ESTUDYR
MED SURG I FINAL HESI UPDATED EXAM WITH MOST TESTED QUESTIONS AND
ANSWERS | GRADED A+ | ASSURED SUCCESS WITH DETAILED RATIONALES
⃣ A client with a productive cough has obtained a sputum specimen for culture as instructed. What
is the best initial nursing action?
A) Administer the first dose of antibiotic therapy
B) ✅Observe the color, consistency, and amount of sputum
C) Encourage the client to consume plenty of warm liquids
D) Send the specimen to the lab for analysis
Rationale: Observing the sputum provides essential assessment data about infection or other lung
problems before lab analysis or therapy.
⃣ A client is brought to the ED in cardiac arrest with CPR in progress. The client is cyanotic, cold, and
diaphoretic. Which assessment is most important for the nurse to obtain?
A) ✅Breath sounds over bilateral lung fields
B) Carotid pulsation during compressions
C) Deep tendon reflexes
D) Core body temperature
Rationale: Checking for breath sounds ensures proper placement of the endotracheal tube and effective
ventilation.
⃣ After hospitalization for SIADH, a client develops pontine myelinolysis. Which intervention should
the nurse implement first?
A) ✅Reorient client to his room
B) Place a patch on one eye
C) Evaluate client's ability to swallow
D) Perform range of motion exercises
Rationale: Pontine myelinolysis can lead to confusion; reorientation addresses immediate safety and
awareness needs.
⃣ A male client with HF reports his shoes feel too tight to wear. Which additional information should
the nurse obtain?
,ESTUDYR
A) What time did he take his last medications?
B) ✅Has his weight changed in the last several days?
C) Is he still able to tighten his belt buckle?
D) How many hours did he sleep last night?
Rationale: Sudden weight gain and edema are key indicators of HF worsening.
⃣ An older woman with COPD is admitted with SOB and a persistent cough. She is anxious with dry
mouth. Which intervention should the nurse implement?
A) Administer a prescribed sedative
B) Encourage client to drink water
C) Apply a high-flow venturi mask
D) ✅Assist her to an upright position
Rationale: Upright positioning optimizes lung expansion and oxygenation.
⃣ A client with asthma and bronchitis has SOB, thick mucus, and exertional breathlessness. Which
self-care instruction is most important?
A) ✅Increase daily intake of oral fluids to liquefy secretions
B) Avoid crowded enclosed areas
C) Call the clinic if medication side effects occur
D) Teach anxiety reduction methods
Rationale: Hydration thins mucus, aiding in its clearance and improving breathing.
⃣ A cardiac cath reveals: 95% LAD, 99% circumflex, and ?% RCA blockages. The client asks what it
means. What should the nurse say?
A) Blood supply to the heart is diminished, requiring lifestyle changes
B) Blockages indicate a past heart attack
C) ✅Three main arteries have major blockages, with only 1–5% of blood flow getting through to the
heart muscle
D) The heart is not receiving enough blood, so there's risk of heart failure
Rationale: This response accurately explains the critical level of blockage.
,ESTUDYR
⃣ A 175-lb client is prescribed 80 units/kg IV heparin. Heparin is 10,000 units/ml. How many ml
should the nurse administer?
✅Answer: 0.6 ml
Rationale: Calculation: 175 ÷ 2.2 = 79.5 kg → 79.5 × 80 = 6,360 units → 6,360 ÷ 10,000 = 0.6 ml.
⃣ What information should the nurse include for a client with GERD?
A) Sleep without pillows at night
B) Adjust to three full meals/day
C) ✅Minimize symptoms by wearing loose, comfortable clothing
D) Avoid aerobic exercise
Rationale: Tight clothing increases intra-abdominal pressure, worsening GERD.
�The nurse is caring for a client with a left lower lobe pulmonary abscess. Which position is best?
A) ✅Left lateral
B) Supine, knees flexed
C) Dorsal recumbent
D) Knee-chest
Rationale: Left lateral allows drainage of secretions from the affected lung.
