Med-Surg Hesi PN
Med-Surg Hesi PN Exam Study Guide
Questions and Answers 2025
During a clinic visit, a client reports to the practical nurse (PN) that they felt a solid mass
in their breast during self-examination, but it was not painful. What instruction should the
PN reinforce with the client?
A. Continue to monitor the mass until the next scheduled annual exam.
B. Notify the PCP if the mass becomes soft or painful or starts to drain.
C. Schedule an appointment with the PCP for evaluation
D. Breast masses are usually insignificant if they feel soft or are easily moveable. -
Correct Ans-c. Schedule an appointment with the health care provider for evaluation.
A painless breast mass is an abnormal finding, and the PN should instruct the client to
obtain prompt medical evaluation.
The health care provider informed a client diagnosed with stage 4 liver cancer that the
cancer has spread to their spine. The client states to the practical nurse, "I have a
cancer, but it is not malignant." What is the best initial nursing action?
A. Encourage the client to attend a cancer education program
B. Perform a complete history and physical assessment
C. Ask the client to explain his understanding of the term malignancy.
D. Offer the client emotional support to deal with the diagnosis
Submit - Correct Ans-c. Ask the client to explain his understanding of the term
malignancy.
The best initial action is to assess the client's knowledge of the term malignancy when
used to describe cancer. The client appears to have inaccurate knowledge. Stage 4
cancer means the cancer has spread (metastasized) from where it has started to
another body part.
A client diagnosed with osteoarthritis. Which intervention should the practical nurse
implement to help relieve joint pain and stiffness?
a. Encourage the client to perform weight-bearing exercises.
b. Teach the client how to perform range-of-motion exercises.
c. Explain the use of ice and massage for pain relief.
d. Instruct the client to take an analgesic before walking daily - Correct Ans-d. Instruct
the client to take an analgesic before walking daily.
Adequate pain management is important for the success of an exercise program.
Keeping the joints active decreases pain, so taking an analgesic and walking daily is
likely to help decrease joint pain and stiffness.
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,Med-Surg Hesi PN
A client diagnosed with prostate cancer is prescribed radioactive seed implantation
(brachytherapy). What is the most important nursing action for the practical nurse (PN)
to do?
a. Follow radiation exposure precautions
b. Encourage regular meals
c. Collect all urine in sealed containers
d. Avoid touching the client. - Correct Ans-a. Follow radiation exposure precautions.
Clients being treated for prostate cancer with brachytherapy (radioactive seeds implant)
should be placed on radiation exposure precautions. The PN needs to follow the
institution's protocols put in place regarding the amount of time and distance needed to
prevent excessive exposure that would pose a hazard to others.
A client diagnosed with emphysema that is oxygen-dependent lives alone at home and
manages self-care with no difficulty. Which finding should prompt the home health
practical nurse to consult the registered nurse case manager?
a. A pulse oximetry reading of 91% on oxygen at 2 L/m
b. A weight loss of 5 pounds since the last monthly home visit
c. The client reports feeling as tired as at the last visit by the nurse
d. Upon entering the home, the PN noticed dirty dishes and clothing scattered around
the home. - Correct Ans-b. A weight loss of 5 pounds since the last monthly home visit
A weight loss of 5 pounds in 1 month is a concern. Clients with COPD need additional
calorie intake because they are using up a lot from the energy they are using to breath.
The practical nurse needs to consult with the registered nurse case manager for a
nutrition consult
The nurse has reinforced instructions to a client with diabetes mellitus on how to self-
monitor for symptoms of diabetic ketoacidosis (DKA). The nurse realizes the
instructions have been effective if the client can list which symptoms? (Select all that
apply.)
a. Fruity breath odor
b. Rapid, weak pulse
c. Cold, clammy skin
d. Extreme thirst
e. Urinary frequency
f. Protruding eyeballs - Correct Ans-a. Fruity breath odor
b. Rapid, weak pulse
d. Extreme thirst
e. Urinary frequency
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,Med-Surg Hesi PN
Diabetic ketoacidosis is caused by a profound deficiency of insulin. Some common
characteristics include a sweet, fruity breath odor, a rapid weak pulse, extreme thirst,
urinary frequency, and sunken-appearing eyeballs.
