Page 1 of 23
HESI MEDICAL SURGICAL EXAM ALL ACTUAL EXAM QUESTIONS WITH
ANSWERS
The nurse is providing dietary instructions to a 68-year-old client who is
at high risk for development of coronary heart disease (CHD). Which
information should the nurse include?
Limit dietary selection of cholesterol to 300 mg per day.
Increase intake of soluble fiber to 10 to 25 grams per day.
Decrease plant stanols and sterols to less than 2 grams/day. Ensure saturated
fat is less than 30% of total caloric intake.
Rationale
To reduce risk factors associated with coronary heart disease, the daily
intake of soluble fiber should be increased to between 10 and 25 gm.
According to the American Heart Association, soluble fibers helps reduce
the LDL cholesterol levels.
Despite several eye surgeries, a 78-year-old client who lives alone has
persistent vision problems. The visiting nurse is discussing home safety
hazards with the client. The nurse suggests that the edges of the steps be
painted which color?
White.
Light green.
Medium yellow.
Black.
Rationale
The color yellow is the easiest for a person with failing
vision to see.
A client receiving cholestyramine (Questran) for hyperlipidemia should be
evaluated for what vitamin deficiency?
B
1
2
Rationale .
This drug is administered to help lower the triglycerides levels. One of the
side effects clients should be monitored for an increased prothrombin time
and prolonged bleeding times which would alert the nurse to a vitamin K
deficiency. These drugs reduce absorption of the fat soluble (lipid) vitamins
A, D, E, and K.
The nurse is caring for a client with a stroke resulting in right-sided paresis
and aphasia. The client attempts to use the left hand for feeding and other
self-care activities. The spouse
, lOMoARcPSD|5422489
becomes frustrated and insists on doing everything for the client. Based on
this data, which nursing diagnosis should the nurse document for this
client?
Situational low self-esteem related to functional impairment and change in role function.
Disabled family coping related to dissonant
coping stylefamily
Interrupted of significant person.
processes related to shif
in health status of family member.
Risk for ineffective therapeutic regimen
Rationale management related to complexity of care.
A stroke affects the whole family and in this case the spouse probably
thinks that she is helping and needs to feel that she is contributing to the
client's care. Her help is noted as being incongruent with attempts of self-
care by the client thereby disabling family coping.
The nurse is interviewing a male client with hypertension. Which additional
medical diagnosis in the client's history presents the greatest risk for
developing a cerebral vascular accident (CVA)?
Diabetes mellitus.
Hypothyroidism.
P
a
r
Rationale
According to the National Stroke Association (2013), history of diabetes
mellitus poses the greatest risk for developing a CVA, 2-4Xs more than
those who do not have diabetes mellitus. The reason for this occurrence is
related to the excess glucose circulating throughout the body not being
utilizing by the cells of the body, leading to the increased fatty deposits or
clots inside the blood vessels in the brain or neck, eventually causing a
stroke.
In assessing a client diagnosed with primary hyperaldosteronism, the
nurse expects the laboratory test results to indicate a decreased serum
level of which substance?
Sodium.
A
n
t
i
Rationale
Clients with primary hyperaldosteronism exhibit a profound decline in the
serum levels of potassium (hypokalemia). Hypertension, along with the
hypokalemia are the most
prominent and universal signs for this condition. If both of these findings
are present, there is 50% likelihood the client to be diagnosed with
hyperaldosteronism.
Which intervention should the nurse implement for a female client
, Page 3 of 23
Describe proper administration of vaginal suppositories and cream.
Encourage the client to perform Kegel exercises 10 times daily.
Explain the importance of using condoms when having sexual intercourse.
Discuss the importance of keeping a diary of daily temperature and menstrual
cycle events. Rationale
Pelvic relaxation disorders are structural disorders resulting from
weakening support tissues of the pelvis. Kegel exercises helps
strengthen the surrounding muscles.
A splint is prescribed for nighttime use by a client with rheumatoid
arthritis. Which statement by the nurse provides the most accurate
explanation for use of the splints?
Prevention of deformities.
Avoidance of joint trauma.
R
e
Rationale l
Splints may be used at night by clients with rheumatoid arthritis to
prevent deformities caused by muscle spasms and contractures.
The nurse is teaching a female client who uses a contraceptive diaphragm
about reducing the risk for toxic shock syndrome (TSS). Which
information should the nurse include?
(Select all that apply.)
Select all that apply
Remove the diaphragm immediately after intercourse.
Wash the diaphragm with an alcohol solution.
