HESI Med Surg Exit Exam 2023-2024
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1. 1. While assessing a client with ANS: C
diabetes mellitus, the nurse ob- Signs of chronic arterial insufficiency include decreased
serves an absence of hair growth hair growth in the legs and feet,
on the client's legs. What addi- absent or decreased pedal pulses, infection in the foot,
tional assessment provides fur- poor wound healing, thickened nails,
ther data to support this and a shiny appearance of the skin (C). Femoral pulses
finding? (A) should still be palpable in the
a. Palpate for the presence of diabetic with chronic arterial insufficiency. A positive
femoral pulses bilaterally. Homan's sign is an indicator of deep
b. Assess for the presence of a vein thrombosis (B). (D) would probably not be affected
positive Homan's sign. significantly by chronic arterial
c. Observe the appearance of the insufficiency.
skin on the client's legs.
d. Watch the client's posture and
balance during ambulation
2. 2. The healthcare provider pre- ANS: C
scribes 15 mg/kg of Streptomycin 4 lbs / 2.2 = 1.8 kg. 1.8 x 15 = 27 mg (C).
for an infant weighing 4 pounds. NOTE, the fact that the drug is diluted in 25 ml of D5W, is
The drug is diluted in 25 ml of not relevant to the calculation
D5W to run over 8 hours. How requested
much Streptomycin will the
infant receive?
a. 9 mg.
b. 18 mg.
c. 27 mg.
d. 36 mg
3. In assessing a client with ANS: C
preeclampsia who is receiving The client is exhibiting symptoms of magnesium sulfate
magnesium sulfate, the nurse toxicity--decreased reflexes (normal is
determines that her deep tendon +2), a low normal respiratory rate (normal is 12 to 20
, HESI Med Surg Exit Exam 2023-2024
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reflexes are 1+; respiratory rate is breaths/min), a less than average
12 breaths/minute; urinary output (30 ml/hour is average), and a low mag-
urinary output is 90 ml in 4 nesium sulfate level (normal is 4 to
hours; magnesium sulfate level is 8mg/dl). Based on these findings, the nurse should stop
9 mg/dl. Based on these the infusion (C). (A) is
findings, what intervention contraindicated. (B) would not fully alleviate the magne-
should the nurse implement? sium sulfate toxicity symptoms. (D)
a. Continue the magnesium sul- (the antagonist for magnesium sulfate) would be indicat-
fate infusion as prescribed. ed if the respiratory rate were less
b. Decrease the magnesium sul- than 12 breaths/minute.
fate infusion by one-half.
c. Stop the magnesium sulfate in-
fusion immediately.
d. Administer calcium gluconate
immediately.
4. A client is on a mechanical venti- ANS: A
lator. Which client response indi- This medication causes paralysis (A) following intra-
cates that the neuromuscular venous injection. Peak effects persist for
blocker tubocurarine chloride 35 to 60 minutes. (B and C) would not be possible if the
(Tubarine) is effective? medication is effective. The Glasgow
a. The client's expremities are coma scale is used to evaluate the neurological status of
paralyzed. the client and does not evaluate the
b. The peripheral nerve stimula- effectiveness (D) of this medication.
tor causes twitching.
c. The client clinches fist upon
command.
d. The client's Glagow Coma Scale
score is 14
5. 5. An elderly female client comes ANS: B
to the clinic for a regular Frequent and/or large doses of acetaminophen can
, HESI Med Surg Exit Exam 2023-2024
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check-up. The client tells the cause an increase in liver enzymes,
nurse indicating possible liver damage (B). If the client reported
that she has increased her unusual bleeding, or an increase in
daily doses of acetaminophen aspirin usage, it would be important for the nurse to
(Tylenol) for the past month to assess for increased bleeding and monitor
control joint pain. Based on this (A and/or C). (D) is not affected by increases in aceta-
client's comment, what previous minophen doses.
lab values should the nurse
compare with today's lab report?
a. Look at last quarter's hemoglo-
bin and hematocrit, expecting an
increase today due
to dehydration.
b. Look for an increase in today's
LDH compared to the previous
one to assess
for possible liver damage. c. Ex-
pect to find an increase in today's
APTT as compared to last quar-
ter's due
to bleeding.
d. Determine if there is a de-
crease in serum potassium due to
renal compromise.
