HESI MED SURG PRACTICE EXAM Questions
and Answers Latest Version 2025 GRADED
A+
1) Which abnormal lab finding indicates that a client with diabetes needs
further evaluation for diabetic nephropathy?
A. Hypokalemia
B. Microalbuminauria
C. Elevated serum lipids
D. Ketonuria
B. Microalbuminuria is the earliest sign of nephropathy and indicates the
need for follow-up evaluation. Hyperkalemia (A) is associated with end
stage renal disease caused by diabetic nephropathy. (C) may be elevated in
end stage renal disease. (D) may signal the onset of DKA.
2) An older male client comes to the geriatric screening clinic complaining
of pain in his left calf. The nurse notices a reddened area on the calf of his
right leg that is warm to touch and the nurse suspects that the client may
,have thrombophlebitis. Which addition assessment is most important for
the nurse to perform?
A. Measure calf circumference.
B. Auscultate the client's breath sounds.
C. Observe for ecchymosis and petechiae.
D. Obtain the client's blood pressure.
B. Since the client may have a pulmonary embolus secondary to the
thrombophlebitis. A. Would support the nurses assessment. C. Least
helpful since bruising is not associated with thrombophlebitis. D. Less
important then auscultation.
3) The nurse know that a client taking diuretics must be assessed for the
development of hypokalemia, and that hypokalemia will create changes in
the client's normal ECG tracing. Which ECG change would be an expected
finding in the client with hypokalemia?
A. Tall, spiked T waves
B. A prolonged QT interval
C. A widening QRS complex
D. Presence of a U wave
D. A U wave is a positive deflection following the T wave and is often
present with hypokalemia. A, B, C indicate hyperkalemia.
4) An older client is admitted with a diagnosis of bacterial pneumonia. The
nurse's assessment of the client will most likely reveal which S/SX? A.
Leukocytosis and febrile.
,B. Polycythemia and crackles.
C. Pharyngitis and sputum production.
D. Confusion and tachycardia.
D. The onset of pneumonia is the older may be signaled by general
deterioration, confusion, increased heart rate or increased respiratory rate.
(A, B, C) are often absent in the older with bacterial pneumonia.
5) The nurse observes ventricular fibrillation on telemetry and upon
entering the clients bathroom finds the client unconscious on the floor.
What intervention should the nurse implement first?
A. Administer an antidysrhythmic medication.
B. Start cardiopulmonary resuscitation.
C. Defibrillate the client at 200 joules.
D. Assess the client's pulse oximetry.
B. Ventricular fibrillation is a life-threatening dysrhythmia and CPR should
be started immediately. A & C are appropriate but B is the priority. D does
not address the seriousness of the situation.
6) An older female client with dementia is transferred from a long term
care unit to an acute care unit. The client's children express concern that
their mother's confusion is worsening. How should the nurse respond?
A. "It is to be expected that older people will experience progressive
confusion."
B. "Confusion in an older person often follows relocation to new
surroundings."
, C. "The dementia is progressing rapidly, but we will do everything we can to
keep your mother safe."
D. "The acute care staff is not as experienced as the long-term care staff at
dealing with dementia."
B. Relocation often results in confusion among older clients and is stressful
to clients of all ages. (A) is an inaccurate stereotype. (C) is most likely false
there are many factors that cause increased temporary confusion. (D) may
be true but does not offer the family a sense of security about the care.
7) The nurse plans to help an 18-year-old developmentally disabled
female client ambulate on the first postoperative day. When the nurse tells
her it is time to get out of bed, the client becomes angry and yells at the
nurse. "Get out of here! I'll get up when I'm ready." Which response should
the nurse provide?
A. "Your healthcare provider has prescribed ambulation on the first
postoperative day."
B. "You must ambulate to avoid serious complications that are much more
painful."
C. "I know how you feel; you're angry about having to do this, but it is
required."
D. "I'll be back in 30 minutes to help you get out of bed and walk around the
room."
D. Returning in 30 minutes provides a cooling off period, is firm, direct,
nonthreatening, and avoids argument with the client. B is threatening. C.
assumes what the client is feeling. A. avoids the nurse's responsibility to
ambulate the client.
and Answers Latest Version 2025 GRADED
A+
1) Which abnormal lab finding indicates that a client with diabetes needs
further evaluation for diabetic nephropathy?