⃣ ⃣ A client with gallstones becomes nauseated and vomits after eating. Which finding should the
nurse report?
A) Belching
B) Amber urine
C) ✅Yellow sclera
D) Flatulence
Rationale: Jaundice (yellow sclera) indicates bile duct obstruction.
⃣ ⃣ While caring for an ALS client, which finding warrants immediate action?
A) Inappropriate laughter
B) Increasing anxiety
, ESTUDYR
C) ✅Weakened cough effort
D) Asymmetrical weakness
Rationale: Weakened cough can lead to respiratory failure, which is life-threatening.
⃣ ⃣ A Jewish client is scheduled for a xenograft. Which statement should the nurse include?
A) Grafting increases infection risk
B) ✅The xenograft is taken from nonhuman sources
C) Grafts are later removed
D) Graft permanently attaches
Rationale: Xenografts come from animals (often pig skin), which may raise religious concerns.
⃣ ⃣ A postoperative male client’s wound eviscerates while repositioning. What should the nurse do
next after moistening sterile dressing?
A) Bring more sterile supplies
B) ✅Prepare the client to return to the operating room
C) Obtain a sample of drainage
D) Auscultate bowel sounds
Rationale: Evisceration is a surgical emergency.
⃣ ⃣ A lung cancer client has serum sodium of 117 mEq/L. Which nursing problem should the nurse
prioritize?
A) Altered urinary elimination
B) Impaired gas exchange
C) ✅Fluid volume excess
D) Decreased cardiac output
Rationale: SIADH associated with lung cancer leads to hyponatremia and fluid retention.
⃣ ⃣ A nurse is assessing a client with suspected deep vein thrombosis (DVT). Which finding requires
immediate intervention?
A) Unilateral leg swelling and pain
B) Mild calf tenderness when walking
C) ✅Sudden shortness of breath and chest pain
D) Warmth and redness over the calf muscle
MED SURG I FINAL HESI UPDATED EXAM WITH MOST TESTED QUESTIONS AND
ANSWERS | GRADED A+ | ASSURED SUCCESS WITH DETAILED RATIONALES
⃣ A client with a productive cough has obtained a sputum specimen for culture as instructed. What
is the best initial nursing action?
A) Administer the first dose of antibiotic therapy
B) ✅Observe the color, consistency, and amount of sputum
C) Encourage the client to consume plenty of warm liquids
D) Send the specimen to the lab for analysis
Rationale: Observing the sputum provides essential assessment data about infection or other lung
problems before lab analysis or therapy.
⃣ A client is brought to the ED in cardiac arrest with CPR in progress. The client is cyanotic, cold, and
diaphoretic. Which assessment is most important for the nurse to obtain?
A) ✅Breath sounds over bilateral lung fields
B) Carotid pulsation during compressions
C) Deep tendon reflexes
D) Core body temperature
Rationale: Checking for breath sounds ensures proper placement of the endotracheal tube and effective
ventilation.
⃣ After hospitalization for SIADH, a client develops pontine myelinolysis. Which intervention should
the nurse implement first?
A) ✅Reorient client to his room
B) Place a patch on one eye
C) Evaluate client's ability to swallow
D) Perform range of motion exercises
Rationale: Pontine myelinolysis can lead to confusion; reorientation addresses immediate safety and
awareness needs.
⃣ A male client with HF reports his shoes feel too tight to wear. Which additional information should
the nurse obtain?
,ESTUDYR
A) What time did he take his last medications?
B) ✅Has his weight changed in the last several days?
C) Is he still able to tighten his belt buckle?
D) How many hours did he sleep last night?
Rationale: Sudden weight gain and edema are key indicators of HF worsening.
⃣ An older woman with COPD is admitted with SOB and a persistent cough. She is anxious with dry
mouth. Which intervention should the nurse implement?
