HESI RN MED SURG EXAM PACK-EXAM
MERGED FROM 2023|2024|2025|2026
ACTUAL EXAMS.NEXT GEN-ACTUAL
EXAM REVIEW MED SURG EXAM PACK
BEST FOR 2026
A client with a nasogastric tube attached to low suction states that she is nauseated. The nurse
assesses that there has been no drainage through the nasogastric tube in the last 2 hours.
Which action should the nurse take first?
A.
Irrigate the nasogastric tube with sterile normal saline.
B.
Reposition the client on her side.
C.
Advance the nasogastric tube 5 cm.
D.
Administer an intravenous antiemetic as prescribed. - ANSWER -B
Rationale:The immediate priority is to determine if the tube is functioning correctly, which
would then relieve the client's nausea. The least invasive intervention, repositioning the client,
should be attempted first, followed by options A and C, unless either of these interventions is
contraindicated. If these measures are unsuccessful, the client may require option D.
The nurse is conducting an osteoporosis screening clinic at a health fair. What information
should the nurse provide to individuals who are at risk for osteoporosis? (Select all that apply.)
A.
Encourage alcohol and smoking cessation.
1|Page
,B.
Suggest supplementing diet with vitamin E.
C.
Promote regular weight-bearing exercises.
D.
Implement a home safety plan to prevent falls.
E.
Propose a regular sleep pattern of 8 hours nightly. - ANSWER -A, C, D
Rationale:Options A, C, and D are factors that decrease the risk for developing osteoporosis.
Vitamin D and calcium are important supplements to aid in the decrease of bone loss. Regular
sleep patterns are important to overall health but are not identified with a decreasing risk for
osteoporosis.
Which nursing action would be appropriate for a client who is newly diagnosed with Cushing
syndrome?
A.
Monitor blood glucose levels daily.
B.
Increase intake of fluids high in potassium.
C.
Encourage adequate rest between activities.
D.
Offer the client a sodium-enriched menu. - ANSWER -A
Rationale:Cushing syndrome results from a hypersecretion of glucocorticoids in the adrenal
cortex. Clients with Cushing syndrome often develop diabetes mellitus. Monitoring of serum
glucose levels assesses for increased blood glucose levels so that treatment can begin early. A
common finding in Cushing syndrome is generalized edema. Although potassium is needed, it is
generally obtained from food intake, not by offering potassium-enhanced fluids. Fatigue is
2|Page
,usually not an overwhelming factor in Cushing syndrome, so an emphasis on the need for rest is
not indicated. A low-calorie, low-carbohydrate, low-sodium diet is not recommended.
A 58-year-old client who has no health problems asks the nurse about receiving the
pneumococcal vaccine. Which statement given by the nurse would offer the client accurate
information about this vaccine?
A.
The vaccine is given annually before the flu season to those older than 50 years.
B.
The immunization is administered once to older adults or those at risk for illness.
C.
The vaccine is for all ages and is given primarily to those persons traveling overseas to areas of
infection.
D.
The vaccine will prevent the occurrence of pneumococcal pneumonia for up to 5 years. -
ANSWER -B
Rationale:It is usually recommended that persons older than 65 years and those with a history
of chronic illness should receive the vaccine once in their lifetime. Some recommend receiving
the vaccine at 50 years of age. The influenza vaccine is given once a year. Although the vaccine
might be given to a person traveling overseas, that is not the main rationale for administering
the vaccine. The vaccine is usually given once in a lifetime, but with immunosuppressed clients
or clients with a history of pneumonia, revaccination is sometimes required.
A client is admitted to the hospital with severe lower left abdominal pain, nausea, vomiting,
fever, and chills. Which nursing action has the highest priority?
A.
Place the client on NPO status.
B.
Assess the client's temperature.
3|Page
, C.
Obtain a stool specimen.
D.
Administer IV fluids. - ANSWER -A
Rationale:A client is showing signs of acute severe diverticulitis and is at risk for peritonitis and
intestinal obstruction. The nurse should make the client NPO to reduce risk of intestinal rupture.
Options B, C, and D are important but are less of a priority than option A, which is implemented
to prevent a severe complication.
A client on telemetry has a pattern of uncontrolled atrial fibrillation with a rapid ventricular
response. Based on this finding, the nurse anticipates assisting the physician with which
treatment?
A.
Administer lidocaine, 75 mg intravenous push.
B.
Perform synchronized cardioversion.
C.
Defibrillate the client as soon as possible.
D.
Administer atropine, 0.4 mg intravenous push. - ANSWER -B
Rationale:With uncontrolled atrial fibrillation, the treatment of choice is synchronized
cardioversion to convert the cardiac rhythm back to normal sinus rhythm. Option A is a
medication used for ventricular dysrhythmias. Option C is not for a client with atrial fibrillation;
it is reserved for clients with life-threatening dysrhythmias, such as ventricular fibrillation and
unstable ventricular tachycardia. Option D is the drug of choice in symptomatic sinus
bradycardia, not atrial fibrillation.
The nurse is preparing a client for discharge after a right total knee replacement. Which client
statements about use of a walker indicate to the nurse the teaching was effective? (Select all
that apply.)
