2026 Medical-Surgical Nursing Test Bank | Actual Questions and
Correct Detailed Answers with Rationales/ HESI - Medical
Surgical Nursing Exam| Already Graded A+|Latest 2026
Update!!!
A nurse is caring for an older adult client who lives alone. Which
economic situation presents the most serious problem for this client?
a. costs of creating a living will
b. stock market fluctuations
c. increased provider benefits
d. social security as the basis of income
D
Older adults on fixed incomes are unable to adjust their income to
meet rising costs associated with meeting basic needs
Controlling pain is important to promoting wellness. Unrelieved pain
has been associated with
a. prolonged stress response and a cascade of harmful effects system
wide.
b. decreased tumor growth and longevity
c. large tidal volumes and decreased lung capacity
d. decreased carbohydrate, protein, and fat destruction
A
Pain triggers a number of physiologic stress responses in the human
body. Unrelieved pain can prolong the stress response and produce a
cascade of harmful effects in all body systems. The stress response
causes the endocrine system to release excessive amounts of
hormones, such as cortisol, catecholamines, and glucagon. Insulin and
pg. 1
,testosterone levels decrease. Increased endocrine activity in turn
initiates a number of metabolic processes, in particular, accelerated
carbohydrate, protein, and fat destruction, which can result in weight
loss, tachycardia, increased respiratory rate, shock, and even death.
The immune system is also affected by pain as demonstrated by
research showing a link between unrelieved pain and a higher
incidence of nosocomial infections and increased tumor growth.
Large tidal volumes are not associated with pain while decreased lung
capacity is associated with unrelieved pain. Decreased tumor growth
and longevity are not associated with unrelieved pain. Decreased
carbs, protein, and fat are not associated with pain or stress response.
Which intervention in a client with dehydration induced confusion is
most likely to relieve the confusion?
a. increasing the IV flow rate to 250 mL/hr
b. applying oxygen by mask or nasal cannula
c. placing the client in a high Fowler's position
d. Measuring intake and output every four hours
A
Dehydration most frequently leads to poor cerebra perfusion and
cerebral hypoxia, causing confusion. Applying oxygen can reduce
confusion, even if perfusion is still less than optimum. Increasing the
IV flow rate would increase perfusion. However, depending on the
degree of dehydration, rehydrating the person too rapidly with IV
fluids can lead to cerebral edema.
Which client is at greatest risk for dehydration?
a. younger adult client on bedrest
b. older adult client receiving hypotonic IV fluid
pg. 2
,c. older adult client with cognitive impairment
d. younger adult client receiving hypertonic IV fluid
C
Older adults, because they have less total body water than younger
adults, are at greater risk for development of dehydration. Anyone
who is cognitively impaired and cannot obtain fluids independently or
cannot make his or her need for fluids known is at high risk for
dehydration
A nurse is caring for several clients. Which client does the nurse
assess most carefully for hyperkalemia?
a. client with type 2 diabetes taking an oral anti-diabetic agent
b. client with heart failure using a salt substitute
c. client taking a thiazide diuretic for hypertension
d. client taking non-steroidal anti-inflammatory drugs daily
B
Many salt substitutes are composed of potassium chloride. Heavy use
cna contribute to the development of hyperkalemia. The client should
be taught to read labels and to choose a salt substitute that does not
contain potassium. NSAIDs promote the retention of sodium but not
potassium.
An older adult client presents with signs and symptoms related to dig
toxicity. Which age related change may have contributed to this
problem?
a. decreased renal blood flow
b. increased gastrointestinal motility
c. decreased ratio of adipose tissue to lean body mass
pg. 3
, d. increased total body water
A
Decreased renal blood flow and reduced glomerular filtration can
result in slower medication excretion time, potentially leading to toxic
drug accumulation. Aging results in decreased total body water and
gastrointestinal motility and an increase in the ratio of adipose tissue
to lean body mass, but is not related to dig toxicity.
A client is being treated for dehydration. Which statement made by
the client indicates understanding of this condition?
a. I will use a salt substitute when making and eating my meals.
b. I must drink a quart of water or other liquid each day.
c. I will not drink liquids after 6 PM so I won't have to get up at night.
d. I will weigh myself each morning before I eat or drink.
D
Because 1 L of water weighs 1 kg, change in body weight is a good
measure of excess fluid loss or fluid retention. Weight loss greater
than 0.5 lb daily is indicative of excessive fluid loss. The other
statements are not indicative of practices that will prevent
dehydration.
The nurse notes that the handgrip of the client with hypokalemia has
diminished since the previous assessment one hour ago. Which
intervention by the nurse is the priority?
a. assess the client's respiratory rate, rhythm, and depth
b. document findings and monitor the client
c. measure the client's pulse and blood pressure
d. call the health care provider
A
pg. 4
Correct Detailed Answers with Rationales/ HESI - Medical
Surgical Nursing Exam| Already Graded A+|Latest 2026
Update!!!