A) Administer a prescribed sedative
B) Encourage client to drink water
C) Apply a high-flow venturi mask
D) ✅Assist her to an upright position
Rationale: Upright positioning optimizes lung expansion and oxygenation.
⃣ A client with asthma and bronchitis has SOB, thick mucus, and exertional breathlessness. Which
self-care instruction is most important?
A) ✅Increase daily intake of oral fluids to liquefy secretions
B) Avoid crowded enclosed areas
C) Call the clinic if medication side effects occur
D) Teach anxiety reduction methods
Rationale: Hydration thins mucus, aiding in its clearance and improving breathing.
⃣ A cardiac cath reveals: 95% LAD, 99% circumflex, and ?% RCA blockages. The client asks what it
means. What should the nurse say?
A) Blood supply to the heart is diminished, requiring lifestyle changes
B) Blockages indicate a past heart attack
C) ✅Three main arteries have major blockages, with only 1–5% of blood flow getting through to the
heart muscle
D) The heart is not receiving enough blood, so there's risk of heart failure
Rationale: This response accurately explains the critical level of blockage.
,ESTUDYR
⃣ A 175-lb client is prescribed 80 units/kg IV heparin. Heparin is 10,000 units/ml. How many ml
should the nurse administer?
✅Answer: 0.6 ml
Rationale: Calculation: 175 ÷ 2.2 = 79.5 kg → 79.5 × 80 = 6,360 units → 6,360 ÷ 10,000 = 0.6 ml.
⃣ What information should the nurse include for a client with GERD?
A) Sleep without pillows at night
B) Adjust to three full meals/day
C) ✅Minimize symptoms by wearing loose, comfortable clothing
D) Avoid aerobic exercise
Rationale: Tight clothing increases intra-abdominal pressure, worsening GERD.
�The nurse is caring for a client with a left lower lobe pulmonary abscess. Which position is best?
A) ✅Left lateral
B) Supine, knees flexed
C) Dorsal recumbent
D) Knee-chest
Rationale: Left lateral allows drainage of secretions from the affected lung.
⃣ ⃣ A client with gallstones becomes nauseated and vomits after eating. Which finding should the
nurse report?
A) Belching
B) Amber urine
C) ✅Yellow sclera
D) Flatulence
Rationale: Jaundice (yellow sclera) indicates bile duct obstruction.
⃣ ⃣ While caring for an ALS client, which finding warrants immediate action?
A) Inappropriate laughter
B) Increasing anxiety
, ESTUDYR
C) ✅Weakened cough effort
D) Asymmetrical weakness
Rationale: Weakened cough can lead to respiratory failure, which is life-threatening.
⃣ ⃣ A Jewish client is scheduled for a xenograft. Which statement should the nurse include?
A) Grafting increases infection risk
B) ✅The xenograft is taken from nonhuman sources
C) Grafts are later removed
D) Graft permanently attaches
Rationale: Xenografts come from animals (often pig skin), which may raise religious concerns.
⃣ ⃣ A postoperative male client’s wound eviscerates while repositioning. What should the nurse do
next after moistening sterile dressing?
A) Bring more sterile supplies
B) ✅Prepare the client to return to the operating room
C) Obtain a sample of drainage
D) Auscultate bowel sounds
Rationale: Evisceration is a surgical emergency.
⃣ ⃣ A lung cancer client has serum sodium of 117 mEq/L. Which nursing problem should the nurse
prioritize?
A) Altered urinary elimination
B) Impaired gas exchange
C) ✅Fluid volume excess
D) Decreased cardiac output
Rationale: SIADH associated with lung cancer leads to hyponatremia and fluid retention.
⃣ ⃣ A nurse is assessing a client with suspected deep vein thrombosis (DVT). Which finding requires
immediate intervention?
A) Unilateral leg swelling and pain
B) Mild calf tenderness when walking
C) ✅Sudden shortness of breath and chest pain
D) Warmth and redness over the calf muscle