4|Page
MERGED FROM 2023|2024|2025|2026
ACTUAL EXAMS.NEXT GEN-ACTUAL
EXAM REVIEW MED SURG EXAM PACK
BEST FOR 2026
A client with a nasogastric tube attached to low suction states that she is nauseated. The nurse
assesses that there has been no drainage through the nasogastric tube in the last 2 hours.
Which action should the nurse take first?
A.
Irrigate the nasogastric tube with sterile normal saline.
B.
Reposition the client on her side.
C.
Advance the nasogastric tube 5 cm.
D.
Administer an intravenous antiemetic as prescribed. - ANSWER -B
Rationale:The immediate priority is to determine if the tube is functioning correctly, which
would then relieve the client's nausea. The least invasive intervention, repositioning the client,
should be attempted first, followed by options A and C, unless either of these interventions is
contraindicated. If these measures are unsuccessful, the client may require option D.
The nurse is conducting an osteoporosis screening clinic at a health fair. What information
should the nurse provide to individuals who are at risk for osteoporosis? (Select all that apply.)
A.
Encourage alcohol and smoking cessation.
1|Page
,B.
Suggest supplementing diet with vitamin E.
C.
Promote regular weight-bearing exercises.
D.
Implement a home safety plan to prevent falls.
E.
Propose a regular sleep pattern of 8 hours nightly. - ANSWER -A, C, D
Rationale:Options A, C, and D are factors that decrease the risk for developing osteoporosis.
Vitamin D and calcium are important supplements to aid in the decrease of bone loss. Regular
sleep patterns are important to overall health but are not identified with a decreasing risk for
osteoporosis.
Which nursing action would be appropriate for a client who is newly diagnosed with Cushing
syndrome?
A.
Monitor blood glucose levels daily.
B.
Increase intake of fluids high in potassium.
C.
Encourage adequate rest between activities.
D.
Offer the client a sodium-enriched menu. - ANSWER -A
Rationale:Cushing syndrome results from a hypersecretion of glucocorticoids in the adrenal
cortex. Clients with Cushing syndrome often develop diabetes mellitus. Monitoring of serum
glucose levels assesses for increased blood glucose levels so that treatment can begin early. A
common finding in Cushing syndrome is generalized edema. Although potassium is needed, it is
generally obtained from food intake, not by offering potassium-enhanced fluids. Fatigue is
2|Page
,usually not an overwhelming factor in Cushing syndrome, so an emphasis on the need for rest is
not indicated. A low-calorie, low-carbohydrate, low-sodium diet is not recommended.
A 58-year-old client who has no health problems asks the nurse about receiving the
pneumococcal vaccine. Which statement given by the nurse would offer the client accurate
information about this vaccine?
A.
The vaccine is given annually before the flu season to those older than 50 years.
B.
The immunization is administered once to older adults or those at risk for illness.
C.
The vaccine is for all ages and is given primarily to those persons traveling overseas to areas of
infection.
D.
The vaccine will prevent the occurrence of pneumococcal pneumonia for up to 5 years. -
ANSWER -B
Rationale:It is usually recommended that persons older than 65 years and those with a history
of chronic illness should receive the vaccine once in their lifetime. Some recommend receiving
the vaccine at 50 years of age. The influenza vaccine is given once a year. Although the vaccine
might be given to a person traveling overseas, that is not the main rationale for administering
the vaccine. The vaccine is usually given once in a lifetime, but with immunosuppressed clients
or clients with a history of pneumonia, revaccination is sometimes required.
A client is admitted to the hospital with severe lower left abdominal pain, nausea, vomiting,
fever, and chills. Which nursing action has the highest priority?
A.
Place the client on NPO status.
B.
Assess the client's temperature.
3|Page
, C.
Obtain a stool specimen.
D.
Administer IV fluids. - ANSWER -A
Rationale:A client is showing signs of acute severe diverticulitis and is at risk for peritonitis and
intestinal obstruction. The nurse should make the client NPO to reduce risk of intestinal rupture.
Options B, C, and D are important but are less of a priority than option A, which is implemented
to prevent a severe complication.
A client on telemetry has a pattern of uncontrolled atrial fibrillation with a rapid ventricular
response. Based on this finding, the nurse anticipates assisting the physician with which
treatment?
A.
Administer lidocaine, 75 mg intravenous push.
B.
Perform synchronized cardioversion.
C.
Defibrillate the client as soon as possible.
D.
Administer atropine, 0.4 mg intravenous push. - ANSWER -B
Rationale:With uncontrolled atrial fibrillation, the treatment of choice is synchronized
cardioversion to convert the cardiac rhythm back to normal sinus rhythm. Option A is a
medication used for ventricular dysrhythmias. Option C is not for a client with atrial fibrillation;
it is reserved for clients with life-threatening dysrhythmias, such as ventricular fibrillation and
unstable ventricular tachycardia. Option D is the drug of choice in symptomatic sinus
bradycardia, not atrial fibrillation.
The nurse is preparing a client for discharge after a right total knee replacement. Which client
statements about use of a walker indicate to the nurse the teaching was effective? (Select all
that apply.)
4|Page