Use the diaphragm to prevent conception during the menstrual cycle.
Do not leave the diaphragm in place longer than 8 hours after intercourse. Replace the old
diaphragm every 3 months.
Rationale
The diaphragm needs to remain against the cervix for 6 to 8 hours to
prevent pregnancy but should not remain for longer than 8 hours to avoid
the risk of TSS.
The diaphragm should be replaced every 3 months to maintain integrity.
A client has a staging procedure for cancer of the breast and ask the
nurse which type of breast cancer has the poorest prognosis. Which
information should the nurse offer the client?
Stage II.
Inva
sive
infiltr
atin
, lOMoARcPSD|5422489
Rationale
Inflammatory breast cancer onset is very rapid and a very rare form of
breast cancer and is considered the most aggressive form of breast
malignancies. It is often mistaken for a breast infection because it has a
thickened appearance like an orange peel (peau d'orange), causing the
breast to become swollen and
tender.
A client with a 16-year history of diabetes mellitus is having renal function
tests because of recent fatigue, weakness, elevated blood urea nitrogen,
and serum creatinine levels. Which finding should the nurse conclude as
an early symptom of renal insufficiency?
Dyspnea.
Nocturia.
C
o
n
Rationale
As the glomerular filtration rate decreases in early renal insufficiency,
metabolic waste products, including urea, creatinine, and other
substances, such phenols, hormones, electrolytes, accumulate in the
blood. In the early stage of renal insufficiency, polyuria results from the
inability of the kidneys to concentrate urine and contribute to nocturia.
The nurse is planning care for a client with newly diagnosed diabetes
mellitus that requires insulin. Which assessment should the nurse identify
before beginning the teaching session?
Present
knowledge
related to
the skill of
Rationale injection.
If a client is incapable or does not want to learn, it is unlikely that
learning will occur, so motivation is the first factor the nurse should
assess before teaching.
Small bowel obstruction is a condition characterized by which finding?
and electrolyte imbalances.
Metabolic acidosis.
Ribbon-like stools.
Intermittent lower abdominal cramping.
Rationale
Among the findings characteristic of a small bowel obstruction is the
presence of severe fluid and electrolyte imbalances.
The nurse is taking a history of a newly diagnosed Type 2 diabetic
HESI MEDICAL SURGICAL EXAM ALL ACTUAL EXAM QUESTIONS WITH
ANSWERS
The nurse is providing dietary instructions to a 68-year-old client who is
at high risk for development of coronary heart disease (CHD). Which
information should the nurse include?
Limit dietary selection of cholesterol to 300 mg per day.
Increase intake of soluble fiber to 10 to 25 grams per day.
Decrease plant stanols and sterols to less than 2 grams/day. Ensure saturated
fat is less than 30% of total caloric intake.
Rationale
To reduce risk factors associated with coronary heart disease, the daily
intake of soluble fiber should be increased to between 10 and 25 gm.
According to the American Heart Association, soluble fibers helps reduce
the LDL cholesterol levels.
Despite several eye surgeries, a 78-year-old client who lives alone has
persistent vision problems. The visiting nurse is discussing home safety
hazards with the client. The nurse suggests that the edges of the steps be
painted which color?
White.
Light green.
Medium yellow.
Black.
Rationale
The color yellow is the easiest for a person with failing
vision to see.
A client receiving cholestyramine (Questran) for hyperlipidemia should be
evaluated for what vitamin deficiency?
B
1
2
Rationale .
This drug is administered to help lower the triglycerides levels. One of the
side effects clients should be monitored for an increased prothrombin time
and prolonged bleeding times which would alert the nurse to a vitamin K
deficiency. These drugs reduce absorption of the fat soluble (lipid) vitamins
A, D, E, and K.
The nurse is caring for a client with a stroke resulting in right-sided paresis
and aphasia. The client attempts to use the left hand for feeding and other
self-care activities. The spouse
, lOMoARcPSD|5422489
becomes frustrated and insists on doing everything for the client. Based on
this data, which nursing diagnosis should the nurse document for this
client?
Situational low self-esteem related to functional impairment and change in role function.
Disabled family coping related to dissonant
coping stylefamily
Interrupted of significant person.
processes related to shif
in health status of family member.
Risk for ineffective therapeutic regimen
Rationale management related to complexity of care.
A stroke affects the whole family and in this case the spouse probably
thinks that she is helping and needs to feel that she is contributing to the
client's care. Her help is noted as being incongruent with attempts of self-
care by the client thereby disabling family coping.
