Practice Questions: HESI Med-Surg Practice Questions &
Answers
Which description of symptoms is characteristic of a client diagnosed with trigeminal neuralgia (tic
douloureux)?
A) Tinnitus, vertigo, and hearing difficulties.
B) Sudden, stabbing, severe pain over the lip and chin.
C) Facial weakness and paralysis.
D) Difficulty in chewing, talking, and swallowing. - ANSWER:B) Sudden, stabbing, severe pain over the lip
and chin.
Trigeminal neuralgia is characterized by paroxysms of pain, similar to an electric shock, in the area
innervated by one or more branches of the trigeminal nerve (5th cranial) (B). (A) would be characteristic
of Méniére's disease (8th cranial nerve). (C) would be characteristic of Bell's palsy (7th cranial nerve). (D)
would be characteristic of disorders of the hypoglossal cranial nerve (12th).
A 67-year-old woman who lives alone is admitted after tripping on a rug in her home and fractures her
hip. Which predisposing factor probably led to the fracture in the proximal end of her femur?
A) Failing eyesight resulting in an unsafe environment.
B) Renal osteodystrophy resulting from chronic renal failure.
C) Osteoporosis resulting from hormonal changes.
D) Cardiovascular changes resulting in small strokes which impair mental acuity. - ANSWER:C)
Osteoporosis resulting from hormonal changes.
The most common cause of a fractured hip in elderly women is osteoporosis, resulting from reduced
calcium in the bones as a result of hormonal changes in later life (C). (A) may or may not have
contributed to the accident, but it had nothing to do with the hip being involved. (B) is not a common
condition of the elderly; it is common in chronic renal failure. (D) may occur in some people, but does
not affect the fragility of the bones as osteoporosis does.
The nurse is assisting a client out of bed for the first time after surgery. What action should the nurse do
first?
A) Place a chair at a right angle to the bedside.
B) Encourage deep breathing prior to standing.
C) Help the client to sit and dangle legs on the side of the bed.
,D) Allow the client to sit with the bed in a high Fowler's position. - ANSWER:D) Allow the client to sit with
the bed in a high Fowler's position.
The first step is to raise the head of the bed to a high Fowler's position (D), which allow venous return to
compensate from lying flat and vasodilating effects of perioperative drugs. (A, B, and C) are implemented
after (D).
A 20-year-old female client calls the nurse to report a lump she found in her breast. Which response is
the best for the nurse to provide?
A) Check it again in one month, and if it is still there schedule an appointment.
B) Most lumps are benign, but it is always best to come in for an examination.
C) Try not to worry too much about it, because usually, most lumps are benign.
D) If you are in your menstrual period it is not a good time to check for lumps. - ANSWER:B) Most lumps
are benign, but it is always best to come in for an examination.
(B) provides the best response because it addresses the client's anxiety most effectively and encourages
prompt and immediate action for a potential problem. (A) postpones treatment if the lump is malignant,
and does not relieve the client's anxiety. (C and D) provide false reassurance and do not help relieve
anxiety.
A female client is brought to the clinic by her daughter for a flu shot. She has lost significant weight since
the last visit. She has poor personal hygiene and inadequate clothing for the weather. The client states
that she lives alone and denies problems or concerns. What action should the nurse implement?
A) Notify social services immediately of suspected elderly abuse.
B) Discuss the need for mental health counseling with the daughter.
C) Explain to the client that she needs to take better care of herself.
D) Collect further data to determine whether self-neglect is occurring. - ANSWER:D) Collect further data
to determine whether self-neglect is occurring.
Changes in weight and hygiene may be indicators of self-neglect or neglect by family members. Further
assessment is needed (D) before notifying social services (A) or discussing a need for counseling (B). Until
further information is obtained, explanations about the client's needs are premature (C).
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. - ANSWER:C) Elevated CK-MB.
The cardiac isoenzyme CK-MB (C) is the most sensitive and most reliable indicator of myocardial damage
of all the cardiac enzymes. It peaks within 12 to 20 hours after myocardial infarction (MI). (A) is a cardiac
enzyme that peaks around 48 hours after an MI. (B) is expected with acute pancreatitis. (D) would be
expected in a client with a fluid volume deficit, which is not a typical finding in MI.
