BSN 266 HESI Med Surg Practice Exam Version 2 (2023/
2024 Update) Questions and Verified Answers with
Rationales|100% Correct| Grade A
A client is admitted to the medical intensive care unit with a diagnosis of myocardial
infarction. The client's history indicates the infarction occurred ten hours ago. Which
laboratory test result should the nurse expect this client to exhibit?
A) Elevated LDH.
B) Elevated serum amylase.
C) Elevated CK-MB.
D) Elevated hematocrit. - correct answer✔✔C
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?
A) Prevention of deformities.
B) Avoidance of joint trauma.
C) Relief of joint inflammation.
D) Improvement in joint strength. - correct answer✔✔A
The nurse should be correct in withholding a dose of digoxin in a client with congestive
heart failure without specific instruction from the healthcare provider if the client's
A) serum digoxin level is 1.5.
B) blood pressure is 104/68.
C) serum potassium level is 3.
D) apical pulse is 68/min. - correct answer✔✔C
During CPR, when attempting to ventilate a client's lungs, the nurse notes that the chest
is not moving. What action should the nurse take first?
A) Use a laryngoscope to check for a foreign body lodged in the esophagus.
B) Reposition the head to validate that the head is in the proper position to open the
airway.
C) Turn the client to the side and administer three back blows.
D) Perform a finger sweep of the mouth to remove any vomitus. - correct answer✔✔B
Despite several eye surgeries, a 78-year-old client who lives alone has persistent vision
problems. The visiting nurse is discussing painting the house with the client. The nurse
suggests that the edge of the steps should be painted which color?
A) Black.
B) White.
C) Light green.
D) Medium yellow. - correct answer✔✔D
,The nurse is assessing a client with bacterial meningitis. Which assessment finding
indicates the client may have developed septic emboli?
A) Cyanosis of the fingertips.
B) Bradycardia and bradypnea.
C) Presence of S3 and S4 heart sounds.
D) 3+ pitting edema of the lower extremities. - correct answer✔✔A
In assessing a client diagnosed with primary hyperaldosteronism, the nurse expects the
laboratory test results to indicate a decreased serum level of which substance?
A) Sodium.
B) Antidiuretic hormone.
C) Potassium.
D) Glucose. - correct answer✔✔C
A client with diabetes mellitus is experiencing polyphagia. Which outcome statement is
the priority for this client?
A) Fluid and electrolyte balance.
B) Prevention of water toxicity.
C) Reduced glucose in the urine.
D) Adequate cellular nourishment. - correct answer✔✔D
Based on the analysis of the client's atrial fibrillation, the nurse should prepare the client
for which treatment protocol?
A) Diuretic therapy.
B) Pacemaker implantation.
C) Anticoagulation therapy.
D) Cardiac catheterization. - correct answer✔✔C
Which information about mammograms is most important to provide a post-menopausal
female client?
A) Breast self-examinations are not needed if annual mammograms are obtained.
B) Radiation exposure is minimized by shielding the abdomen with a lead-lined apron.
C) Yearly mammograms should be done regardless of previous normal x-rays.
D) Women at high risk should have annual routine and ultrasound mammograms. -
correct answer✔✔C
In assessing cancer risk, the nurse identifies which woman as being at greatest risk of
developing breast cancer?
A) A 35-year-old multipara who never breastfed.
B) A 50-year-old whose mother had unilateral breast cancer.
C) A 55-year-old whose mother-in-law had bilateral breast cancer.
D) A 20-year-old whose menarche occurred at age 9. - correct answer✔✔B
A client with multiple sclerosis has experienced an exacerbation of symptoms, including
paresthesias, diplopia, and nystagmus. Which instruction should the nurse provide?
A) Stay out of direct sunlight.
, B) Restrict intake of high protein foods.
C) Schedule extra rest periods.
D) Go to the emergency room immediately. - correct answer✔✔C
Which reaction should the nurse identify in a client who is responding to stimulation of
the sympathetic nervous system?
A) Pupil constriction.
B) Increased heart rate.
C) Bronchial constriction.
D) Decreased blood pressure. - correct answer✔✔B
A client receiving cholestyramine (Questran) for hyperlipidemia should be evaluated for
what vitamin deficiency?
A) K.
B) B12.
C) B6.
D) C. - correct answer✔✔A
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 becomes frustrated and insists on doing everything for the client. Based on this
data, which nursing diagnosis should the nurse document for this client?
A) Situational low self-esteem related to functional impairment and change in role
function.
B) Disabled family coping related to dissonant coping style of significant person.
C) Interrupted family processes related to shift in health status of family member.
D) Risk for ineffective therapeutic regimen management related to complexity of care. -
correct answer✔✔B
When teaching diaphragmatic breathing to a client with chronic obstructive pulmonary
disease (COPD), which information should the nurse provide?
A) Place a small book or magazine on the abdomen and make it rise while inhaling
deeply.
B) Purse the lips while inhaling as deeply as possible and then exhale through the nose.
C) Wrap a towel around the abdomen and push against the towel while forcefully
exhaling.
D) Place one hand on the chest, one hand the abdomen and make both hands move
outward. - correct answer✔✔A
A middle-aged male client with diabetes continues to eat an abundance of foods that
are high in sugar and fat. According to the Health Belief Model, which event is most
likely to increase the client's willingness to become compliant with the prescribed diet?
A) He visits his diabetic brother who just had surgery to amputate an infected foot.
