 hours before procedure
✔✔The nurse is assessing a client admitted from the emergency room with GI bleeding
related to peptic ulcer disease (PUD). Which physiological factors can produce
ulceration? - ✔✔Vagal stimulation
Decreased duodenal inhibition
Hypersecretion of hydrochloric acid
An increased number of parietal cells
✔✔When caring for a client with percutaneous endoscopic gastrostomy (PEG) tube,
what protocols should the nurse implement for intermittent feedings? - ✔✔Keep HOB 30
degrees
Change enteral-feeding bag every 24 hours
Checking placement of tube by means of gastric aspiration
Flushing tube with 50 mL of normal saline solution after each feeding
✔✔A client with a chronic infection of Hepatitis C virus (HCV) is scheduled for liver
biopsy. Which intervention should the nurse perform after the procedure? - ✔✔Assess
for signs of bleeding and hypovolemia. because internal bleeding is the greatest risk
following liver biopsy
Place client in a right lateral position which would apply pressure at the site
✔✔A nurse is preparing a teaching plan for a client who is post-menopausal. Which
measure is most important for the nurse to include to prevent osteoporosis? -