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. - ANSWER:A) Prevention of deformities.
Splints may be used at night by clients with rheumatoid arthritis to prevent deformities (A) caused by
muscle spasms and contractures. Splints are not used for (B). (C) is usually treated with medications,
particularly those classified as non-steroidal antiinflammatory drugs (NSAIDs). For (D), a prescribed
exercise program is indicated.
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. - ANSWER:C) serum potassium level is 3.
Hypokalemia (C) can precipitate digitalis toxicity in persons receiving digoxin which will increase the
chance of dangerous dysrhythmias (normal potassium level is 3.5 to 5.5 mEq/L). The therapeutic range
for digoxin is 0.8 to 2 ng/ml (toxic levels= >2 ng/ml); (A) is within this range. (B) would not warrant the
nurse withholding the digoxin. The nurse should withhold the digoxin if the apical pulse is less than
60/min (D).
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. - ANSWER:B) Reposition the head to
validate that the head is in the proper position to open the airway.
The most frequent cause of inadequate aeration of the client's lungs during CPR is improper positioning
of the head resulting in occlusion of the airway (B). A foreign body can occlude the airway, but this is not
common unless choking preceded the cardiac emergency, and (A, C and D) should not be the nurse's first
action.
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. - ANSWER:D) Medium yellow.
Yellow is the easiest for a person with failing vision to see (D). (A) will be almost impossible to see at
night because the shadows of the steps will be too difficult to determine, and would pose a safety
hazard. (B) is very hard to see with a glare from the sun and it could hurt the eyes in the daytime to look
at them. (C) is a pastel color and is difficult for elderly clients to see.
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. - ANSWER:A) Cyanosis of the fingertips.
Septic emboli secondary to meningitis commonly lodge in the small arterioles of the extremities, causing
a decrease in circulation to the hands (A) which may lead to gangrene. (B, C, and D) are abnormal
findings, but do not indicate the development of septic emboli.
Answers
Which description of symptoms is characteristic of a client diagnosed with trigeminal neuralgia (tic
douloureux)?
A) Tinnitus, vertigo, and hearing difficulties.
B) Sudden, stabbing, severe pain over the lip and chin.
C) Facial weakness and paralysis.
D) Difficulty in chewing, talking, and swallowing. - ANSWER:B) Sudden, stabbing, severe pain over the lip
and chin.
Trigeminal neuralgia is characterized by paroxysms of pain, similar to an electric shock, in the area
innervated by one or more branches of the trigeminal nerve (5th cranial) (B). (A) would be characteristic
of Méniére's disease (8th cranial nerve). (C) would be characteristic of Bell's palsy (7th cranial nerve). (D)
would be characteristic of disorders of the hypoglossal cranial nerve (12th).
A 67-year-old woman who lives alone is admitted after tripping on a rug in her home and fractures her
hip. Which predisposing factor probably led to the fracture in the proximal end of her femur?
A) Failing eyesight resulting in an unsafe environment.
B) Renal osteodystrophy resulting from chronic renal failure.
C) Osteoporosis resulting from hormonal changes.
D) Cardiovascular changes resulting in small strokes which impair mental acuity. - ANSWER:C)
Osteoporosis resulting from hormonal changes.
The most common cause of a fractured hip in elderly women is osteoporosis, resulting from reduced
calcium in the bones as a result of hormonal changes in later life (C). (A) may or may not have
contributed to the accident, but it had nothing to do with the hip being involved. (B) is not a common
condition of the elderly; it is common in chronic renal failure. (D) may occur in some people, but does
not affect the fragility of the bones as osteoporosis does.
The nurse is assisting a client out of bed for the first time after surgery. What action should the nurse do
first?
A) Place a chair at a right angle to the bedside.
B) Encourage deep breathing prior to standing.
C) Help the client to sit and dangle legs on the side of the bed.
,D) Allow the client to sit with the bed in a high Fowler's position. - ANSWER:D) Allow the client to sit with
the bed in a high Fowler's position.
