HESI RN MEDICAL SURGICAL EXAM PACK 2024/2025
STUDY QUESTIONS WITH ANSWERS WITH RATIONALES
GUARANTEED PASS | RATED A+
1. A male client with chronic atrial fibrillation and a slow ventricular response is scheduled for
surgical placement of a permanent pacemaker. The client asks the nurse how this devise will help
him. How should the nurse explain the action of a synchronous pacemaker?
A) Ventricular irritability is prevented by the constant rate setting of pacemaker.
B) Ectopic stimulus in the atria is suppressed by the device usurping depolarization.
C) An impulse is fired every second to maintain a heart rate of 60 beats per minute.
D) An electrical stimulus is discharged when no ventricular response is sensed. - Answer>>> D)
An electrical stimulus is discharged when no ventricular response is sensed.
Rationale: The artificial cardiac pacemaker is an electronic device used to pace the heart when
the normal conduction pathway is damaged or diseased, such as a symptomatic dysrhythmias
like atrial fibrillation with a slow ventricular response. Pacing modes that are synchronous
(impulse generated on demand or as needed according to the patient's intrinsic rhythm) send an
electrical signal from the pacemaker to the wall of the myocardium stimulating it to contract
when no ventricular depolarization is sensed (D). (A, B, and C) do not provide accurate
information.
2. The unlicensed assistive personnel (UAP) reports that an 87-year-old female client who is sitting
in a chair at the bedside has an oral temperature of 97.2° F. Which intervention should thenurse
implement?
A) Document the temperature reading on the vital sign graphic sheet.
B) Report the temperature to the healthcare provider immediately.
C) Instruct the UAP to take the client's temperature again in 30 minutes.
D) Advise the UAP to assist the client in returning to her bed. - Answer>>> A) Document the
temperature reading on the vital sign graphic sheet.
Rationale: A subnormal temperature of 97.2° F (orally) is a common finding in elderly clients, so
the nurse should document the findings (A) and continue with the plan of care. (B, C, and D) are
not indicated unless the temperature falls below 97° F or if other symptoms occur.
,3. The nurse is completing the health assessment of a 79-year-old male client who denies any
significant health problems. Which finding requires the most immediate follow-up assessment?
A) Kyphosis with a reduction in height.
B) Dilated superficial veins on both legs.
C) External hemorrhoids with itching.
D) Yellowish discoloration of the sclerae. - Answer>>> D) Yellowish discoloration of the
sclerae.
Rationale: Jaundice, a yellowish discoloration of the sclerae (D), may indicate liver damage and
requires further assessment. Kyphosis and height reduction (A) due to bone loss, varicose veins
(B), and external hemorrhoids with itching (C) are common findings in the elderly that do not
require immediate intervention.
4. Which finding should the nurse report to the healthcare provider for a client with a
circumferential extremity burn?
A) Full thickness burns rather than partial thickness.
B) Supinates extremity but unable to fully pronate the extremity.
C) Slow capillary refill in the digits with absent distal pulse points.
D) Inability to distinguish sharp versus dull sensations in the extremity. - Answer>>> C) Slow
capillary refill in the digits with absent distal pulse points
Rationale: A circumferential burn can form an eschar that results from burn exudate fluid that
dries and acts as a tourniquet as fluid shifts occur in the interstitial tissue. As edema increases
tissue pressure, blood flow to the distal extremity is compromised, which is manifested by slow
capillary refill and absent distal pulses (C), so the healthcare provider should be notified about
any compromised circulation that requires escharotomy. Although eschar formation occurs more
readily over full thickness burns (A), the circumferential location of the burn is most likely to
constrict underlying structures. Limited movement (B) is often due to pain. (D) may be related to
the depth of the burn.
5. The nurse completes visual inspection of a client's abdomen. What technique should the
nurse perform next in the abdominal examination?
A) Percussion.
, B) Auscultation.
C) Deep palpation.
D) Light palpation. - Answer>>> B) Auscultation.
Rationale: Auscultation (B) of the client's abdomen is performed next because manual
manipulation (A, C, and D) can stimulate the bowel and create false sounds heard during
auscultation.
6. A client who has just tested positive for human immunodeficiency virus (HIV) does not
appear to hear what the nurse is saying during post-test counseling. Which information should
the nurse offer to facilitate the client's adjustment to HIV infection?
A) Inform the client how to protect sexual and needle-sharing partners.
B) Teach the client about the medications that are available for treatment.
C) Identify the need to test others who have had risky contact with the client.
D) Discuss retesting to verify the results, which will ensure continuing contact. - Answer>>> D)
Discuss retesting to verify the results, which will ensure continuing contact.
Rationale: Encouraging retesting (D) supports hope and gives the client time to cope with the
diagnosis. Although post-test counseling should include education about (A, B, and C), retesting
encourages the client to maintain medical follow-up and management.
