HESI RN MED SURG EXAM PACK-EXAM
MERGED FROM 2024|2025|2026|ACTUAL
EXAMS.NEXT GEN-ACTUAL EXAM
REVIEW MED SURG EXAM PACK BEST
FOR 2026
The nurse is caring for a client with an oxygen saturation of 88% and accessory muscle use. The
nurse provides oxygen and anticipates which of these physician orders?
A) Administration of IV sodium bicarbonate
B) Computed tomography (CT) of the chest, stat
C) Intubation and mechanical ventilation
D) Administration of concentrated potassium chloride solution - ANSWER -C) Intubation and
mechanical ventilation
Rationale: Support with mechanical ventilation may be needed for clients who cannot keep
their oxygen saturation at 90% or who have respiratory muscle fatigue. A) Sodium bicarbonate is
used to treat metabolic acidosis; this client displays hypoxemia. B) Although the underlying
reason for this client's hypoxemia may eventually require a diagnostic study, the priority is to
restore oxygenation. D) No indication suggests that this client has hypokalemia. Signs of
hypoxemia and work of breathing are present, requiring correction with intubation and
mechanical ventilation.
A male client receives a local anesthetic during surgery. During the post-operative assessment,
the nurse notices the client is slurring his speech. Which action should the nurse take?
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,A) Determine the client is anxious and allow him to sleep.
B) Evaluate his blood pressure, pulse, and respiratory status.
C) Review the client's pre-operative history for alcohol abuse.
D) Continue to monitor the client for reactivity to anesthesia. - ANSWER -B) Evaluate his blood
pressure, pulse, and respiratory status.
Rationale: Slurred speech in the post-operative client who received a local anesthetic is an
atypical finding and may indicate neurological deficits that require further assessment, so
obtaining the client's vital signs (B) will provide information about possible cardiovascular
complications, such as stroke. The client's anxiety (A), a history of alcohol abuse (D), or local
anesthesia (D) are unrelated to the client's sudden onset of slurred speech.
When providing discharge teaching for a client with osteoporosis, the nurse should reinforce
which home care activity?
A) A diet low in phosphates.
B) Skin inspection for bruising.
C) Exercise regimen, including swimming.
D) Elimination of hazards to home safety. - ANSWER -D) Elimination of hazards to home safety.
Rationale: Discussion about fall prevention strategies is imperative for the discharged client with
osteoporosis so that advice about safety measures can be given (D). A low phosphorus diet is
not recommended in the treatment of osteoporosis (A). Bruising (B) is not a related symptom to
osteoporosis. Weight-bearing exercise is most beneficial for clients with osteoporosis.
Swimming (C) is not a weight-bearing exercise.
During lung assessment, the nurse places a stethoscope on a client's chest and instructs
him/her to say "99" each time the chest is touched with the stethoscope. What should be the
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,correct interpretation if the nurse hears the spoken words "99" very clearly through the
stethoscope?
A) This is a normal auscultatory finding.
B) May indicate pneumothorax.
C) May indicate pneumonia.
D) May indicate severe emphysema. - ANSWER -C) May indicate pneumonia.
Rationale: This test (whispered pectoriloquy) demonstrates hyperresonance and helps
determine the clarity with which spoken words are heard upon auscultation. Normally, the
spoken word is not well transmitted through lung tissue, and is heard as a muffled or unclear
transmission of the spoken word. Increased clarity of a spoken word is indicative of some sort of
consolidation process (e.g., tumor, pneumonia) (C), and is not a normal finding (A). When lung
tissue is filled with more air than normal, the voice sounds are absent or very diminished (e.g.,
pneumothorax, severe emphysema) (B and D).
The nurse is caring for a group of clients with acidosis. The nurse recognizes that Kussmaul
respirations are consistent with which situation?
A) Client receiving mechanical ventilation
B) Use of hydrochlorothiazide
C) Aspirin overdose
D) Administration of sodium bicarbonate - ANSWER -C) Aspirin overdose
Rationale: If acidosis is metabolic in origin, the rate and depth of breathing increase as the
hydrogen ion level rises; this is known as Kussmaul respirations. Metabolic acidosis is caused by
alcoholic beverages, methyl alcohol, and acetylsalicylic acid (aspirin). A) Mechanical ventilation
is used to correct hypoxemia and hypercapnia (elevated Pco2). B) Hydrochlorothiazide causes
metabolic alkalosis; clients who display metabolic acidosis compensate with Kussmaul
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, respirations. D) Sodium bicarbonate is used in the treatment of metabolic acidosis;
administration of this buffer may cause metabolic alkalosis.
During an interview with a client planning elective surgery, the client asks the nurse, "What is
the advantage of having a preferred provider organization insurance plan?" Which response is
best for the nurse to provide?
A) Long-term relationships with healthcare providers are more likely.
B) There are fewer healthcare providers to choose from than in an HMO plan.
C) Insurance coverage of employees is less expensive to employers.
D) An individual can become a member of a PPO without belonging to a group. - ANSWER -C)
Insurance coverage of employees is less expensive to employers.
Rationale: The financial advantage of (C) is the feature of a PPO that is most relevant to the
average consumer. The nurse must have knowledge about PPOs, which provide discounted rates
to large employers who provide insurance coverage for their employees. In return, the
insurance company receives a large pool of clients for their facilities. (A, B, and D) are not
accurate representations of the PPO.
A client has taken steroids for 12 years to help manage chronic obstructive pulmonary disease
(COPD). When making a home visit, which nursing function is of greatest importance to this
client? Assess the client's
A) pulse rate, both apically and radially.
B) blood pressure, both standing and sitting.
C) temperature.
D) skin color and turgor. - ANSWER -C) temperature.
