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© lec_Bismark | Educational Resources
HESI MED SURGE
KEY INTERVENTIONS AND NURSING
CONSIDERATIONS
NEWLY UPDATED 2026//GUARANTEED PASS
1) A client with oral cancer is receiving radiotherapy (RT) prior to surgery. Which
intervention should the nurse teach the client to implement
in managing mucositis related to RT?
A Normal saline mouth rinses as swish and spit after meals and bedtime. B Place
chin down and tilt head for dyspahgia during meals.
C Use a commercial mouth wash for xerostomia D Eat
high caloric meals to prevent weight loss.
Answer A
2) Lactulose was prescribed two days ago for a client who was recently diagnosed with hepatic
encephalopathy. The client is confused and experiencing frequent loose stools. Laboratory findings
show an elevated serum ammonia (NH) level of 220 mcg/dL (157.08 pmol/L).Which action
should the nurse take?
Reference Range:
Ammonia [10 to 80 mcg/dL (6 to 47 pmol/L)]
A Replace total volume voided with oral or IV fluids. B
Hold the next dose of lactulose.
C Continue the prescribed dose of lactulose.
D Report the number of diarrhea stools to the healthcare provider (HCP). Answer
B
3) A client presents with the onset of a severe headache, fever, nuchal rigidity, and a petechial
rash on arms and legs. The nurse recognizes the client is exhibiting symptoms of which
condition?
A Rocky mountain spotted fever. B
Meningococcal meningitis.
C Cerebrovascular accident (CVA). D
Intracerebral hemorrhage.
ANSWER B
4) A client who takes daily supplemental iron tablets for iron deficiency anemia reports feeling
increasingly fatigued. Which laboratory value should the nurse review?
A Platelet count.
B Complete blood count. C
Serum electrolytes.
D Liver enzymes.
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ANSWER B
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5) The nurse is providing teaching to a client newly diagnosed with type 2
diabetes mellitus about disease management. Which information stated by the client
indicates understanding?
A Check blood sugar levels every four to six hours every day. B Avoid
seasoning foods with salt and salt-containing spices.
C Limit maximum daily fat intake to 15% of total calories.
D Eat a protein snack 30 minutes before any exercise workout.
Answer B
6) When teaching a client with Parkinson's disease, which rationale for the prescription
of carbidopa levodopa should the nurse include?
A Slows the scarring in the myelin sheath improving muscle tone and strength.
B Acts as an anti seizure medication reducing the tremors caused by the disease. C Reduces
the inflammatory process improving nerve transmission and function. D Increases the
amount of dopamine available for muscles to function correctly.
ANSWER D
7) Two weeks after returning home from traveling, a client presents to the clinic with
conjunctivitis and describes a recent loss in the ability to taste and smell. The nurse
obtains a nasal swab to test for COVID-19. Which action is most important for the nurse to take?
A Teach the client to wear a mask, hand wash, and social distance to prevent spreading the virus.
B Report the COVID-19 result to the local health department according to CDC
guidelines.
C Isolate the client from other clients, family, and healthcare workers not wearing proper PPE.
D Explain to the client to inform others that they may have been potentially exposed in the last
14 days.
ANSWER C
8) A family suspects that AIDS dementia is occurring in their adult child who is HIV
positive. Which symptom confirms the suspicion?
A Exhibits angry outbursts when the subject of dying is approached. B
Increased intervals of sleep 18 out of 24 hours.
C A change has recently occurred in handwriting.
D Refuses to see friends or to return their phone calls.
ANSWER C
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© lec_Bismark | Educational Resources
9) The nurse is preparing an older client for a magnetic resonance imaging (MRI) with contrast.
Which laboratory value should the nurse report to the healthcare provider
(HCP) before the scan is performed?
Reference Range:
Glycosylated hemoglobin Alc (HbAlc) [Nondiabetic 4% to 5.9%]
Serum creatinine [0.6 to 1.2 mg/dL (53 to 106 mol/L)]
Fasting blood sugar [70 to 110 mg/dL (less than 6.1 mmol/L)) Blood urea
nitrogen (BUN) [10 to 20 mg/dL (3.6 to 7.1 mmol/L)] A Fasting blood
sugar of 200 mg/dL (11.1 mmol/L).
B Serum creatinine of 1.9 mg/dL (168 umol/L).
C Blood urea nitrogen of 22 mg/dL (7.9 mmol/L). D
Glycosylated hemoglobin Alc (HbAlc) of 5.7%.
Answer B
10) A client with metastatic cancer reports a pain level of 10 on a 0 to 10 scale. Twenty minutes
after the nurse administers an IV analgesic, the client states "No pain relief
yet." Which intervention is most important for the nurse to include in this client's plan of care?
A Frequently evaluate the client's pain.
B Replace transdermal analgesic patches every 72 hours.
C Administer analgesics on a fixed and continuous schedule. D
Monitor client for break through pain
.
Answer A
11) The nurse is admitting a client with possible tuberculosis (TB). The client is placed in a
private room with airborne precautions pending diagnostic test results. Which diagnostic test
should the nurse review to confirm the diagnosis of TB?
A Positive purified protein derivative (PPD) skin test.
B Hemoccult test on sputum collected from hemoptysis. C
Chest x-ray or computerized tomography (CT).
D Sputum culture positive for Mycobacterium tuberculosis.
ANSWER D
12) Which nursing problem should be selected for a client who is receiving thrombolytic
infusions for treatment of an acute myocardial
A Ineffective breathing pattern related to adverse drug effects. B Risk
for injury related to effects of thrombolysis.
C Deficient knowledge related to a new medication regimen. D
Activity intolerance related to ischemia.