A client mentions using garlic daily as an herb to lower cholesterol and triglyceride
levels. Which nursing action is a priority?
a. Monitor the client for signs of bleeding.
b. Instruct the client that garlic tends to cause hypertension.
c. This may relieve fever in the same way that acetaminophen does.
d. Remind the patient to use tooth brushing and mouthwash to prevent garlic odor. -
Correct Ans-a. Monitor the client for signs of bleeding.
Garlic inhibits platelet aggregation in the same way that aspirin works, and the client
should be monitored for bleeding. Garlic can lower the blood pressure, not raise it. It
does not relieve fever. While the client will likely want to avoid garlic odor, it is not a
priority.
The practical nurse (PN) is reviewing the health histories of assigned clients. Which
factors have a potential for development of throat cancer? (Select all that apply.)
a. Tobacco use
b. Excessive intake of alcohol
c. Intake of hot and spicy foods
d. Human papillomavirus (HPV)
e. Lack of exercise
f. Lack of dietary fiber - Correct Ans-a. Tobacco use
b. Excessive intake of alcohol
d. Human papillomavirus (HPV)
Rationale:
The most common risk factors for throat cancer are tobacco use, alcohol abuse, human
papillomavirus (HPV), a diet lacking in fruits and vegetable, and gastroesophageal
reflux disease (GERD). Foods seasoned with herbs and spices have shown to have
some health benefits in decreasing the risk of developing cancer.
A client has undergone craniotomy to remove a brain tumor. The client spent several
days in the intensive care unit, and is now on the post-surgical unit. The nurse has
urgently contact the surgeon to report signs of increasing intracranial pressure (ICP).
Which was the most likely EARLY sign that the client was experiencing increased ICP?
a. The client's blood pressure dropped from 128/70 to 124/68, preoperative BP 122/72
b. The client became more confused than he was upon transfer to the post-surgical unit.
c. The client had a large amount of sanguineous drainage noted on the gauze
dressings.
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, Med-Surg Hesi PN
d. The client's pulse rate had increased from 70 to 82 beats/min. - Correct Ans-b. The
client became more confused than he was upon transfer to the post-surgical unit.
Rationale:
A change in the level of consciousness is most likely the earliest symptom of increased
ICP. Vital sign changes can also occur, with a widening pulse pressure and
bradycardia. Neither of these are indicated by data in the options. Sanguineous
drainage does not indicate increased ICP.
The home health practical nurse is visiting with a client who has a history of second-
degree heart block and pacemaker placement 6 months ago. Which symptom compliant
by the client would be indicative of pacemaker failure?
a. Facial flushing
b. Nausea
c. Pounding headache
d. Feelings of dizziness - Correct Ans-d. Feelings of dizziness
Rationale:
Feelings of dizziness may occur as the result of a decreased heart rate, leading to
decreased cardiac output as a result of pacemaker failure.
Which actions demonstrate to the practical nurse that the client understands the correct
procedure administration of a metered dose inhaler (MDI)? (Select all that apply.)
a. Sit or stand.
b. Shake the inhaler.
c. Attach the canister of medication to the mouthpiece.
d. Breathe in through the mouth, filling the lungs.
e. Use a spacer attachment and place the mouthpiece in the mouth.
f. Close the lips around the mouthpiece.
g. After inhaling the medication, hold the breath 10 seconds. - Correct Ans-b. Shake the
inhaler.
c. Attach the canister of medication to the mouthpiece.
e. Use a spacer attachment and place the mouthpiece in the mouth.
f. Close the lips around the mouthpiece.
g. After inhaling the medication, hold the breath 10 seconds.
Rationale:
The correct sequence of MDI administration includes shaking the inhaler, attaching the
canister to the mouthpiece, attaching the spacer, the client should then let their breath
out through the mouth to empty the lungs and place the mouthpiece in the mouth,
closing the lips and mouth around the mouthpiece, and inhaling medication and holding
the breath for 10 seconds.