The first step is to raise the head of the bed to a high Fowler's position (D), which allow venous return to
compensate from lying flat and vasodilating effects of perioperative drugs. (A, B, and C) are implemented
after (D).
A 20-year-old female client calls the nurse to report a lump she found in her breast. Which response is
the best for the nurse to provide?
A) Check it again in one month, and if it is still there schedule an appointment.
B) Most lumps are benign, but it is always best to come in for an examination.
C) Try not to worry too much about it, because usually, most lumps are benign.
D) If you are in your menstrual period it is not a good time to check for lumps. - ANSWER:B) Most lumps
are benign, but it is always best to come in for an examination.
(B) provides the best response because it addresses the client's anxiety most effectively and encourages
prompt and immediate action for a potential problem. (A) postpones treatment if the lump is malignant,
and does not relieve the client's anxiety. (C and D) provide false reassurance and do not help relieve
anxiety.
A female client is brought to the clinic by her daughter for a flu shot. She has lost significant weight since
the last visit. She has poor personal hygiene and inadequate clothing for the weather. The client states
that she lives alone and denies problems or concerns. What action should the nurse implement?
A) Notify social services immediately of suspected elderly abuse.
B) Discuss the need for mental health counseling with the daughter.
C) Explain to the client that she needs to take better care of herself.
D) Collect further data to determine whether self-neglect is occurring. - ANSWER:D) Collect further data
to determine whether self-neglect is occurring.
Changes in weight and hygiene may be indicators of self-neglect or neglect by family members. Further
assessment is needed (D) before notifying social services (A) or discussing a need for counseling (B). Until
further information is obtained, explanations about the client's needs are premature (C).
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. - ANSWER:C) Elevated CK-MB.
The cardiac isoenzyme CK-MB (C) is the most sensitive and most reliable indicator of myocardial damage
of all the cardiac enzymes. It peaks within 12 to 20 hours after myocardial infarction (MI). (A) is a cardiac
enzyme that peaks around 48 hours after an MI. (B) is expected with acute pancreatitis. (D) would be
expected in a client with a fluid volume deficit, which is not a typical finding in MI.
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. - ANSWER:A) Prevention of deformities.
Splints may be used at night by clients with rheumatoid arthritis to prevent deformities (A) caused by
muscle spasms and contractures. Splints are not used for (B). (C) is usually treated with medications,
particularly those classified as non-steroidal antiinflammatory drugs (NSAIDs). For (D), a prescribed
exercise program is indicated.
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. - ANSWER:C) serum potassium level is 3.
Hypokalemia (C) can precipitate digitalis toxicity in persons receiving digoxin which will increase the
chance of dangerous dysrhythmias (normal potassium level is 3.5 to 5.5 mEq/L). The therapeutic range
for digoxin is 0.8 to 2 ng/ml (toxic levels= >2 ng/ml); (A) is within this range. (B) would not warrant the
nurse withholding the digoxin. The nurse should withhold the digoxin if the apical pulse is less than
60/min (D).
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. - ANSWER:B) Reposition the head to
validate that the head is in the proper position to open the airway.
The most frequent cause of inadequate aeration of the client's lungs during CPR is improper positioning
of the head resulting in occlusion of the airway (B). A foreign body can occlude the airway, but this is not
common unless choking preceded the cardiac emergency, and (A, C and D) should not be the nurse's first
action.
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. - ANSWER:D) Medium yellow.
Yellow is the easiest for a person with failing vision to see (D). (A) will be almost impossible to see at
night because the shadows of the steps will be too difficult to determine, and would pose a safety
hazard. (B) is very hard to see with a glare from the sun and it could hurt the eyes in the daytime to look
at them. (C) is a pastel color and is difficult for elderly clients to see.
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. - ANSWER:A) Cyanosis of the fingertips.
Septic emboli secondary to meningitis commonly lodge in the small arterioles of the extremities, causing
a decrease in circulation to the hands (A) which may lead to gangrene. (B, C, and D) are abnormal
findings, but do not indicate the development of septic emboli.