6. 6. Aspirin is prescribed for a ANS: C
9-year-old child with rheumatic Ringing in the ears (tinnitus) (C) is an important sign of
fever to control the inflammato- aspirin overdosage and should be
ry reported immediately. Though a tepid sponge bath may
process, promote comfort, and lower the child's temperature, the
reduce fever. What intervention is prescription for aspirin should not be held (A). Aspirin
most important for the should be taken with at least eight
, HESI Med Surg Exit Exam 2023-2024
Study online at https://quizlet.com/_ewrakp
nurse to implement? ounces of water to completely wash the tablet into the
a. Instruct the parents to hold the stomach and to help prevent GI
aspirin until the child has first had discomfort (B). Yellow halos are associated with Digoxin
a tepid sponge toxicity, not aspirin (D)
bath.
b. Administer the aspirin with
at least two ounces of water or
juice.
c. Notify the healthcare provider
if the child complains of ringing in
the ears.
d. Advise the parents to question
the child about seeing yellow ha-
los around objects
7. 7. Which signs or symptoms are ANS: D
characteristic of an adult client di- The classic picture of Cushing's syndrome in the adult is
agnosed with Cushing's central-type obesity with thin
syndrome? extremities (D), along with a "buffalo hump" in the supr-
a. Husky voice and complaints of aclavicular area, heavy trunk, and
hoarseness. thin fragile skin. The symptoms described in (A) are clin-
b. Warm, soft, moist, salmon-col- ical manifestations of
ored skin. hypothyroidism, and in (B) of hyperthyroidism. (C) may
c. Visible swelling of the neck, indicate a goiter or a tumor of the
with no pain. thyroid gland
d. Central-type obesity, with thin
extremities.
8. 8. A charge nurse agrees to cover ANS: D
another nurse's assignment dur- A pulse oximeter reading of 90% indicates an arterial
ing a lunch break. Based on the blood gas of less than 80 to 100 and
status report provided by the should be assessed immediately (D). (A) is an expected
Study online at https://quizlet.com/_ewrakp
1. 1. While assessing a client with ANS: C
diabetes mellitus, the nurse ob- Signs of chronic arterial insufficiency include decreased
serves an absence of hair growth hair growth in the legs and feet,
on the client's legs. What addi- absent or decreased pedal pulses, infection in the foot,
tional assessment provides fur- poor wound healing, thickened nails,
ther data to support this and a shiny appearance of the skin (C). Femoral pulses
finding? (A) should still be palpable in the
a. Palpate for the presence of diabetic with chronic arterial insufficiency. A positive
femoral pulses bilaterally. Homan's sign is an indicator of deep
b. Assess for the presence of a vein thrombosis (B). (D) would probably not be affected
positive Homan's sign. significantly by chronic arterial
c. Observe the appearance of the insufficiency.
skin on the client's legs.
d. Watch the client's posture and
balance during ambulation
2. 2. The healthcare provider pre- ANS: C
scribes 15 mg/kg of Streptomycin 4 lbs / 2.2 = 1.8 kg. 1.8 x 15 = 27 mg (C).
for an infant weighing 4 pounds. NOTE, the fact that the drug is diluted in 25 ml of D5W, is
The drug is diluted in 25 ml of not relevant to the calculation
D5W to run over 8 hours. How requested
much Streptomycin will the
infant receive?
a. 9 mg.
b. 18 mg.
c. 27 mg.
d. 36 mg
3. In assessing a client with ANS: C
preeclampsia who is receiving The client is exhibiting symptoms of magnesium sulfate
magnesium sulfate, the nurse toxicity--decreased reflexes (normal is
determines that her deep tendon +2), a low normal respiratory rate (normal is 12 to 20
, HESI Med Surg Exit Exam 2023-2024
Study online at https://quizlet.com/_ewrakp
reflexes are 1+; respiratory rate is breaths/min), a less than average
12 breaths/minute; urinary output (30 ml/hour is average), and a low mag-
urinary output is 90 ml in 4 nesium sulfate level (normal is 4 to
hours; magnesium sulfate level is 8mg/dl). Based on these findings, the nurse should stop
9 mg/dl. Based on these the infusion (C). (A) is
findings, what intervention contraindicated. (B) would not fully alleviate the magne-
should the nurse implement? sium sulfate toxicity symptoms. (D)
a. Continue the magnesium sul- (the antagonist for magnesium sulfate) would be indicat-
fate infusion as prescribed. ed if the respiratory rate were less
b. Decrease the magnesium sul- than 12 breaths/minute.
fate infusion by one-half.
c. Stop the magnesium sulfate in-
fusion immediately.
d. Administer calcium gluconate
immediately.
