lOMoARcPSD|5422489
HESI MEDICAL SURGICAL EXAM
TEST BANK 2026/ACTUAL EXAM WITH CORRECT
DETAILED AND VERIFIED ANSWERS/ MEDICAL
SURGICAL HESI EXAM 2026
A male client with sickle cell anemia, who has been hospitalized for another health problem, tells the nurse he has
had an erection for over 4 hours. What action should the nurse implement first?
Notify the client’s healthcare provider.
Document the Finding in the client record.
Prepare a warm enema solution for rectal instillation.
Obtain a large bore needle for aspiration of the corpora cavernosa.
Explanation
Priapism, a urologic emergency, is common during sickle cell crisis due to sickle cells clogging the
microcirculation in the penis, causing a reduction of blood ow and oxygenation to the penis, so the
healthcare provider should be rst noti ed immediately. The prescribed therapy may consist of noninvasive
measures such as applying ice to the penis, instilling a warm solution enema to increase out ow in the
corpora cavernosa and giving pain medications. If noninvasive measures do not work, then needle aspiration
of the corpora cavernosa is implemented by the healthcare provider.
The nurse completes visual inspection of a client’s abdomen. What technique should the nurse perform next in the
abdominal examination?
Percussion.
Auscultation.
Deep palpation. Light
palpation.
Explanation
Auscultation of the client’s abdomen is performed next because manual manipulation of the abdomen can
stimulate peristalsis and create inaccurate assessment of bowel sounds heard during auscultation.
Which intervention should the nurse implement that best con rms placement of an endotracheal tube (ETT)?
, lOMoARcPSD|5422489
Use an end-tital CO2 detector.
Ascultate for bilateral breath sounds.
Obtain pulse oximeter reading.
Check symmetrical chest movement.
Explanation
The end-tidal carbon dioxide detector indicates the prescence of CO2tidalby a color change or a number
indicated on the detector, which is supporting evidence that the ETT is in the trachea, not the esophagus.
A female client with type 2 diabetes mellitus reports dysuria. Which assessment nding is most important for the
nurse to report to the healthcare provider?
Suprapublic pain and distention.
Bounding pulse at 100 beats/minute.
Fingerstick glucose of 300 mg/dl.
Small vesicular perineal lesions.
Explanation
Elevated ngerstick glucose levels needs to be reported tot he healthcare provider, so a plan of care can be
adjusted to treat the elevated glucose level. Also elevated glucose levels, spills into the urine and provide a
medium for bacterial growth.
A client with type II diabetes arrives at the clinic with a blood glucose of 50 mg/dL. The nurse provides the client
with 6 ounces of orange juice. In 15 minutes the client’s capillary glucose is 74 mg/dL. What action should the
nurse take?
Obtain a specimen for serum glucose level.
Administer insulin per sliding scale.
Provide cheese and bread to eat.
Collect a glycosylated hemoglobin specimen.
Explanation
Once blood glucose is greater than 70 mg/dl, the client should eat a regularly scheduled meal or a snack that
contains protein and carbohydrates to help prevent hypoglycemia from recurring.
A 48-year-old client with endometrial cancer is being discharged after a total hysterectomy and bilateral salpingo-
oophorectomy.
Which client statement indicates that further teaching is needed?
, lOMoARcPSD|5422489
"Well, I don’t have to worry about getting pregnant anymore."
"I can’t wait to go on the cruise that I have planned for this summer."
"I know I will miss having sexual intercourse with my husband."
"I have asked my daughter to stay with me next week after I am discharged."
Explanation
Further teaching is needed in response to the client’s misunderstanding of not being able to have sexual
intercourse after a hysterectomy, needs to be addressed.
A client asks the nurse about the purpose of beginning chemotherapy (CT) because the tumor is still very small.
Which information supports the explanation that the nurse should provide?
Side eûects are less likely if therapy is started early.
Collateral circulation increases as the tumor grows.
Sensitivity of cancer cells to CT is based on cell cycle rate.
The cell count of the tumor reduces by half with each dose.
Explanation
Initiating chemotherapy while the tumor is small provides a better chance of eradicating all cancer cells
because 50% of cancer cells or tumor cells are killed with each dose.