7. The nurse hears short, high-pitched sounds just before the end of inspiration in the right andleft
lower lobes when auscultating a client's lungs. How should this finding be recorded?
A) Inspiratory wheezes in both lungs.
B) Crackles in the right and left lower lobes.
C) Abnormal lung sounds in the bases of both lungs.
D) Pleural friction rub in the right and left lower lobes. - Answer>>> B) Crackles in the right and
left lower lobes.
Rationale: Fine crackles (B) are short, high-pitched sounds heard just before the end of
inspiration that are the result of rapid equalization of pressure when collapsed alveoli or terminal
bronchioles suddenly snap open. Wheezing (A) is a continuous high-pitched squeaking or
musical sound caused by rapid vibration of bronchial walls that are first evident on expiration
, and may be audible. Although (C) describes an adventitious lung sound, this documentation is
vague. (D) is a creaking or grating sound from roughened, inflamed surfaces of the pleura
rubbing together heard during inspiration, expiration, and with no change during coughing.
8. A client asks the nurse about the purpose of beginning chemotherapy (CT) because the tumoris
still very small. Which information supports the explanation that the nurse should provide?
A) Side effects are less likely if therapy is started early.
B) Collateral circulation increases as the tumor grows.
C) Sensitivity of cancer cells to CT is based on cell cycle rate.
D) The cell count of the tumor reduces by half with each dose. - Answer>>> D) The cell count
of the tumor reduces by half with each dose.
Rationale: 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, B, and C) vary based on the type of cancer.
9. The nurse is caring for a client with non-Hodgkin's lymphoma who is receiving chemotherapy.
Laboratory results reveal a platelet count of 10,000/ml. What action should thenurse implement?
A) Encourage fluids to 3000 ml/day.
B) Check stools for occult blood.
C) Provide oral hygiene every 2 hours.
D) Check for fever every 4 hours. - Answer>>> B) Check stools for occult blood.
Rationale: Platelet counts less than 100,000/mm3 are indicative of thrombocytopenia, a common
side effect of chemotherapy. A client with thrombocytopenia should be assessed frequently for
occult bleeding in the emesis, sputum, feces (B), urine, nasogastric secretions, or wounds. (A)
does not minimize the risk for bleeding associated with thrombocytopenia. (C) may cause
increased bleeding in a client with thromobcytopenia. (D) assesses for infection, not risk for
bleeding.
10. The nurse is caring for a client with end stage liver disease who is being assessed for the
presence of asterixis. To assess the client for asterixis, what position should the nurse ask the
STUDY QUESTIONS WITH ANSWERS WITH RATIONALES
GUARANTEED PASS | RATED A+
1. A male client with chronic atrial fibrillation and a slow ventricular response is scheduled for
surgical placement of a permanent pacemaker. The client asks the nurse how this devise will help
him. How should the nurse explain the action of a synchronous pacemaker?
A) Ventricular irritability is prevented by the constant rate setting of pacemaker.
B) Ectopic stimulus in the atria is suppressed by the device usurping depolarization.
C) An impulse is fired every second to maintain a heart rate of 60 beats per minute.
D) An electrical stimulus is discharged when no ventricular response is sensed. - Answer>>> D)
An electrical stimulus is discharged when no ventricular response is sensed.
Rationale: The artificial cardiac pacemaker is an electronic device used to pace the heart when
the normal conduction pathway is damaged or diseased, such as a symptomatic dysrhythmias
like atrial fibrillation with a slow ventricular response. Pacing modes that are synchronous
(impulse generated on demand or as needed according to the patient's intrinsic rhythm) send an
electrical signal from the pacemaker to the wall of the myocardium stimulating it to contract
when no ventricular depolarization is sensed (D). (A, B, and C) do not provide accurate
information.
2. The unlicensed assistive personnel (UAP) reports that an 87-year-old female client who is sitting
in a chair at the bedside has an oral temperature of 97.2° F. Which intervention should thenurse
implement?
A) Document the temperature reading on the vital sign graphic sheet.
B) Report the temperature to the healthcare provider immediately.
C) Instruct the UAP to take the client's temperature again in 30 minutes.
D) Advise the UAP to assist the client in returning to her bed. - Answer>>> A) Document the
temperature reading on the vital sign graphic sheet.
Rationale: A subnormal temperature of 97.2° F (orally) is a common finding in elderly clients, so
the nurse should document the findings (A) and continue with the plan of care. (B, C, and D) are
not indicated unless the temperature falls below 97° F or if other symptoms occur.
,3. The nurse is completing the health assessment of a 79-year-old male client who denies any
significant health problems. Which finding requires the most immediate follow-up assessment?
A) Kyphosis with a reduction in height.
B) Dilated superficial veins on both legs.
C) External hemorrhoids with itching.
D) Yellowish discoloration of the sclerae. - Answer>>> D) Yellowish discoloration of the
sclerae.