4. A client is on a mechanical venti- ANS: A
lator. Which client response indi- This medication causes paralysis (A) following intra-
cates that the neuromuscular venous injection. Peak effects persist for
blocker tubocurarine chloride 35 to 60 minutes. (B and C) would not be possible if the
(Tubarine) is effective? medication is effective. The Glasgow
a. The client's expremities are coma scale is used to evaluate the neurological status of
paralyzed. the client and does not evaluate the
b. The peripheral nerve stimula- effectiveness (D) of this medication.
tor causes twitching.
c. The client clinches fist upon
command.
d. The client's Glagow Coma Scale
score is 14
5. 5. An elderly female client comes ANS: B
to the clinic for a regular Frequent and/or large doses of acetaminophen can
, HESI Med Surg Exit Exam 2023-2024
Study online at https://quizlet.com/_ewrakp
check-up. The client tells the cause an increase in liver enzymes,
nurse indicating possible liver damage (B). If the client reported
that she has increased her unusual bleeding, or an increase in
daily doses of acetaminophen aspirin usage, it would be important for the nurse to
(Tylenol) for the past month to assess for increased bleeding and monitor
control joint pain. Based on this (A and/or C). (D) is not affected by increases in aceta-
client's comment, what previous minophen doses.
lab values should the nurse
compare with today's lab report?
a. Look at last quarter's hemoglo-
bin and hematocrit, expecting an
increase today due
to dehydration.
b. Look for an increase in today's
LDH compared to the previous
one to assess
for possible liver damage. c. Ex-
pect to find an increase in today's
APTT as compared to last quar-
ter's due
to bleeding.
d. Determine if there is a de-
crease in serum potassium due to
renal compromise.
6. 6. Aspirin is prescribed for a ANS: C
9-year-old child with rheumatic Ringing in the ears (tinnitus) (C) is an important sign of
fever to control the inflammato- aspirin overdosage and should be
ry reported immediately. Though a tepid sponge bath may
process, promote comfort, and lower the child's temperature, the
reduce fever. What intervention is prescription for aspirin should not be held (A). Aspirin
most important for the should be taken with at least eight
, HESI Med Surg Exit Exam 2023-2024
Study online at https://quizlet.com/_ewrakp
nurse to implement? ounces of water to completely wash the tablet into the
a. Instruct the parents to hold the stomach and to help prevent GI
aspirin until the child has first had discomfort (B). Yellow halos are associated with Digoxin
a tepid sponge toxicity, not aspirin (D)
bath.
b. Administer the aspirin with
at least two ounces of water or
juice.
c. Notify the healthcare provider
if the child complains of ringing in
the ears.
d. Advise the parents to question
the child about seeing yellow ha-
los around objects
7. 7. Which signs or symptoms are ANS: D
characteristic of an adult client di- The classic picture of Cushing's syndrome in the adult is
agnosed with Cushing's central-type obesity with thin
syndrome? extremities (D), along with a "buffalo hump" in the supr-
a. Husky voice and complaints of aclavicular area, heavy trunk, and
hoarseness. thin fragile skin. The symptoms described in (A) are clin-
b. Warm, soft, moist, salmon-col- ical manifestations of
ored skin. hypothyroidism, and in (B) of hyperthyroidism. (C) may
c. Visible swelling of the neck, indicate a goiter or a tumor of the
with no pain. thyroid gland
d. Central-type obesity, with thin
extremities.
8. 8. A charge nurse agrees to cover ANS: D
another nurse's assignment dur- A pulse oximeter reading of 90% indicates an arterial
ing a lunch break. Based on the blood gas of less than 80 to 100 and
status report provided by the should be assessed immediately (D). (A) is an expected
