Page 1 of 114
MED SURG FINAL HESI 2024 ACTUAL EXAM ALL QUESTIONS
AND WELL ELABORATED ANSWERS UPDATED VERSION
||COMPLETE A+ GUIDE
A female client with a nasogastric tube attached to low suction states
f f f f f f f f f f f
that she is nauseated. The nurse assesses that there has been no
f f f f f f f f f f f f
drainage through the nasogastric tube in the last 2 hours. Which action
f f f f f f f f f f f f
should the nurse take first? - answer-Reposition the client on her side.
f f f f f f f f f f f f
The priority is to determined if the tube is functioning correctly, which
f f f f f f f f f f f f
would relieve the client's nausea. The least invasive intervention is to
f f f f f f f f f f f
reposition the client (B), should be attempted first, followed by (A & C)
f f f f f f f f f f f f f
if these are unsuccessful then (D).
f f f f f f
When assigning clients on a medical-surgical floor to a RN and a LPN, it
f f f f f f f f f f f f f
is best for the charge nurse to assign which client to the LPN?
f f f f f f f f f f f f f
A. A child with bacterial meningitis with recent seizures.
f f f f f f f f
B. An older adult client with pneumonia and viral meningitis.
f f f f f f f f f
C. A female client in isolation wiht meningococcal meningitis.
f f f f f f f f
D. A male client 1 day post-op after drainage of a brain abscess. -
f f f f f f f f f f f f f
answer-B. Is the most stable. A, C, D have an increased risk for elevated
f f f f f f f f f f f f f f
ICP.
f
Which description of symptoms is characteristic of a client diagnosed
f f f f f f f f f
with trigeminal neuralgia (tic douloureux)?
f f f f f
A. Tinnitus, vertigo, and hearing difficulties.
f f f f f
,Page 2 of 114
B. Sudden, stabbing, severe pain over the lip and chin.
f f f f f f f f f
C. Unilateral facial weakness and paralysis.
f f f f f
D. Difficulty in talking, chewing, and swallowing. - answer-B. Trigeminal
f f f f f f f f f
neuralgia is characterized by paroxysms of pain, similar to an electric
f f f f f f f f f f f
shock, in the area innervated by one or more branches of the
f f f f f f f f f f f f
trigeminal nerve.
f f
A. Characteristic of Meniere's
f f f
C. Characteristic of Bell palsey
f f f f
D. Characteristic of disorders of the hypoglossal (12th cranial nerve)
f f f f f f f f f
Which abnormal lab finding indicates that a client with diabetes needs
f f f f f f f f f f
further evaluation for diabetic nephropathy?
f f f f f
A. Hypokalemia
f
B. Microalbuminauria
f
C. Elevated serum lipids
f f f
D. Ketonuria - answer-B. Microalbuminuria is the earliest sign of
f f f f f f f f f
nephropathy and indicates the need for follow-up evaluation.
f f f f f f f f
Hyperkalemia (A) is associated with end stage renal disease caused by
f f f f f f f f f f f
diabetic nephropathy. (C) may be elevated in end stage renal disease.
f f f f f f f f f f f
(D) may signal the onset of DKA.
f f f f f f f
An older male client comes to the geriatric screening clinic
f f f f f f f f f
complaining of pain in his left calf. The nurse notices a reddened area
f f f f f f f f f f f f f
on the calf of his right leg that is warm to touch and the nurse suspects
f f f f f f f f f f f f f f f f
that the client may have thrombophlebitis. Which addition
f f f f f f f f
assessment is most important for the nurse to perform?
f f f f f f f f f
,Page 3 of 114
A. Measure calf circumference.
f f f
B. Auscultate the client's breath sounds.
f f f f f
C. Observe for ecchymosis and petechiae.
f f f f f
D. Obtain the client's blood pressure. - answer-B. Since the client may
f f f f f f f f f f f
have a pulmonary embolus secondary to the thrombophlebitis.
f f f f f f f f f
A. Would support the nurses assessment.
f f f f f
C. Least helpful since bruising is not associated with thrombophlebitis.
f f f f f f f f f
D. Less important then auscultation.
f f f f
The nurse know that a client taking diuretics must be assessed for the
f f f f f f f f f f f f
development of hypokalemia, and that hypokalemia will create
f f f f f f f f
changes in the client's normal ECG tracing. Which ECG change would
f f f f f f f f f f f
be an expected finding in the client with hypokalemia?