A. Hypokalemia
B. Microalbuminauria
C. Elevated serum lipids
D. Ketonuria
B. Microalbuminuria is the earliest sign of nephropathy and indicates the
need for follow-up evaluation. Hyperkalemia (A) is associated with end
stage renal disease caused by diabetic nephropathy. (C) may be elevated in
end stage renal disease. (D) may signal the onset of DKA.
2) An older male client comes to the geriatric screening clinic complaining
of pain in his left calf. The nurse notices a reddened area on the calf of his
right leg that is warm to touch and the nurse suspects that the client may
,have thrombophlebitis. Which addition assessment is most important for
the nurse to perform?
A. Measure calf circumference.
B. Auscultate the client's breath sounds.
C. Observe for ecchymosis and petechiae.
D. Obtain the client's blood pressure.
B. Since the client may have a pulmonary embolus secondary to the
thrombophlebitis. A. Would support the nurses assessment. C. Least
helpful since bruising is not associated with thrombophlebitis. D. Less
important then auscultation.
3) The nurse know that a client taking diuretics must be assessed for the
development of hypokalemia, and that hypokalemia will create changes in
the client's normal ECG tracing. Which ECG change would be an expected
finding in the client with hypokalemia?
A. Tall, spiked T waves
B. A prolonged QT interval
C. A widening QRS complex
D. Presence of a U wave
D. A U wave is a positive deflection following the T wave and is often
present with hypokalemia. A, B, C indicate hyperkalemia.
4) An older client is admitted with a diagnosis of bacterial pneumonia. The
nurse's assessment of the client will most likely reveal which S/SX? A.
Leukocytosis and febrile.
,B. Polycythemia and crackles.
C. Pharyngitis and sputum production.
D. Confusion and tachycardia.
D. The onset of pneumonia is the older may be signaled by general
deterioration, confusion, increased heart rate or increased respiratory rate.
(A, B, C) are often absent in the older with bacterial pneumonia.
5) The nurse observes ventricular fibrillation on telemetry and upon
entering the clients bathroom finds the client unconscious on the floor.
What intervention should the nurse implement first?
A. Administer an antidysrhythmic medication.
B. Start cardiopulmonary resuscitation.
C. Defibrillate the client at 200 joules.
D. Assess the client's pulse oximetry.
B. Ventricular fibrillation is a life-threatening dysrhythmia and CPR should
be started immediately. A & C are appropriate but B is the priority. D does
not address the seriousness of the situation.
6) An older female client with dementia is transferred from a long term
care unit to an acute care unit. The client's children express concern that
their mother's confusion is worsening. How should the nurse respond?
A. "It is to be expected that older people will experience progressive
confusion."
B. "Confusion in an older person often follows relocation to new
surroundings."
, C. "The dementia is progressing rapidly, but we will do everything we can to
keep your mother safe."
D. "The acute care staff is not as experienced as the long-term care staff at
dealing with dementia."
B. Relocation often results in confusion among older clients and is stressful
to clients of all ages. (A) is an inaccurate stereotype. (C) is most likely false
there are many factors that cause increased temporary confusion. (D) may
be true but does not offer the family a sense of security about the care.
7) The nurse plans to help an 18-year-old developmentally disabled
female client ambulate on the first postoperative day. When the nurse tells
her it is time to get out of bed, the client becomes angry and yells at the
nurse. "Get out of here! I'll get up when I'm ready." Which response should
the nurse provide?
A. "Your healthcare provider has prescribed ambulation on the first
postoperative day."
B. "You must ambulate to avoid serious complications that are much more
painful."
C. "I know how you feel; you're angry about having to do this, but it is
required."
D. "I'll be back in 30 minutes to help you get out of bed and walk around the
room."
D. Returning in 30 minutes provides a cooling off period, is firm, direct,
nonthreatening, and avoids argument with the client. B is threatening. C.
assumes what the client is feeling. A. avoids the nurse's responsibility to
ambulate the client.