4|Page
MERGED FROM 2024|2025|2026|ACTUAL
EXAMS.NEXT GEN-ACTUAL EXAM
REVIEW MED SURG EXAM PACK BEST
FOR 2026
The nurse is caring for a client with an oxygen saturation of 88% and accessory muscle use. The
nurse provides oxygen and anticipates which of these physician orders?
A) Administration of IV sodium bicarbonate
B) Computed tomography (CT) of the chest, stat
C) Intubation and mechanical ventilation
D) Administration of concentrated potassium chloride solution - ANSWER -C) Intubation and
mechanical ventilation
Rationale: Support with mechanical ventilation may be needed for clients who cannot keep
their oxygen saturation at 90% or who have respiratory muscle fatigue. A) Sodium bicarbonate is
used to treat metabolic acidosis; this client displays hypoxemia. B) Although the underlying
reason for this client's hypoxemia may eventually require a diagnostic study, the priority is to
restore oxygenation. D) No indication suggests that this client has hypokalemia. Signs of
hypoxemia and work of breathing are present, requiring correction with intubation and
mechanical ventilation.
A male client receives a local anesthetic during surgery. During the post-operative assessment,
the nurse notices the client is slurring his speech. Which action should the nurse take?
1|Page
,A) Determine the client is anxious and allow him to sleep.
B) Evaluate his blood pressure, pulse, and respiratory status.
C) Review the client's pre-operative history for alcohol abuse.
D) Continue to monitor the client for reactivity to anesthesia. - ANSWER -B) Evaluate his blood
pressure, pulse, and respiratory status.
Rationale: Slurred speech in the post-operative client who received a local anesthetic is an
atypical finding and may indicate neurological deficits that require further assessment, so
obtaining the client's vital signs (B) will provide information about possible cardiovascular
complications, such as stroke. The client's anxiety (A), a history of alcohol abuse (D), or local
anesthesia (D) are unrelated to the client's sudden onset of slurred speech.
When providing discharge teaching for a client with osteoporosis, the nurse should reinforce
which home care activity?
A) A diet low in phosphates.
B) Skin inspection for bruising.
C) Exercise regimen, including swimming.
D) Elimination of hazards to home safety. - ANSWER -D) Elimination of hazards to home safety.
Rationale: Discussion about fall prevention strategies is imperative for the discharged client with
osteoporosis so that advice about safety measures can be given (D). A low phosphorus diet is
not recommended in the treatment of osteoporosis (A). Bruising (B) is not a related symptom to
osteoporosis. Weight-bearing exercise is most beneficial for clients with osteoporosis.
Swimming (C) is not a weight-bearing exercise.
During lung assessment, the nurse places a stethoscope on a client's chest and instructs
him/her to say "99" each time the chest is touched with the stethoscope. What should be the
2|Page
,correct interpretation if the nurse hears the spoken words "99" very clearly through the
stethoscope?
A) This is a normal auscultatory finding.
B) May indicate pneumothorax.
C) May indicate pneumonia.
D) May indicate severe emphysema. - ANSWER -C) May indicate pneumonia.
Rationale: This test (whispered pectoriloquy) demonstrates hyperresonance and helps
determine the clarity with which spoken words are heard upon auscultation. Normally, the
spoken word is not well transmitted through lung tissue, and is heard as a muffled or unclear
transmission of the spoken word. Increased clarity of a spoken word is indicative of some sort of
consolidation process (e.g., tumor, pneumonia) (C), and is not a normal finding (A). When lung
tissue is filled with more air than normal, the voice sounds are absent or very diminished (e.g.,
pneumothorax, severe emphysema) (B and D).
The nurse is caring for a group of clients with acidosis. The nurse recognizes that Kussmaul
respirations are consistent with which situation?
A) Client receiving mechanical ventilation
B) Use of hydrochlorothiazide
C) Aspirin overdose
D) Administration of sodium bicarbonate - ANSWER -C) Aspirin overdose
Rationale: If acidosis is metabolic in origin, the rate and depth of breathing increase as the
hydrogen ion level rises; this is known as Kussmaul respirations. Metabolic acidosis is caused by
alcoholic beverages, methyl alcohol, and acetylsalicylic acid (aspirin). A) Mechanical ventilation
is used to correct hypoxemia and hypercapnia (elevated Pco2). B) Hydrochlorothiazide causes
metabolic alkalosis; clients who display metabolic acidosis compensate with Kussmaul
3|Page
, respirations. D) Sodium bicarbonate is used in the treatment of metabolic acidosis;
administration of this buffer may cause metabolic alkalosis.
During an interview with a client planning elective surgery, the client asks the nurse, "What is
the advantage of having a preferred provider organization insurance plan?" Which response is
best for the nurse to provide?
A) Long-term relationships with healthcare providers are more likely.
B) There are fewer healthcare providers to choose from than in an HMO plan.
C) Insurance coverage of employees is less expensive to employers.
D) An individual can become a member of a PPO without belonging to a group. - ANSWER -C)
Insurance coverage of employees is less expensive to employers.
Rationale: The financial advantage of (C) is the feature of a PPO that is most relevant to the
average consumer. The nurse must have knowledge about PPOs, which provide discounted rates
to large employers who provide insurance coverage for their employees. In return, the
insurance company receives a large pool of clients for their facilities. (A, B, and D) are not
accurate representations of the PPO.
A client has taken steroids for 12 years to help manage chronic obstructive pulmonary disease
(COPD). When making a home visit, which nursing function is of greatest importance to this
client? Assess the client's
A) pulse rate, both apically and radially.
B) blood pressure, both standing and sitting.
C) temperature.
D) skin color and turgor. - ANSWER -C) temperature.
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