f f f f f f f f f
A. Tall, spiked T waves
f f f f
B. A prolonged QT interval
f f f f
C. A widening QRS complex
f f f f
D. Presence of a U wave - answer-D. A U wave is a positive deflection
f f f f f f f f f f f f f f
following the T wave and is often present with hypokalemia. A, B, C
f f f f f f f f f f f f f
indicate hyperkalemia.
f f
An older client is admitted with a diagnosis of bacterial pneumonia.
f f f f f f f f f f
The nurse's assessment of the client will most likely reveal which S/SX?
f f f f f f f f f f f f
A. Leukocytosis and febrile.
f f f
B. Polycythemia and crackles.
f f f
C. Pharyngitis and sputum production.
f f f f
, Page 4 of 114
D. Confusion and tachycardia. - answer-D. The onset of pneumonia is
f f f f f f f f f f
the older may be signaled by general deterioration, confusion,
f f f f f f f f f
increased heart rate or increased respiratory rate.
f f f f f f f f
(A, B, C) are often absent in the older with bacterial pneumonia.
f f f f f f f f f f f
The nurse observes ventricular fibrillation on telemetry and upon
f f f f f f f f
entering the clients bathroom finds the client unconscious on the
f f f f f f f f f f
floor. What intervention should the nurse implement first?
f f f f f f f f
A. Administer an antidysrhythmic medication.
f f f f
B. Start cardiopulmonary resuscitation.
f f f
C. Defibrillate the client at 200 joules.
f f f f f f
D. Assess the client's pulse oximetry. - answer-B. Ventricular fibrillation
f f f f f f f f f
is a life-threatening dysrhythmia and CPR should be started
f f f f f f f f f
immediately. A & C are appropriate but B is the priority. D does not
f f f f f f f f f f f f f f
address the seriousness of the situation.
f f f f f f
An older female client with dementia is transferred from a long term
f f f f f f f f f f f
care unit to an acute care unit. The client's children express concern
f f f f f f f f f f f f
that their mother's confusion is worsening. How should the nurse
f f f f f f f f f f
respond?
f
A. "It is to be expected that older people will experience progressive
f f f f f f f f f f f
confusion."
f
B. "Confusion in an older person often follows relocation to new
f f f f f f f f f f
surroundings."
f
MED SURG FINAL HESI 2024 ACTUAL EXAM ALL QUESTIONS
AND WELL ELABORATED ANSWERS UPDATED VERSION
||COMPLETE A+ GUIDE
A female client with a nasogastric tube attached to low suction states
f f f f f f f f f f f
that she is nauseated. The nurse assesses that there has been no
f f f f f f f f f f f f
drainage through the nasogastric tube in the last 2 hours. Which action
f f f f f f f f f f f f
should the nurse take first? - answer-Reposition the client on her side.
f f f f f f f f f f f f
The priority is to determined if the tube is functioning correctly, which
f f f f f f f f f f f f
would relieve the client's nausea. The least invasive intervention is to
f f f f f f f f f f f
reposition the client (B), should be attempted first, followed by (A & C)
f f f f f f f f f f f f f
if these are unsuccessful then (D).
f f f f f f
When assigning clients on a medical-surgical floor to a RN and a LPN, it
f f f f f f f f f f f f f
is best for the charge nurse to assign which client to the LPN?
f f f f f f f f f f f f f
A. A child with bacterial meningitis with recent seizures.
f f f f f f f f
B. An older adult client with pneumonia and viral meningitis.
f f f f f f f f f
C. A female client in isolation wiht meningococcal meningitis.
f f f f f f f f
D. A male client 1 day post-op after drainage of a brain abscess. -
f f f f f f f f f f f f f
answer-B. Is the most stable. A, C, D have an increased risk for elevated
f f f f f f f f f f f f f f
ICP.
f
Which description of symptoms is characteristic of a client diagnosed
f f f f f f f f f
with trigeminal neuralgia (tic douloureux)?
f f f f f
A. Tinnitus, vertigo, and hearing difficulties.
f f f f f
,Page 2 of 114
B. Sudden, stabbing, severe pain over the lip and chin.
f f f f f f f f f
C. Unilateral facial weakness and paralysis.
f f f f f
D. Difficulty in talking, chewing, and swallowing. - answer-B. Trigeminal
f f f f f f f f f
neuralgia is characterized by paroxysms of pain, similar to an electric
f f f f f f f f f f f
shock, in the area innervated by one or more branches of the
f f f f f f f f f f f f
trigeminal nerve.