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?
Give the drug and allow the client to read and sign the consent form.
Counter-sign the client’s initials on the consent form after giving the drug.
Withhold the drug until the client validates understanding of the surgical procedure and signs the
consent form.
Call the healthcare provider to explain the surgical procedure before the client signs the consent.
Explanation
Midazolam, a benzodiazepine sedative, is commonly used for conscious-sedation intraoperatively and
interferes with the client s cognition and level of consciousness, so the consent form should be signed before
the drug is administered.
Which client should the nurse assess rst?
A 27-year-old complaining of severe back pain.
, lOMoARcPSD|5422489
A 63-year-old complaining of foot and ankle pain.
A 49-year-old with pancreatitis complaining of unrelenting abdominal pain.
A 55-year-old newly admitted client complaining of jaw pain and indigestion.
Explanation
The 55-year-old client should be assessed rst to rule out cardiac involvement because jaw pain and indigestion
are common descriptors of myocardial injury.
What is the primary nursing problem for a client with asymptomatic primary syphilis?
Acute pain.
Risk for injury.
Sexual dysfunction.
De cient knowledge.
Explanation
An asymptomatic client with primary syphilis is most likely unaware of this disease, so to prevent transmission
to others and recurrence in the client, the priority nursing diagnosis is de cient knowledge of the disease
pathophysiology.
An 85-year-old male client comes to the clinic for his annual physical exam and renewal of antihypertensive
medication prescriptions. The client’s radial pulse rate is 104 beats/minute. Which additional assessment should
the nurse complete?
Palpate the pedal pulse volume.
Count the brachial pulse rate.
Measure the blood pressure.
Assess for a carotid bruit.
Explanation
Elderly clients who take antihypertensive medications often experience side eûects, such as hypotension, which
causes tachycardia, a compensatory mechanism to maintain adequate cardiac output, so the client’s blood
pressure should be measured.
The nurse assesses a long-term resident of a nursing home and nds the client has a fungal infection (candidiasis)
beneath both breasts. To prevent nosocomial infection, which protocol should the nurse review with the rest of
the staû?
Follow contact isolation procedures.
HESI MEDICAL SURGICAL EXAM
TEST BANK 2026/ACTUAL EXAM WITH CORRECT
DETAILED AND VERIFIED ANSWERS/ MEDICAL
SURGICAL HESI EXAM 2026
A male client with sickle cell anemia, who has been hospitalized for another health problem, tells the nurse he has
had an erection for over 4 hours. What action should the nurse implement first?
Notify the client’s healthcare provider.
Document the Finding in the client record.
Prepare a warm enema solution for rectal instillation.
Obtain a large bore needle for aspiration of the corpora cavernosa.
Explanation
Priapism, a urologic emergency, is common during sickle cell crisis due to sickle cells clogging the
microcirculation in the penis, causing a reduction of blood ow and oxygenation to the penis, so the
healthcare provider should be rst noti ed immediately. The prescribed therapy may consist of noninvasive
measures such as applying ice to the penis, instilling a warm solution enema to increase out ow in the
corpora cavernosa and giving pain medications. If noninvasive measures do not work, then needle aspiration
of the corpora cavernosa is implemented by the healthcare provider.
The nurse completes visual inspection of a client’s abdomen. What technique should the nurse perform next in the
abdominal examination?
Percussion.
Auscultation.
Deep palpation. Light
palpation.
Explanation
Auscultation of the client’s abdomen is performed next because manual manipulation of the abdomen can
stimulate peristalsis and create inaccurate assessment of bowel sounds heard during auscultation.
Which intervention should the nurse implement that best con rms placement of an endotracheal tube (ETT)?
, lOMoARcPSD|5422489
Use an end-tital CO2 detector.
Ascultate for bilateral breath sounds.
Obtain pulse oximeter reading.
Check symmetrical chest movement.
Explanation
The end-tidal carbon dioxide detector indicates the prescence of CO2tidalby a color change or a number
indicated on the detector, which is supporting evidence that the ETT is in the trachea, not the esophagus.
A female client with type 2 diabetes mellitus reports dysuria. Which assessment nding is most important for the
nurse to report to the healthcare provider?
Suprapublic pain and distention.