Rationale: Jaundice, a yellowish discoloration of the sclerae (D), may indicate liver damage and
requires further assessment. Kyphosis and height reduction (A) due to bone loss, varicose veins
(B), and external hemorrhoids with itching (C) are common findings in the elderly that do not
require immediate intervention.
4. Which finding should the nurse report to the healthcare provider for a client with a
circumferential extremity burn?
A) Full thickness burns rather than partial thickness.
B) Supinates extremity but unable to fully pronate the extremity.
C) Slow capillary refill in the digits with absent distal pulse points.
D) Inability to distinguish sharp versus dull sensations in the extremity. - Answer>>> C) Slow
capillary refill in the digits with absent distal pulse points
Rationale: A circumferential burn can form an eschar that results from burn exudate fluid that
dries and acts as a tourniquet as fluid shifts occur in the interstitial tissue. As edema increases
tissue pressure, blood flow to the distal extremity is compromised, which is manifested by slow
capillary refill and absent distal pulses (C), so the healthcare provider should be notified about
any compromised circulation that requires escharotomy. Although eschar formation occurs more
readily over full thickness burns (A), the circumferential location of the burn is most likely to
constrict underlying structures. Limited movement (B) is often due to pain. (D) may be related to
the depth of the burn.
5. The nurse completes visual inspection of a client's abdomen. What technique should the
nurse perform next in the abdominal examination?
A) Percussion.
, B) Auscultation.
C) Deep palpation.
D) Light palpation. - Answer>>> B) Auscultation.
Rationale: Auscultation (B) of the client's abdomen is performed next because manual
manipulation (A, C, and D) can stimulate the bowel and create false sounds heard during
auscultation.
6. A client who has just tested positive for human immunodeficiency virus (HIV) does not
appear to hear what the nurse is saying during post-test counseling. Which information should
the nurse offer to facilitate the client's adjustment to HIV infection?
A) Inform the client how to protect sexual and needle-sharing partners.
B) Teach the client about the medications that are available for treatment.
C) Identify the need to test others who have had risky contact with the client.
D) Discuss retesting to verify the results, which will ensure continuing contact. - Answer>>> D)
Discuss retesting to verify the results, which will ensure continuing contact.
Rationale: Encouraging retesting (D) supports hope and gives the client time to cope with the
diagnosis. Although post-test counseling should include education about (A, B, and C), retesting
encourages the client to maintain medical follow-up and management.
7. The nurse hears short, high-pitched sounds just before the end of inspiration in the right andleft
lower lobes when auscultating a client's lungs. How should this finding be recorded?
A) Inspiratory wheezes in both lungs.
B) Crackles in the right and left lower lobes.
C) Abnormal lung sounds in the bases of both lungs.
D) Pleural friction rub in the right and left lower lobes. - Answer>>> B) Crackles in the right and
left lower lobes.
Rationale: Fine crackles (B) are short, high-pitched sounds heard just before the end of
inspiration that are the result of rapid equalization of pressure when collapsed alveoli or terminal
bronchioles suddenly snap open. Wheezing (A) is a continuous high-pitched squeaking or
musical sound caused by rapid vibration of bronchial walls that are first evident on expiration
, and may be audible. Although (C) describes an adventitious lung sound, this documentation is
vague. (D) is a creaking or grating sound from roughened, inflamed surfaces of the pleura
rubbing together heard during inspiration, expiration, and with no change during coughing.
8. A client asks the nurse about the purpose of beginning chemotherapy (CT) because the tumoris
still very small. Which information supports the explanation that the nurse should provide?
A) Side effects are less likely if therapy is started early.
B) Collateral circulation increases as the tumor grows.
C) Sensitivity of cancer cells to CT is based on cell cycle rate.
D) The cell count of the tumor reduces by half with each dose. - Answer>>> D) The cell count
of the tumor reduces by half with each dose.
Rationale: 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, B, and C) vary based on the type of cancer.
9. The nurse is caring for a client with non-Hodgkin's lymphoma who is receiving chemotherapy.
Laboratory results reveal a platelet count of 10,000/ml. What action should thenurse implement?
A) Encourage fluids to 3000 ml/day.
B) Check stools for occult blood.
C) Provide oral hygiene every 2 hours.
D) Check for fever every 4 hours. - Answer>>> B) Check stools for occult blood.
Rationale: Platelet counts less than 100,000/mm3 are indicative of thrombocytopenia, a common
side effect of chemotherapy. A client with thrombocytopenia should be assessed frequently for
occult bleeding in the emesis, sputum, feces (B), urine, nasogastric secretions, or wounds. (A)
does not minimize the risk for bleeding associated with thrombocytopenia. (C) may cause
increased bleeding in a client with thromobcytopenia. (D) assesses for infection, not risk for
bleeding.
10. The nurse is caring for a client with end stage liver disease who is being assessed for the
presence of asterixis. To assess the client for asterixis, what position should the nurse ask the
