HESI RN Med Surg EXIT EXAM 2 / MED
SURG HESI PN LATEST EXAM 2026-2027
ACTUAL EXAM TEST BANK 1 QUESTIONS
AND CORRECT DETAILED 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. - Correct AnswerC. The
client smokes one to two packs of cigarettes per day.
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.
Page 1 of 258
,A family member was taught to suction a client's tracheostomy prior to the client's
discharge from the hospital. Which observation by the nurse indicates that the
family member is capable of correctly performing the suctioning technique?
A.Turns on the continuous wall suction to 190 mm Hg.
B.Inserts the catheter until resistance or coughing occurs.
C.Withdraws the catheter while maintaining suctioning.
D.Reclears the tracheostomy after suctioning the mouth. - Correct AnswerB.
Inserts the catheter until resistance or coughing occurs.
Rationale:
Option B indicates correct technique for performing suctioning. Suction pressure
should be between 80 and 120 mm Hg, not 190 mm Hg. The catheter should be
withdrawn 1 to 2 cm at a time with intermittent, not continuous, suction. Option
D introduces pathogens unnecessarily into the tracheobronchial tree.
A 74-year-old male client is admitted to the intensive care unit (ICU) with a
diagnosis of respiratory failure secondary to pneumonia. Currently, he is
ventilator-dependent, with settings of tidal volume (VT) of 750 mL and an
intermittent mandatory ventilation (IMV) rate of 10 breaths/min. Arterial blood
gas (ABG) results are as follows: pH, 7.48; PaCO2, 30 mm Hg; PaO2, 64 mm Hg;
HCO3, 25 mEq/L; and FiO2, 0.80. Which intervention should the nurse implement
first?
A.Increase the ventilator VT to 850 mL.
B.Decrease the ventilator IMV to a rate of 8 breaths/min.
C. Reduce the FiO2 to 0.70 and redraw ABGs.
D.Add 5 cm positive end-expiratory pressure (PEEP). - Correct AnswerD. Add 5 cm
positive end-expiratory pressure (PEEP).
Page 2 of 258
,Rationale:
Adding PEEP helps improve oxygenation while reducing FiO2 to a less toxic level.
Options A, B, and C will not result in improved oxygenation and could cause
further complications for this client, who is experiencing respiratory failure.
The nurse is administering a nystatin suspension for stomatitis. Which instruction
will the nurse provide to the client when administering this medication?
A."Hold the medication in your mouth for a few minutes before swallowing it."
B. "Do not drink or eat milk products for 1 hour prior to taking this medication."
C. "Dilute the medication with juice to reduce the unpleasant taste and odor."
D. "Take the medication before meals to promote increased absorption." - Correct
AnswerA."Hold the medication in your mouth for a few minutes before
swallowing it."
Rationale:
Nystatin suspension is prescribed for fungal infections of the mouth. The client
should swish the medication in the mouth for 2 minutes and then swallow. Option
B does not affect administration of this medication. The medication should not be
diluted because this will reduce its effectiveness. Option D is not necessary.
The nurse is caring for a client with a fractured right elbow. Which assessment
finding has the highest priority and requires immediate intervention?
A.Ecchymosis over the right elbow area
B.Deep unrelenting pain in the right arm
C.An edematous right elbow
Page 3 of 258
, D.The presence of crepitus in the right elbow - Correct AnswerB. Deep
unrelenting pain in the right arm
Rationale:
Compartment syndrome is a condition involving increased pressure and
constriction of the nerves and vessels within an anatomic compartment, causing
pain uncontrolled by opioids and neurovascular compromise. Option A is an
expected finding. Option C related to compartment syndrome cannot be seen,
and any visible edema is an expected finding related to the injury. Option D is an
expected finding.
A home health nurse knows that a 70-year-old male client who is convalescing at
home following a hip replacement is at risk for developing pressure ulcers. Which
physical characteristic of aging puts the client at risk?
A.16% increase in overall body fat
B.Reduced melanin production
C.Thinning of the skin, with loss of elasticity
D.Calcium loss in the bones - Correct AnswerC.Thinning of the skin, with loss of
elasticity
Rationale:
Thin nonelastic skin is an important factor in pressure formation. The proportion
of body fat to lean mass increases with age and might help decrease ulcer
tendency. Option B causes gray hair. Option D can contribute to broken bones, but
it is probably not a factor in pressure ulcer formation.
In assessing a client with an arteriovenous (AV) shunt who is scheduled for dialysis
today, the nurse notes the absence of a thrill or bruit at the shunt site. What
action should the nurse take?