Answer B
© lec_Bismark | Educational Resources
HESI MED SURGE
KEY INTERVENTIONS AND NURSING
CONSIDERATIONS
NEWLY UPDATED 2026//GUARANTEED PASS
1) A client with oral cancer is receiving radiotherapy (RT) prior to surgery. Which
intervention should the nurse teach the client to implement
in managing mucositis related to RT?
A Normal saline mouth rinses as swish and spit after meals and bedtime. B Place
chin down and tilt head for dyspahgia during meals.
C Use a commercial mouth wash for xerostomia D Eat
high caloric meals to prevent weight loss.
Answer A
2) Lactulose was prescribed two days ago for a client who was recently diagnosed with hepatic
encephalopathy. The client is confused and experiencing frequent loose stools. Laboratory findings
show an elevated serum ammonia (NH) level of 220 mcg/dL (157.08 pmol/L).Which action
should the nurse take?
Reference Range:
Ammonia [10 to 80 mcg/dL (6 to 47 pmol/L)]
A Replace total volume voided with oral or IV fluids. B
Hold the next dose of lactulose.
C Continue the prescribed dose of lactulose.
D Report the number of diarrhea stools to the healthcare provider (HCP). Answer
B
3) A client presents with the onset of a severe headache, fever, nuchal rigidity, and a petechial
rash on arms and legs. The nurse recognizes the client is exhibiting symptoms of which
condition?
A Rocky mountain spotted fever. B
Meningococcal meningitis.
C Cerebrovascular accident (CVA). D
Intracerebral hemorrhage.
ANSWER B
4) A client who takes daily supplemental iron tablets for iron deficiency anemia reports feeling
increasingly fatigued. Which laboratory value should the nurse review?
A Platelet count.
B Complete blood count. C
Serum electrolytes.
D Liver enzymes.
, 2
© lec_Bismark | Educational Resources
ANSWER B
Downloaded by ANTONY KIMANI ()
, 3
© lec_Bismark | Educational Resources
5) The nurse is providing teaching to a client newly diagnosed with type 2
diabetes mellitus about disease management. Which information stated by the client
indicates understanding?
A Check blood sugar levels every four to six hours every day. B Avoid
seasoning foods with salt and salt-containing spices.
C Limit maximum daily fat intake to 15% of total calories.
D Eat a protein snack 30 minutes before any exercise workout.
Answer B
6) When teaching a client with Parkinson's disease, which rationale for the prescription
of carbidopa levodopa should the nurse include?
A Slows the scarring in the myelin sheath improving muscle tone and strength.
B Acts as an anti seizure medication reducing the tremors caused by the disease. C Reduces
the inflammatory process improving nerve transmission and function. D Increases the
amount of dopamine available for muscles to function correctly.
ANSWER D
7) Two weeks after returning home from traveling, a client presents to the clinic with
conjunctivitis and describes a recent loss in the ability to taste and smell. The nurse
obtains a nasal swab to test for COVID-19. Which action is most important for the nurse to take?
A Teach the client to wear a mask, hand wash, and social distance to prevent spreading the virus.
B Report the COVID-19 result to the local health department according to CDC
guidelines.
C Isolate the client from other clients, family, and healthcare workers not wearing proper PPE.
D Explain to the client to inform others that they may have been potentially exposed in the last
14 days.
ANSWER C
8) A family suspects that AIDS dementia is occurring in their adult child who is HIV
positive. Which symptom confirms the suspicion?
A Exhibits angry outbursts when the subject of dying is approached. B
Increased intervals of sleep 18 out of 24 hours.
C A change has recently occurred in handwriting.
D Refuses to see friends or to return their phone calls.
ANSWER C
Downloaded by ANTONY KIMANI ()
, 4
© lec_Bismark | Educational Resources
9) The nurse is preparing an older client for a magnetic resonance imaging (MRI) with contrast.
Which laboratory value should the nurse report to the healthcare provider
(HCP) before the scan is performed?
Reference Range:
Glycosylated hemoglobin Alc (HbAlc) [Nondiabetic 4% to 5.9%]
Serum creatinine [0.6 to 1.2 mg/dL (53 to 106 mol/L)]
Fasting blood sugar [70 to 110 mg/dL (less than 6.1 mmol/L)) Blood urea
nitrogen (BUN) [10 to 20 mg/dL (3.6 to 7.1 mmol/L)] A Fasting blood
sugar of 200 mg/dL (11.1 mmol/L).
B Serum creatinine of 1.9 mg/dL (168 umol/L).
C Blood urea nitrogen of 22 mg/dL (7.9 mmol/L). D
Glycosylated hemoglobin Alc (HbAlc) of 5.7%.
Answer B
10) A client with metastatic cancer reports a pain level of 10 on a 0 to 10 scale. Twenty minutes
after the nurse administers an IV analgesic, the client states "No pain relief
yet." Which intervention is most important for the nurse to include in this client's plan of care?
A Frequently evaluate the client's pain.
B Replace transdermal analgesic patches every 72 hours.
C Administer analgesics on a fixed and continuous schedule. D
Monitor client for break through pain
.
Answer A
11) The nurse is admitting a client with possible tuberculosis (TB). The client is placed in a
private room with airborne precautions pending diagnostic test results. Which diagnostic test
should the nurse review to confirm the diagnosis of TB?
A Positive purified protein derivative (PPD) skin test.
B Hemoccult test on sputum collected from hemoptysis. C
Chest x-ray or computerized tomography (CT).
D Sputum culture positive for Mycobacterium tuberculosis.
ANSWER D
12) Which nursing problem should be selected for a client who is receiving thrombolytic
infusions for treatment of an acute myocardial
A Ineffective breathing pattern related to adverse drug effects. B Risk
for injury related to effects of thrombolysis.
C Deficient knowledge related to a new medication regimen. D
Activity intolerance related to ischemia.
Answer B