f f
A. Characteristic of Meniere's
f f f
C. Characteristic of Bell palsey
f f f f
D. Characteristic of disorders of the hypoglossal (12th cranial nerve)
f f f f f f f f f
Which abnormal lab finding indicates that a client with diabetes needs
f f f f f f f f f f
further evaluation for diabetic nephropathy?
f f f f f
A. Hypokalemia
f
B. Microalbuminauria
f
C. Elevated serum lipids
f f f
D. Ketonuria - answer-B. Microalbuminuria is the earliest sign of
f f f f f f f f f
nephropathy and indicates the need for follow-up evaluation.
f f f f f f f f
Hyperkalemia (A) is associated with end stage renal disease caused by
f f f f f f f f f f f
diabetic nephropathy. (C) may be elevated in end stage renal disease.
f f f f f f f f f f f
(D) may signal the onset of DKA.
f f f f f f f
An older male client comes to the geriatric screening clinic
f f f f f f f f f
complaining of pain in his left calf. The nurse notices a reddened area
f f f f f f f f f f f f f
on the calf of his right leg that is warm to touch and the nurse suspects
f f f f f f f f f f f f f f f f
that the client may have thrombophlebitis. Which addition
f f f f f f f f
assessment is most important for the nurse to perform?
f f f f f f f f f
,Page 3 of 114
A. Measure calf circumference.
f f f
B. Auscultate the client's breath sounds.
f f f f f
C. Observe for ecchymosis and petechiae.
f f f f f
D. Obtain the client's blood pressure. - answer-B. Since the client may
f f f f f f f f f f f
have a pulmonary embolus secondary to the thrombophlebitis.
f f f f f f f f f
A. Would support the nurses assessment.
f f f f f
C. Least helpful since bruising is not associated with thrombophlebitis.
f f f f f f f f f
D. Less important then auscultation.
f f f f
The nurse know that a client taking diuretics must be assessed for the
f f f f f f f f f f f f
development of hypokalemia, and that hypokalemia will create
f f f f f f f f
changes in the client's normal ECG tracing. Which ECG change would
f f f f f f f f f f f
be an expected finding in the client with hypokalemia?
f f f f f f f f f
A. Tall, spiked T waves
f f f f
B. A prolonged QT interval
f f f f
C. A widening QRS complex
f f f f
D. Presence of a U wave - answer-D. A U wave is a positive deflection
f f f f f f f f f f f f f f
following the T wave and is often present with hypokalemia. A, B, C
f f f f f f f f f f f f f
indicate hyperkalemia.
f f
An older client is admitted with a diagnosis of bacterial pneumonia.
f f f f f f f f f f
The nurse's assessment of the client will most likely reveal which S/SX?
f f f f f f f f f f f f
A. Leukocytosis and febrile.
f f f
B. Polycythemia and crackles.
f f f
C. Pharyngitis and sputum production.
f f f f
, Page 4 of 114
D. Confusion and tachycardia. - answer-D. The onset of pneumonia is
f f f f f f f f f f
the older may be signaled by general deterioration, confusion,
f f f f f f f f f
increased heart rate or increased respiratory rate.
f f f f f f f f
(A, B, C) are often absent in the older with bacterial pneumonia.
f f f f f f f f f f f
The nurse observes ventricular fibrillation on telemetry and upon
f f f f f f f f
entering the clients bathroom finds the client unconscious on the
f f f f f f f f f f
floor. What intervention should the nurse implement first?
f f f f f f f f
A. Administer an antidysrhythmic medication.
f f f f
B. Start cardiopulmonary resuscitation.
f f f
C. Defibrillate the client at 200 joules.
f f f f f f
D. Assess the client's pulse oximetry. - answer-B. Ventricular fibrillation
f f f f f f f f f
is a life-threatening dysrhythmia and CPR should be started
f f f f f f f f f
immediately. A & C are appropriate but B is the priority. D does not
f f f f f f f f f f f f f f
address the seriousness of the situation.
f f f f f f
An older female client with dementia is transferred from a long term
f f f f f f f f f f f
care unit to an acute care unit. The client's children express concern
f f f f f f f f f f f f
that their mother's confusion is worsening. How should the nurse
f f f f f f f f f f
respond?
f
A. "It is to be expected that older people will experience progressive
f f f f f f f f f f f
confusion."
f
B. "Confusion in an older person often follows relocation to new
f f f f f f f f f f
surroundings."
f