A nurse is caring for an older adult client who lives alone. Which
economic situation presents the most serious problem for this client?
a. costs of creating a living will
b. stock market fluctuations
c. increased provider benefits
d. social security as the basis of income
D
Older adults on fixed incomes are unable to adjust their income to
meet rising costs associated with meeting basic needs
Controlling pain is important to promoting wellness. Unrelieved pain
has been associated with
a. prolonged stress response and a cascade of harmful effects system
wide.
b. decreased tumor growth and longevity
c. large tidal volumes and decreased lung capacity
d. decreased carbohydrate, protein, and fat destruction
A
Pain triggers a number of physiologic stress responses in the human
body. Unrelieved pain can prolong the stress response and produce a
cascade of harmful effects in all body systems. The stress response
causes the endocrine system to release excessive amounts of
hormones, such as cortisol, catecholamines, and glucagon. Insulin and
pg. 1
,testosterone levels decrease. Increased endocrine activity in turn
initiates a number of metabolic processes, in particular, accelerated
carbohydrate, protein, and fat destruction, which can result in weight
loss, tachycardia, increased respiratory rate, shock, and even death.
The immune system is also affected by pain as demonstrated by
research showing a link between unrelieved pain and a higher
incidence of nosocomial infections and increased tumor growth.
Large tidal volumes are not associated with pain while decreased lung
capacity is associated with unrelieved pain. Decreased tumor growth
and longevity are not associated with unrelieved pain. Decreased
carbs, protein, and fat are not associated with pain or stress response.
Which intervention in a client with dehydration induced confusion is
most likely to relieve the confusion?
a. increasing the IV flow rate to 250 mL/hr
b. applying oxygen by mask or nasal cannula
c. placing the client in a high Fowler's position
d. Measuring intake and output every four hours
A
Dehydration most frequently leads to poor cerebra perfusion and
cerebral hypoxia, causing confusion. Applying oxygen can reduce
confusion, even if perfusion is still less than optimum. Increasing the
IV flow rate would increase perfusion. However, depending on the
degree of dehydration, rehydrating the person too rapidly with IV
fluids can lead to cerebral edema.
Which client is at greatest risk for dehydration?
a. younger adult client on bedrest
b. older adult client receiving hypotonic IV fluid
pg. 2
,c. older adult client with cognitive impairment
d. younger adult client receiving hypertonic IV fluid
C
Older adults, because they have less total body water than younger
adults, are at greater risk for development of dehydration. Anyone
who is cognitively impaired and cannot obtain fluids independently or
cannot make his or her need for fluids known is at high risk for
dehydration
A nurse is caring for several clients. Which client does the nurse
assess most carefully for hyperkalemia?
a. client with type 2 diabetes taking an oral anti-diabetic agent
b. client with heart failure using a salt substitute
c. client taking a thiazide diuretic for hypertension
d. client taking non-steroidal anti-inflammatory drugs daily
B
Many salt substitutes are composed of potassium chloride. Heavy use
cna contribute to the development of hyperkalemia. The client should
be taught to read labels and to choose a salt substitute that does not
contain potassium. NSAIDs promote the retention of sodium but not
potassium.
An older adult client presents with signs and symptoms related to dig
toxicity. Which age related change may have contributed to this
problem?
a. decreased renal blood flow
b. increased gastrointestinal motility
c. decreased ratio of adipose tissue to lean body mass
pg. 3
, d. increased total body water
A
Decreased renal blood flow and reduced glomerular filtration can
result in slower medication excretion time, potentially leading to toxic
drug accumulation. Aging results in decreased total body water and
gastrointestinal motility and an increase in the ratio of adipose tissue
to lean body mass, but is not related to dig toxicity.
A client is being treated for dehydration. Which statement made by
the client indicates understanding of this condition?
a. I will use a salt substitute when making and eating my meals.
b. I must drink a quart of water or other liquid each day.
c. I will not drink liquids after 6 PM so I won't have to get up at night.
d. I will weigh myself each morning before I eat or drink.
D
Because 1 L of water weighs 1 kg, change in body weight is a good
measure of excess fluid loss or fluid retention. Weight loss greater
than 0.5 lb daily is indicative of excessive fluid loss. The other
statements are not indicative of practices that will prevent
dehydration.
The nurse notes that the handgrip of the client with hypokalemia has
diminished since the previous assessment one hour ago. Which
intervention by the nurse is the priority?
a. assess the client's respiratory rate, rhythm, and depth
b. document findings and monitor the client
c. measure the client's pulse and blood pressure
d. call the health care provider
A
pg. 4