Bounding pulse at 100 beats/minute.
Fingerstick glucose of 300 mg/dl.
Small vesicular perineal lesions.
Explanation
Elevated ngerstick glucose levels needs to be reported tot he healthcare provider, so a plan of care can be
adjusted to treat the elevated glucose level. Also elevated glucose levels, spills into the urine and provide a
medium for bacterial growth.
A client with type II diabetes arrives at the clinic with a blood glucose of 50 mg/dL. The nurse provides the client
with 6 ounces of orange juice. In 15 minutes the client’s capillary glucose is 74 mg/dL. What action should the
nurse take?
Obtain a specimen for serum glucose level.
Administer insulin per sliding scale.
Provide cheese and bread to eat.
Collect a glycosylated hemoglobin specimen.
Explanation
Once blood glucose is greater than 70 mg/dl, the client should eat a regularly scheduled meal or a snack that
contains protein and carbohydrates to help prevent hypoglycemia from recurring.
A 48-year-old client with endometrial cancer is being discharged after a total hysterectomy and bilateral salpingo-
oophorectomy.
Which client statement indicates that further teaching is needed?
, lOMoARcPSD|5422489
"Well, I don’t have to worry about getting pregnant anymore."
"I can’t wait to go on the cruise that I have planned for this summer."
"I know I will miss having sexual intercourse with my husband."
"I have asked my daughter to stay with me next week after I am discharged."
Explanation
Further teaching is needed in response to the client’s misunderstanding of not being able to have sexual
intercourse after a hysterectomy, needs to be addressed.
A client asks the nurse about the purpose of beginning chemotherapy (CT) because the tumor is still very small.
Which information supports the explanation that the nurse should provide?
Side eûects are less likely if therapy is started early.
Collateral circulation increases as the tumor grows.
Sensitivity of cancer cells to CT is based on cell cycle rate.
The cell count of the tumor reduces by half with each dose.
Explanation
Initiating chemotherapy while the tumor is small provides a better chance of eradicating all cancer cells
because 50% of cancer cells or tumor cells are killed with each dose.
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?
Give the drug and allow the client to read and sign the consent form.
Counter-sign the client’s initials on the consent form after giving the drug.
Withhold the drug until the client validates understanding of the surgical procedure and signs the
consent form.
Call the healthcare provider to explain the surgical procedure before the client signs the consent.
Explanation
Midazolam, a benzodiazepine sedative, is commonly used for conscious-sedation intraoperatively and
interferes with the client s cognition and level of consciousness, so the consent form should be signed before
the drug is administered.
Which client should the nurse assess rst?
A 27-year-old complaining of severe back pain.
, lOMoARcPSD|5422489
A 63-year-old complaining of foot and ankle pain.
A 49-year-old with pancreatitis complaining of unrelenting abdominal pain.
A 55-year-old newly admitted client complaining of jaw pain and indigestion.
Explanation
The 55-year-old client should be assessed rst to rule out cardiac involvement because jaw pain and indigestion
are common descriptors of myocardial injury.
What is the primary nursing problem for a client with asymptomatic primary syphilis?
Acute pain.
Risk for injury.
Sexual dysfunction.
De cient knowledge.
Explanation
An asymptomatic client with primary syphilis is most likely unaware of this disease, so to prevent transmission
to others and recurrence in the client, the priority nursing diagnosis is de cient knowledge of the disease
pathophysiology.
An 85-year-old male client comes to the clinic for his annual physical exam and renewal of antihypertensive
medication prescriptions. The client’s radial pulse rate is 104 beats/minute. Which additional assessment should
the nurse complete?
Palpate the pedal pulse volume.
Count the brachial pulse rate.
Measure the blood pressure.
Assess for a carotid bruit.
Explanation
Elderly clients who take antihypertensive medications often experience side eûects, such as hypotension, which
causes tachycardia, a compensatory mechanism to maintain adequate cardiac output, so the client’s blood
pressure should be measured.
The nurse assesses a long-term resident of a nursing home and nds the client has a fungal infection (candidiasis)
beneath both breasts. To prevent nosocomial infection, which protocol should the nurse review with the rest of
the staû?
Follow contact isolation procedures.
