HESI-Style Medical-Surgical Nursing NCLEX-RN® Test
Bank | 2025 Edition | Based on “HESI Comprehensive
Review for the NCLEX-RN® Examination,” 6th Edition
(ISBN: 9780323582451) by Elsevier, 2023 | NCLEX & HESI
Exit Exam Questions with Answers, Rationales, and
Updated Clinical Focus.
,
,. A client with a colostomy says, “I feel like my body is no longer mine.” What is the best
response?
A. “You’ll adjust soon.”
B. “That’s a normal part of recovery.”
C. “Tell me more about how you’re feeling.”
D. “Many patients feel the same way.”
-Answer-: C
Rationale: Encouraging expression promotes psychosocial healing.
Tag: Psychosocial → Body Image Disturbance
. Which finding in a client with diabetes insipidus requires immediate intervention?
A. Urine output 2,000 mL in 4 hours
B. Serum sodium 150 mEq/L
C. Thirst and dry mucous membranes
D. Hypotension and tachycardia
-Answer-: D
Rationale: Fluid volume deficit leads to hypovolemic shock; priority.
Tag: Endocrine → Diabetes Insipidus
. A nurse is caring for a client in diabetic ketoacidosis (DKA). Which insulin route is used
initially?
A. Oral
B. Subcutaneous
C. Intramuscular
D. Intravenous
-Answer-: D
Rationale: IV insulin is used for rapid correction of hyperglycemia in DKA.
Tag: Endocrine → DKA Treatment
. A client with hypothyroidism is started on levothyroxine. Which finding indicates
overdose?
A. Bradycardia and constipation
B. Weight gain and fatigue
C. Palpitations and anxiety
, D. Cold intolerance
-Answer-: C
Rationale: Overdose mimics hyperthyroid symptoms.
Tag: Endocrine → Thyroid Disorders
Which symptom is expected in Addison’s disease?
A. Hyperpigmented skin
B. Hypertension
C. Facial puffiness
D. Weight gain
-Answer-: A
Rationale: Melanin stimulation from ↑ ACTH causes bronze pigmentation.
Tag: Endocrine → Adrenal Disorders
Which finding is most concerning in a client with hyperparathyroidism?
A. Serum calcium 11.5 mg/dL
B. Decreased DTRs
C. Bone pain
D. Positive Chvostek’s sign
-Answer-: D
Rationale: Chvostek’s sign indicates hypocalcemia, which is not expected in
hyperparathyroidism—suggests complications.
Tag: Endocrine → Calcium Balance
3. A nurse is reviewing blood glucose logs. Which pattern suggests the Somogyi effect?
A. Morning hyperglycemia after overnight hypoglycemia
B. High fasting glucose and bedtime glucose
C. Morning hypoglycemia with tremors
D. Evening hypoglycemia after dinner
-Answer-: A
Rationale: Somogyi effect is rebound hyperglycemia following nocturnal hypoglycemia.
Tag: Endocrine → Diabetes Patterns
Bank | 2025 Edition | Based on “HESI Comprehensive
Review for the NCLEX-RN® Examination,” 6th Edition
(ISBN: 9780323582451) by Elsevier, 2023 | NCLEX & HESI
Exit Exam Questions with Answers, Rationales, and
Updated Clinical Focus.
,
,. A client with a colostomy says, “I feel like my body is no longer mine.” What is the best
response?
A. “You’ll adjust soon.”
B. “That’s a normal part of recovery.”
C. “Tell me more about how you’re feeling.”
D. “Many patients feel the same way.”
-Answer-: C
Rationale: Encouraging expression promotes psychosocial healing.
Tag: Psychosocial → Body Image Disturbance
. Which finding in a client with diabetes insipidus requires immediate intervention?
A. Urine output 2,000 mL in 4 hours
B. Serum sodium 150 mEq/L
C. Thirst and dry mucous membranes
D. Hypotension and tachycardia
-Answer-: D
Rationale: Fluid volume deficit leads to hypovolemic shock; priority.
Tag: Endocrine → Diabetes Insipidus
. A nurse is caring for a client in diabetic ketoacidosis (DKA). Which insulin route is used
initially?
A. Oral
B. Subcutaneous
C. Intramuscular
D. Intravenous
-Answer-: D
Rationale: IV insulin is used for rapid correction of hyperglycemia in DKA.
Tag: Endocrine → DKA Treatment
. A client with hypothyroidism is started on levothyroxine. Which finding indicates
overdose?
A. Bradycardia and constipation
B. Weight gain and fatigue
C. Palpitations and anxiety
, D. Cold intolerance
-Answer-: C
Rationale: Overdose mimics hyperthyroid symptoms.
Tag: Endocrine → Thyroid Disorders
Which symptom is expected in Addison’s disease?
A. Hyperpigmented skin
B. Hypertension
C. Facial puffiness
D. Weight gain
-Answer-: A
Rationale: Melanin stimulation from ↑ ACTH causes bronze pigmentation.
Tag: Endocrine → Adrenal Disorders
Which finding is most concerning in a client with hyperparathyroidism?
A. Serum calcium 11.5 mg/dL
B. Decreased DTRs
C. Bone pain
D. Positive Chvostek’s sign
-Answer-: D
Rationale: Chvostek’s sign indicates hypocalcemia, which is not expected in
hyperparathyroidism—suggests complications.
Tag: Endocrine → Calcium Balance
3. A nurse is reviewing blood glucose logs. Which pattern suggests the Somogyi effect?
A. Morning hyperglycemia after overnight hypoglycemia
B. High fasting glucose and bedtime glucose
C. Morning hypoglycemia with tremors
D. Evening hypoglycemia after dinner
-Answer-: A
Rationale: Somogyi effect is rebound hyperglycemia following nocturnal hypoglycemia.
Tag: Endocrine → Diabetes Patterns
