MED SURG II HESI ELSEVIER 2026 AND 2027
MASTER GUIDE FULL QUESTIONS AND 100%
VERIFIED CORRECT ANSWERS.
◎ A 55-year-old male client has been admitted to the hospital with a medical diagnosis
of chronic obstructive pulmonary disease (COPD). Which risk factor is the most
significant in the development of this client's COPD?
A.
The client's father was diagnosed with COPD in his 50s.
B.
A close family member contracted tuberculosis last year.
C.
The client smokes one to two packs of cigarettes per day.
D.
The client has been 40 pounds overweight for 15 years. ANSWER:- C
Rationale:Smoking, considered to be a modifiable risk factor, is the most significant risk
factor for the development of COPD. The exact mechanism of genetic and hereditary
implications for the development of COPD is still under investigation, although exposure
to similar predisposing factors (e.g., smoking or inhaling secondhand smoke) may
increase the likelihood of COPD incidence among family members. Options B and D do
not exceed the risks associated with cigarette smoking in the development of COPD.
◎ In assessing a client diagnosed with primary aldosteronism, the nurse expects the
laboratory test results to indicate a decreased serum level of which substance?
A.
Sodium
B.
Phosphate
C.
Potassium
D.
Glucose ANSWER:- C
Rationale:Clients with primary aldosteronism exhibit a profound decline in serum levels
of potassium; hypokalemia; hypertension is the most prominent and universal sign. The
serum sodium level is normal or elevated, depending on the amount of water resorbed
with the sodium. Option B is influenced by parathyroid hormone (PTH). Option D is not
affected by primary aldosteronism.
◎ The nurse is completing an admission interview for a client with Parkinson disease.
Which question will provide additional information about manifestations that the client is
likely to experience?
A.
"Have you ever experienced any paralysis of your arms or legs?"
, B.
"Do you have frequent blackout spells?"
C.
"Have you ever been frozen in one spot, unable to move?"
D.
"Do you have headaches, especially ones with throbbing pain?" ANSWER:- C
Rationale:Clients with Parkinson disease frequently experience difficulty in initiating,
maintaining, and performing motor activities. They may even experience being rooted to
the spot and unable to move. Parkinson disease does not typically cause option A, B, or
D.
◎ Client census is often used to determine staffing needs. Which method of obtaining
census determination for a particular unit provides the best formula for determining
long-range staffing patterns?
A.
Midnight census
B.
Oncoming shift census
C.
Average daily census
D.
Hourly census ANSWER:- C
Rationale:An average daily census is determined by trend data and takes into account
seasonal and daily fluctuations, so it is the best method for determining staffing needs.
Options A and B provide data at a certain point in time, and that data could change
quickly. It is unrealistic to expect to obtain an hourly census, and such data would only
provide information about a certain point in time.
◎ A male client has just undergone a laryngectomy and has a cuffed tracheostomy
tube in place. When initiating bolus tube feedings postoperatively, when should the
nurse inflate the cuff?
A.
Immediately after feeding
B.
Just prior to tube feeding
C.
Continuous inflation is required
D.
Inflation is not required ANSWER:- B
Rationale:The cuff should be inflated before the feeding to block the trachea and
prevent food from entering if oral feedings are started while a cuffed tracheostomy tube
is in place. It should remain inflated throughout the feeding to prevent aspiration of food
into the respiratory system. Options A and D place the client at risk for aspiration.
Option C places the client at risk for tracheal wall necrosis.
,◎ 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.
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 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.
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.
MASTER GUIDE FULL QUESTIONS AND 100%
VERIFIED CORRECT ANSWERS.
◎ A 55-year-old male client has been admitted to the hospital with a medical diagnosis
of chronic obstructive pulmonary disease (COPD). Which risk factor is the most
significant in the development of this client's COPD?
A.
The client's father was diagnosed with COPD in his 50s.
B.
A close family member contracted tuberculosis last year.
C.
The client smokes one to two packs of cigarettes per day.
D.
The client has been 40 pounds overweight for 15 years. ANSWER:- C
Rationale:Smoking, considered to be a modifiable risk factor, is the most significant risk
factor for the development of COPD. The exact mechanism of genetic and hereditary
implications for the development of COPD is still under investigation, although exposure
to similar predisposing factors (e.g., smoking or inhaling secondhand smoke) may
increase the likelihood of COPD incidence among family members. Options B and D do
not exceed the risks associated with cigarette smoking in the development of COPD.
◎ In assessing a client diagnosed with primary aldosteronism, the nurse expects the
laboratory test results to indicate a decreased serum level of which substance?
A.
Sodium
B.
Phosphate
C.
Potassium
D.
Glucose ANSWER:- C
Rationale:Clients with primary aldosteronism exhibit a profound decline in serum levels
of potassium; hypokalemia; hypertension is the most prominent and universal sign. The
serum sodium level is normal or elevated, depending on the amount of water resorbed
with the sodium. Option B is influenced by parathyroid hormone (PTH). Option D is not
affected by primary aldosteronism.
◎ The nurse is completing an admission interview for a client with Parkinson disease.
Which question will provide additional information about manifestations that the client is
likely to experience?
A.
"Have you ever experienced any paralysis of your arms or legs?"
, B.
"Do you have frequent blackout spells?"
C.
"Have you ever been frozen in one spot, unable to move?"
D.
"Do you have headaches, especially ones with throbbing pain?" ANSWER:- C
Rationale:Clients with Parkinson disease frequently experience difficulty in initiating,
maintaining, and performing motor activities. They may even experience being rooted to
the spot and unable to move. Parkinson disease does not typically cause option A, B, or
D.
◎ Client census is often used to determine staffing needs. Which method of obtaining
census determination for a particular unit provides the best formula for determining
long-range staffing patterns?
A.
Midnight census
B.
Oncoming shift census
C.
Average daily census
D.
Hourly census ANSWER:- C
Rationale:An average daily census is determined by trend data and takes into account
seasonal and daily fluctuations, so it is the best method for determining staffing needs.
Options A and B provide data at a certain point in time, and that data could change
quickly. It is unrealistic to expect to obtain an hourly census, and such data would only
provide information about a certain point in time.
◎ A male client has just undergone a laryngectomy and has a cuffed tracheostomy
tube in place. When initiating bolus tube feedings postoperatively, when should the
nurse inflate the cuff?
A.
Immediately after feeding
B.
Just prior to tube feeding
C.
Continuous inflation is required
D.
Inflation is not required ANSWER:- B
Rationale:The cuff should be inflated before the feeding to block the trachea and
prevent food from entering if oral feedings are started while a cuffed tracheostomy tube
is in place. It should remain inflated throughout the feeding to prevent aspiration of food
into the respiratory system. Options A and D place the client at risk for aspiration.
Option C places the client at risk for tracheal wall necrosis.
,◎ 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.
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 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.
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.