Page 4 of 258
SURG HESI PN LATEST EXAM 2026-2027
ACTUAL EXAM TEST BANK 1 QUESTIONS
AND CORRECT DETAILED 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. - Correct AnswerC. The
client smokes one to two packs of cigarettes per day.
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.
Page 1 of 258
,A family member was taught to suction a client's tracheostomy prior to the client's
discharge from the hospital. Which observation by the nurse indicates that the
family member is capable of correctly performing the suctioning technique?
A.Turns on the continuous wall suction to 190 mm Hg.
B.Inserts the catheter until resistance or coughing occurs.
C.Withdraws the catheter while maintaining suctioning.
D.Reclears the tracheostomy after suctioning the mouth. - Correct AnswerB.
Inserts the catheter until resistance or coughing occurs.
Rationale:
Option B indicates correct technique for performing suctioning. Suction pressure
should be between 80 and 120 mm Hg, not 190 mm Hg. The catheter should be
withdrawn 1 to 2 cm at a time with intermittent, not continuous, suction. Option
D introduces pathogens unnecessarily into the tracheobronchial tree.
A 74-year-old male client is admitted to the intensive care unit (ICU) with a
diagnosis of respiratory failure secondary to pneumonia. Currently, he is
ventilator-dependent, with settings of tidal volume (VT) of 750 mL and an
intermittent mandatory ventilation (IMV) rate of 10 breaths/min. Arterial blood
gas (ABG) results are as follows: pH, 7.48; PaCO2, 30 mm Hg; PaO2, 64 mm Hg;
HCO3, 25 mEq/L; and FiO2, 0.80. Which intervention should the nurse implement
first?
A.Increase the ventilator VT to 850 mL.
B.Decrease the ventilator IMV to a rate of 8 breaths/min.
C. Reduce the FiO2 to 0.70 and redraw ABGs.
D.Add 5 cm positive end-expiratory pressure (PEEP). - Correct AnswerD. Add 5 cm
positive end-expiratory pressure (PEEP).
Page 2 of 258
,Rationale:
Adding PEEP helps improve oxygenation while reducing FiO2 to a less toxic level.
Options A, B, and C will not result in improved oxygenation and could cause
further complications for this client, who is experiencing respiratory failure.
The nurse is administering a nystatin suspension for stomatitis. Which instruction
will the nurse provide to the client when administering this medication?
A."Hold the medication in your mouth for a few minutes before swallowing it."
B. "Do not drink or eat milk products for 1 hour prior to taking this medication."
C. "Dilute the medication with juice to reduce the unpleasant taste and odor."
D. "Take the medication before meals to promote increased absorption." - Correct
AnswerA."Hold the medication in your mouth for a few minutes before
swallowing it."
Rationale:
Nystatin suspension is prescribed for fungal infections of the mouth. The client
should swish the medication in the mouth for 2 minutes and then swallow. Option
B does not affect administration of this medication. The medication should not be
diluted because this will reduce its effectiveness. Option D is not necessary.
The nurse is caring for a client with a fractured right elbow. Which assessment
finding has the highest priority and requires immediate intervention?
A.Ecchymosis over the right elbow area
B.Deep unrelenting pain in the right arm
C.An edematous right elbow
Page 3 of 258
, D.The presence of crepitus in the right elbow - Correct AnswerB. Deep
unrelenting pain in the right arm
Rationale:
Compartment syndrome is a condition involving increased pressure and
constriction of the nerves and vessels within an anatomic compartment, causing
pain uncontrolled by opioids and neurovascular compromise. Option A is an
expected finding. Option C related to compartment syndrome cannot be seen,
and any visible edema is an expected finding related to the injury. Option D is an
expected finding.
A home health nurse knows that a 70-year-old male client who is convalescing at
home following a hip replacement is at risk for developing pressure ulcers. Which
physical characteristic of aging puts the client at risk?
A.16% increase in overall body fat
B.Reduced melanin production
C.Thinning of the skin, with loss of elasticity
D.Calcium loss in the bones - Correct AnswerC.Thinning of the skin, with loss of
elasticity
Rationale:
Thin nonelastic skin is an important factor in pressure formation. The proportion
of body fat to lean mass increases with age and might help decrease ulcer
tendency. Option B causes gray hair. Option D can contribute to broken bones, but
it is probably not a factor in pressure ulcer formation.
In assessing a client with an arteriovenous (AV) shunt who is scheduled for dialysis
today, the nurse notes the absence of a thrill or bruit at the shunt site. What
action should the nurse take?
Page 4 of 258