The nurse is interviewing a male client with hypertension. Which additional
medical diagnosis in the client's history presents the greatest risk for
developing a cerebral vascular accident (CVA)?
Diabetes mellitus.
Hypothyroidism.
P
a
r
Rationale
According to the National Stroke Association (2013), history of diabetes
mellitus poses the greatest risk for developing a CVA, 2-4Xs more than
those who do not have diabetes mellitus. The reason for this occurrence is
related to the excess glucose circulating throughout the body not being
utilizing by the cells of the body, leading to the increased fatty deposits or
clots inside the blood vessels in the brain or neck, eventually causing a
stroke.
In assessing a client diagnosed with primary hyperaldosteronism, the
nurse expects the laboratory test results to indicate a decreased serum
level of which substance?
Sodium.
A
n
t
i
Rationale
Clients with primary hyperaldosteronism exhibit a profound decline in the
serum levels of potassium (hypokalemia). Hypertension, along with the
hypokalemia are the most
prominent and universal signs for this condition. If both of these findings
are present, there is 50% likelihood the client to be diagnosed with
hyperaldosteronism.
Which intervention should the nurse implement for a female client
, Page 3 of 23
Describe proper administration of vaginal suppositories and cream.
Encourage the client to perform Kegel exercises 10 times daily.
Explain the importance of using condoms when having sexual intercourse.
Discuss the importance of keeping a diary of daily temperature and menstrual
cycle events. Rationale
Pelvic relaxation disorders are structural disorders resulting from
weakening support tissues of the pelvis. Kegel exercises helps
strengthen the surrounding muscles.
A splint is prescribed for nighttime use by a client with rheumatoid
arthritis. Which statement by the nurse provides the most accurate
explanation for use of the splints?
Prevention of deformities.
Avoidance of joint trauma.
R
e
Rationale l
Splints may be used at night by clients with rheumatoid arthritis to
prevent deformities caused by muscle spasms and contractures.
The nurse is teaching a female client who uses a contraceptive diaphragm
about reducing the risk for toxic shock syndrome (TSS). Which
information should the nurse include?
(Select all that apply.)
Select all that apply
Remove the diaphragm immediately after intercourse.
Wash the diaphragm with an alcohol solution.
Use the diaphragm to prevent conception during the menstrual cycle.
Do not leave the diaphragm in place longer than 8 hours after intercourse. Replace the old
diaphragm every 3 months.
Rationale
The diaphragm needs to remain against the cervix for 6 to 8 hours to
prevent pregnancy but should not remain for longer than 8 hours to avoid
the risk of TSS.
The diaphragm should be replaced every 3 months to maintain integrity.
A client has a staging procedure for cancer of the breast and ask the
nurse which type of breast cancer has the poorest prognosis. Which
information should the nurse offer the client?
Stage II.
Inva
sive
infiltr
atin
, lOMoARcPSD|5422489
Rationale
Inflammatory breast cancer onset is very rapid and a very rare form of
breast cancer and is considered the most aggressive form of breast
malignancies. It is often mistaken for a breast infection because it has a
thickened appearance like an orange peel (peau d'orange), causing the
breast to become swollen and
tender.
A client with a 16-year history of diabetes mellitus is having renal function
tests because of recent fatigue, weakness, elevated blood urea nitrogen,
and serum creatinine levels. Which finding should the nurse conclude as
an early symptom of renal insufficiency?
Dyspnea.
Nocturia.
C
o
n
Rationale
As the glomerular filtration rate decreases in early renal insufficiency,
metabolic waste products, including urea, creatinine, and other
substances, such phenols, hormones, electrolytes, accumulate in the
blood. In the early stage of renal insufficiency, polyuria results from the
inability of the kidneys to concentrate urine and contribute to nocturia.
The nurse is planning care for a client with newly diagnosed diabetes
mellitus that requires insulin. Which assessment should the nurse identify
before beginning the teaching session?
Present
knowledge
related to
the skill of
Rationale injection.
If a client is incapable or does not want to learn, it is unlikely that
learning will occur, so motivation is the first factor the nurse should
assess before teaching.
Small bowel obstruction is a condition characterized by which finding?
and electrolyte imbalances.
Metabolic acidosis.
Ribbon-like stools.
Intermittent lower abdominal cramping.
Rationale
Among the findings characteristic of a small bowel obstruction is the
presence of severe fluid and electrolyte imbalances.
The nurse is taking a history of a newly diagnosed Type 2 diabetic
