HESI RN MEDICAL SURGICAL EXAM
PACK 2024 QUESTIONS AND 100%
CORRECT ANSWERS
The severity of diabetic retinopathy is directly related to which condition?
A) Poor blood glucose control.
B) Neurological effects of diabetes.
C) Susceptibility to infection.
D) Uncontrolled hypertension. ✔️✔️Correct Answer(s): A
* Poor glucose control (A) worsens diabetic retinopathy, where as tight glucose control can
lessen its severity. (B, C, and D) do not affect the severity of diabetic retinopathy.
A client with acute appendicitis is experiencing anxiety and loss of sleep about missing final
examination week at college. Which outcome is most important for the nurse to include in the
plan of care?
A) Sleeping six to eight hours.
B) Achieve a sense of control.
C) Utilize problem solving skills.
D) Increased focus of attention. ✔️✔️Correct Answer(s): B
,* The experience of psychological discomfort may be as real as physical pain for the client and
should be seen as a priority in care. Because the client is experiencing anxiety, achieving a sense
of control is a key need (B) before (A, C and D) are addressed.
Which client should the nurse assess first?
A) A 27-year-old complaining of severe back pain.
B) A 63-year-old complaining of foot and ankle pain.
C) A 49-year-old with pancreatitis complaining of unrelenting abdominal pain.
D) A 55-year-old newly admitted client complaining of jaw pain and indigestion. ✔️✔️Correct
Answer(s): D
* The 55-year-old client (D) should be assessed first to rule out cardiac involvement because jaw
pain and indigestion are common descriptors of myocardial injury. While severe back pain (A)
may indicate a dissecting abdominal aortic aneurysm, a 27-year-old client is less likely to be
experiencing cardiac syndrome. The client with foot and ankle pain (B) is not experiencing a
life-threatening condition. The client with pancreatitis (C) requires pain management but this is
not as high a priority as (D).
The nurse is caring for a client who is admitted with a hemorrhagic stroke. Which nursing action
should be included in the plan of care?
A) Perform active range of motion three times daily.
,B) Monitor for Battle's sign every four hours.
C) Teach measures to avoid the Valsalva maneuver.
D) Maintain the head of bed in a flat position. ✔️✔️Correct Answer(s): C
* The Valsalva maneuver, straining with bowel movements while holding one's breath, increases
intracerebral pressure (ICP) which may induce bleeding or rupture of cerebral blood vessels (C).
Passive, not active ROM (A) is performed to avoid ICP, bleeding, and rupture. Battle's sign (B),
bruising noted behind the ear, is a manifestation that may be seen with a basilar skull fracture,
not hemorrhagic stroke. The flat position for the head of bed is avoided (D) because it increases
venous congestion and ICP.
The nurse is assessing a client admitted from the emergency room with gastrointestinal bleeding
related to peptic ulcer disease (PUD). Which physiological factors can produce ulceration?
(Select all that apply.)
A) Vagal stimulation.
B) An increased level of stress.
C) Decreased duodenal inhibition.
D) Hypersecretion of hydrochloric acid.
E) An increased number of parietal cells. ✔️✔️Correct Answer(s): A, C, D, E
* Hypersecretion of gastric juices (D) and an increased number of parietal cells (E) that stimulate
secretion are most often the causes of ulceration. Vagal stimulation (A) and decreased duodenal
, inhibition (C) also increase the secretion of caustic fluids. An increased stress level is not
physiologic and is not a direct cause of ulceration (B).
Which condition is associated with an oversecretion of renin?
A) Hypertension.
B) Diabetes mellitus.
C) Diabetes insipidus.
D) Alzheimer's disease. ✔️✔️Correct Answer(s): A
* Renin is an enzyme synthesized and secreted by the juxtaglomerular cells of the kidney in
response to renal artery blood volume and pressure changes. Low renal perfusion stimulates the
release of renin, which is converted by angiotensinogen into angiotensin I, which causes the
secretion of aldosterone, resulting in renal reabsorption of sodium, water, and subsequently
increases blood pressure (A). (B, C, and D) are not directly related to renin oversecretion.
The nurse is caring for a client who had an excision of a malignant pituitary tumor. Which
findings should the nurse document that indicate the client is developing syndrome of
inappropriate antidiuretic hormone (SIADH)?
A) Hypernatremia and periorbial edema.
B) Muscle spasticity and hypertension.