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Med-Surg Hesi PN Exam Study Guide
Questions and Answers 2025
During a clinic visit, a client reports to the practical nurse (PN) that they felt a solid mass
in their breast during self-examination, but it was not painful. What instruction should the
PN reinforce with the client?
A. Continue to monitor the mass until the next scheduled annual exam.
B. Notify the PCP if the mass becomes soft or painful or starts to drain.
C. Schedule an appointment with the PCP for evaluation
D. Breast masses are usually insignificant if they feel soft or are easily moveable. -
Correct Ans-c. Schedule an appointment with the health care provider for evaluation.
A painless breast mass is an abnormal finding, and the PN should instruct the client to
obtain prompt medical evaluation.
The health care provider informed a client diagnosed with stage 4 liver cancer that the
cancer has spread to their spine. The client states to the practical nurse, "I have a
cancer, but it is not malignant." What is the best initial nursing action?
A. Encourage the client to attend a cancer education program
B. Perform a complete history and physical assessment
C. Ask the client to explain his understanding of the term malignancy.
D. Offer the client emotional support to deal with the diagnosis
Submit - Correct Ans-c. Ask the client to explain his understanding of the term
malignancy.
The best initial action is to assess the client's knowledge of the term malignancy when
used to describe cancer. The client appears to have inaccurate knowledge. Stage 4
cancer means the cancer has spread (metastasized) from where it has started to
another body part.
A client diagnosed with osteoarthritis. Which intervention should the practical nurse
implement to help relieve joint pain and stiffness?
a. Encourage the client to perform weight-bearing exercises.
b. Teach the client how to perform range-of-motion exercises.
c. Explain the use of ice and massage for pain relief.
d. Instruct the client to take an analgesic before walking daily - Correct Ans-d. Instruct
the client to take an analgesic before walking daily.
Adequate pain management is important for the success of an exercise program.
Keeping the joints active decreases pain, so taking an analgesic and walking daily is
likely to help decrease joint pain and stiffness.
1|Page
,Med-Surg Hesi PN
A client diagnosed with prostate cancer is prescribed radioactive seed implantation
(brachytherapy). What is the most important nursing action for the practical nurse (PN)
to do?
a. Follow radiation exposure precautions
b. Encourage regular meals
c. Collect all urine in sealed containers
d. Avoid touching the client. - Correct Ans-a. Follow radiation exposure precautions.
Clients being treated for prostate cancer with brachytherapy (radioactive seeds implant)
should be placed on radiation exposure precautions. The PN needs to follow the
institution's protocols put in place regarding the amount of time and distance needed to
prevent excessive exposure that would pose a hazard to others.
A client diagnosed with emphysema that is oxygen-dependent lives alone at home and
manages self-care with no difficulty. Which finding should prompt the home health
practical nurse to consult the registered nurse case manager?
a. A pulse oximetry reading of 91% on oxygen at 2 L/m
b. A weight loss of 5 pounds since the last monthly home visit
c. The client reports feeling as tired as at the last visit by the nurse
d. Upon entering the home, the PN noticed dirty dishes and clothing scattered around
the home. - Correct Ans-b. A weight loss of 5 pounds since the last monthly home visit
A weight loss of 5 pounds in 1 month is a concern. Clients with COPD need additional
calorie intake because they are using up a lot from the energy they are using to breath.
The practical nurse needs to consult with the registered nurse case manager for a
nutrition consult
The nurse has reinforced instructions to a client with diabetes mellitus on how to self-
monitor for symptoms of diabetic ketoacidosis (DKA). The nurse realizes the
instructions have been effective if the client can list which symptoms? (Select all that
apply.)
a. Fruity breath odor
b. Rapid, weak pulse
c. Cold, clammy skin
d. Extreme thirst
e. Urinary frequency
f. Protruding eyeballs - Correct Ans-a. Fruity breath odor
b. Rapid, weak pulse
d. Extreme thirst
e. Urinary frequency
2|Page
,Med-Surg Hesi PN
Diabetic ketoacidosis is caused by a profound deficiency of insulin. Some common
characteristics include a sweet, fruity breath odor, a rapid weak pulse, extreme thirst,
urinary frequency, and sunken-appearing eyeballs.