B) He is provided with the most current information about the dangers of untreated
diabetes.
2024 Update) Questions and Verified Answers with
Rationales|100% Correct| Grade A
A client is admitted to the medical intensive care unit with a diagnosis of myocardial
infarction. The client's history indicates the infarction occurred ten hours ago. Which
laboratory test result should the nurse expect this client to exhibit?
A) Elevated LDH.
B) Elevated serum amylase.
C) Elevated CK-MB.
D) Elevated hematocrit. - correct answer✔✔C
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?
A) Prevention of deformities.
B) Avoidance of joint trauma.
C) Relief of joint inflammation.
D) Improvement in joint strength. - correct answer✔✔A
The nurse should be correct in withholding a dose of digoxin in a client with congestive
heart failure without specific instruction from the healthcare provider if the client's
A) serum digoxin level is 1.5.
B) blood pressure is 104/68.
C) serum potassium level is 3.
D) apical pulse is 68/min. - correct answer✔✔C
During CPR, when attempting to ventilate a client's lungs, the nurse notes that the chest
is not moving. What action should the nurse take first?
A) Use a laryngoscope to check for a foreign body lodged in the esophagus.
B) Reposition the head to validate that the head is in the proper position to open the
airway.
C) Turn the client to the side and administer three back blows.
D) Perform a finger sweep of the mouth to remove any vomitus. - correct answer✔✔B
Despite several eye surgeries, a 78-year-old client who lives alone has persistent vision
problems. The visiting nurse is discussing painting the house with the client. The nurse
suggests that the edge of the steps should be painted which color?
A) Black.
B) White.
C) Light green.
D) Medium yellow. - correct answer✔✔D
,The nurse is assessing a client with bacterial meningitis. Which assessment finding
indicates the client may have developed septic emboli?
A) Cyanosis of the fingertips.
B) Bradycardia and bradypnea.
C) Presence of S3 and S4 heart sounds.
D) 3+ pitting edema of the lower extremities. - correct answer✔✔A
In assessing a client diagnosed with primary hyperaldosteronism, the nurse expects the
laboratory test results to indicate a decreased serum level of which substance?
A) Sodium.
B) Antidiuretic hormone.
C) Potassium.
D) Glucose. - correct answer✔✔C
A client with diabetes mellitus is experiencing polyphagia. Which outcome statement is
the priority for this client?
A) Fluid and electrolyte balance.
B) Prevention of water toxicity.
C) Reduced glucose in the urine.
D) Adequate cellular nourishment. - correct answer✔✔D
Based on the analysis of the client's atrial fibrillation, the nurse should prepare the client
for which treatment protocol?
A) Diuretic therapy.
B) Pacemaker implantation.
C) Anticoagulation therapy.
D) Cardiac catheterization. - correct answer✔✔C
Which information about mammograms is most important to provide a post-menopausal
female client?
A) Breast self-examinations are not needed if annual mammograms are obtained.
B) Radiation exposure is minimized by shielding the abdomen with a lead-lined apron.
C) Yearly mammograms should be done regardless of previous normal x-rays.
D) Women at high risk should have annual routine and ultrasound mammograms. -
correct answer✔✔C
In assessing cancer risk, the nurse identifies which woman as being at greatest risk of
developing breast cancer?
A) A 35-year-old multipara who never breastfed.
B) A 50-year-old whose mother had unilateral breast cancer.
C) A 55-year-old whose mother-in-law had bilateral breast cancer.
D) A 20-year-old whose menarche occurred at age 9. - correct answer✔✔B
A client with multiple sclerosis has experienced an exacerbation of symptoms, including
paresthesias, diplopia, and nystagmus. Which instruction should the nurse provide?
A) Stay out of direct sunlight.
, B) Restrict intake of high protein foods.
C) Schedule extra rest periods.
D) Go to the emergency room immediately. - correct answer✔✔C
Which reaction should the nurse identify in a client who is responding to stimulation of
the sympathetic nervous system?
A) Pupil constriction.
B) Increased heart rate.
C) Bronchial constriction.
D) Decreased blood pressure. - correct answer✔✔B
A client receiving cholestyramine (Questran) for hyperlipidemia should be evaluated for
what vitamin deficiency?
A) K.
B) B12.
C) B6.
D) C. - correct answer✔✔A
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 becomes frustrated and insists on doing everything for the client. Based on this
data, which nursing diagnosis should the nurse document for this client?
A) Situational low self-esteem related to functional impairment and change in role
function.
B) Disabled family coping related to dissonant coping style of significant person.
C) Interrupted family processes related to shift in health status of family member.
D) Risk for ineffective therapeutic regimen management related to complexity of care. -
correct answer✔✔B
When teaching diaphragmatic breathing to a client with chronic obstructive pulmonary
disease (COPD), which information should the nurse provide?
A) Place a small book or magazine on the abdomen and make it rise while inhaling
deeply.
B) Purse the lips while inhaling as deeply as possible and then exhale through the nose.
C) Wrap a towel around the abdomen and push against the towel while forcefully
exhaling.
D) Place one hand on the chest, one hand the abdomen and make both hands move
outward. - correct answer✔✔A
A middle-aged male client with diabetes continues to eat an abundance of foods that
are high in sugar and fat. According to the Health Belief Model, which event is most
likely to increase the client's willingness to become compliant with the prescribed diet?
A) He visits his diabetic brother who just had surgery to amputate an infected foot.
B) He is provided with the most current information about the dangers of untreated
diabetes.