C) Weight gain with low serum sodium.
PACK 2024 QUESTIONS AND 100%
CORRECT ANSWERS
The severity of diabetic retinopathy is directly related to which condition?
A) Poor blood glucose control.
B) Neurological effects of diabetes.
C) Susceptibility to infection.
D) Uncontrolled hypertension. ✔️✔️Correct Answer(s): A
* Poor glucose control (A) worsens diabetic retinopathy, where as tight glucose control can
lessen its severity. (B, C, and D) do not affect the severity of diabetic retinopathy.
A client with acute appendicitis is experiencing anxiety and loss of sleep about missing final
examination week at college. Which outcome is most important for the nurse to include in the
plan of care?
A) Sleeping six to eight hours.
B) Achieve a sense of control.
C) Utilize problem solving skills.
D) Increased focus of attention. ✔️✔️Correct Answer(s): B
,* The experience of psychological discomfort may be as real as physical pain for the client and
should be seen as a priority in care. Because the client is experiencing anxiety, achieving a sense
of control is a key need (B) before (A, C and D) are addressed.
Which client should the nurse assess first?
A) A 27-year-old complaining of severe back pain.
B) A 63-year-old complaining of foot and ankle pain.
C) A 49-year-old with pancreatitis complaining of unrelenting abdominal pain.
D) A 55-year-old newly admitted client complaining of jaw pain and indigestion. ✔️✔️Correct
Answer(s): D
* The 55-year-old client (D) should be assessed first to rule out cardiac involvement because jaw
pain and indigestion are common descriptors of myocardial injury. While severe back pain (A)
may indicate a dissecting abdominal aortic aneurysm, a 27-year-old client is less likely to be
experiencing cardiac syndrome. The client with foot and ankle pain (B) is not experiencing a
life-threatening condition. The client with pancreatitis (C) requires pain management but this is
not as high a priority as (D).
The nurse is caring for a client who is admitted with a hemorrhagic stroke. Which nursing action
should be included in the plan of care?
A) Perform active range of motion three times daily.
,B) Monitor for Battle's sign every four hours.
C) Teach measures to avoid the Valsalva maneuver.
D) Maintain the head of bed in a flat position. ✔️✔️Correct Answer(s): C
* The Valsalva maneuver, straining with bowel movements while holding one's breath, increases
intracerebral pressure (ICP) which may induce bleeding or rupture of cerebral blood vessels (C).
Passive, not active ROM (A) is performed to avoid ICP, bleeding, and rupture. Battle's sign (B),
bruising noted behind the ear, is a manifestation that may be seen with a basilar skull fracture,
not hemorrhagic stroke. The flat position for the head of bed is avoided (D) because it increases
venous congestion and ICP.
The nurse is assessing a client admitted from the emergency room with gastrointestinal bleeding
related to peptic ulcer disease (PUD). Which physiological factors can produce ulceration?
(Select all that apply.)
A) Vagal stimulation.
B) An increased level of stress.
C) Decreased duodenal inhibition.
D) Hypersecretion of hydrochloric acid.
E) An increased number of parietal cells. ✔️✔️Correct Answer(s): A, C, D, E
* Hypersecretion of gastric juices (D) and an increased number of parietal cells (E) that stimulate
secretion are most often the causes of ulceration. Vagal stimulation (A) and decreased duodenal
, inhibition (C) also increase the secretion of caustic fluids. An increased stress level is not
physiologic and is not a direct cause of ulceration (B).
Which condition is associated with an oversecretion of renin?
A) Hypertension.
B) Diabetes mellitus.
C) Diabetes insipidus.
D) Alzheimer's disease. ✔️✔️Correct Answer(s): A
* Renin is an enzyme synthesized and secreted by the juxtaglomerular cells of the kidney in
response to renal artery blood volume and pressure changes. Low renal perfusion stimulates the
release of renin, which is converted by angiotensinogen into angiotensin I, which causes the
secretion of aldosterone, resulting in renal reabsorption of sodium, water, and subsequently
increases blood pressure (A). (B, C, and D) are not directly related to renin oversecretion.
The nurse is caring for a client who had an excision of a malignant pituitary tumor. Which
findings should the nurse document that indicate the client is developing syndrome of
inappropriate antidiuretic hormone (SIADH)?
A) Hypernatremia and periorbial edema.
B) Muscle spasticity and hypertension.
C) Weight gain with low serum sodium.