A client mentions using garlic daily as an herb to lower cholesterol and triglyceride
levels. Which nursing action is a priority?
a. Monitor the client for signs of bleeding.
b. Instruct the client that garlic tends to cause hypertension.
c. This may relieve fever in the same way that acetaminophen does.
d. Remind the patient to use tooth brushing and mouthwash to prevent garlic odor. -
Correct Ans-a. Monitor the client for signs of bleeding.
Garlic inhibits platelet aggregation in the same way that aspirin works, and the client
should be monitored for bleeding. Garlic can lower the blood pressure, not raise it. It
does not relieve fever. While the client will likely want to avoid garlic odor, it is not a
priority.
The practical nurse (PN) is reviewing the health histories of assigned clients. Which
factors have a potential for development of throat cancer? (Select all that apply.)
a. Tobacco use
b. Excessive intake of alcohol
c. Intake of hot and spicy foods
d. Human papillomavirus (HPV)
e. Lack of exercise
f. Lack of dietary fiber - Correct Ans-a. Tobacco use
b. Excessive intake of alcohol
d. Human papillomavirus (HPV)
Rationale:
The most common risk factors for throat cancer are tobacco use, alcohol abuse, human
papillomavirus (HPV), a diet lacking in fruits and vegetable, and gastroesophageal
reflux disease (GERD). Foods seasoned with herbs and spices have shown to have
some health benefits in decreasing the risk of developing cancer.
A client has undergone craniotomy to remove a brain tumor. The client spent several
days in the intensive care unit, and is now on the post-surgical unit. The nurse has
urgently contact the surgeon to report signs of increasing intracranial pressure (ICP).
Which was the most likely EARLY sign that the client was experiencing increased ICP?
a. The client's blood pressure dropped from 128/70 to 124/68, preoperative BP 122/72
b. The client became more confused than he was upon transfer to the post-surgical unit.
c. The client had a large amount of sanguineous drainage noted on the gauze
dressings.
3|Page
, Med-Surg Hesi PN
d. The client's pulse rate had increased from 70 to 82 beats/min. - Correct Ans-b. The
client became more confused than he was upon transfer to the post-surgical unit.
Rationale:
A change in the level of consciousness is most likely the earliest symptom of increased
ICP. Vital sign changes can also occur, with a widening pulse pressure and
bradycardia. Neither of these are indicated by data in the options. Sanguineous
drainage does not indicate increased ICP.
The home health practical nurse is visiting with a client who has a history of second-
degree heart block and pacemaker placement 6 months ago. Which symptom compliant
by the client would be indicative of pacemaker failure?
a. Facial flushing
b. Nausea
c. Pounding headache
d. Feelings of dizziness - Correct Ans-d. Feelings of dizziness
Rationale:
Feelings of dizziness may occur as the result of a decreased heart rate, leading to
decreased cardiac output as a result of pacemaker failure.
Which actions demonstrate to the practical nurse that the client understands the correct
procedure administration of a metered dose inhaler (MDI)? (Select all that apply.)
a. Sit or stand.
b. Shake the inhaler.
c. Attach the canister of medication to the mouthpiece.
d. Breathe in through the mouth, filling the lungs.
e. Use a spacer attachment and place the mouthpiece in the mouth.
f. Close the lips around the mouthpiece.
g. After inhaling the medication, hold the breath 10 seconds. - Correct Ans-b. Shake the
inhaler.
c. Attach the canister of medication to the mouthpiece.
e. Use a spacer attachment and place the mouthpiece in the mouth.
f. Close the lips around the mouthpiece.
g. After inhaling the medication, hold the breath 10 seconds.
Rationale:
The correct sequence of MDI administration includes shaking the inhaler, attaching the
canister to the mouthpiece, attaching the spacer, the client should then let their breath
out through the mouth to empty the lungs and place the mouthpiece in the mouth,
closing the lips and mouth around the mouthpiece, and inhaling medication and holding
the breath for 10 seconds.
4|Page
