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HESI practice Med-Surge
HESI practice Med-Surge Exam Study
Guide Questions with Verified Solutions
2025
The nurse is assessing a client who smokes cigarettes and has been diagnosed with
emphysema. Which finding would the nurse expect this client to exhibit?
A decreased total lung capacity.
Normal arterial blood gases.
Normal skin coloring.
An absence of sputum.
Normal skin coloring.
The differentiation between the "pink puffer" and the "blue bloater" is a well-known
method of differentiating clients exhibiting symptoms of emphysema (normal color
but puffing respirations) from those exhibiting symptoms of chronic bronchitis
(edematous, cyanotic, shallow respirations).
A female client receiving IV vasopressin (Pitressin) for esophageal varice rupture
reports to the nurse that she feels substernal tightness and pressure across her chest.
Which PRN protocol should the nurse initiate?
Start an IV nitroglycerin infusion.
Nasogastric lavage with cool saline.
Increase the vasopressin infusion.
Prepare for endotracheal intubation.
Start an IV nitroglycerin infusion.
Vasopressin is used to promote vasoconstriction, thereby reducing bleeding from the
esophageal varice. Vasoconstriction of the coronary arteries can lead to angina and
HESI practice Med-Surge
, 2
HESI practice Med-Surge
myocardial infarction, and should be counteracted by IV nitroglycerin per prescribed
protocol.
In assessing a client diagnosed with primary hyperaldosteronism, the nurse expects the
laboratory test results to indicate an increased serum level of which substance?
Sodium.
Antidiuretic hormone.
Potassium.
Glucose.
Sodium
Clients with primary aldosteronism exhibit an increase in serum sodium levels
(hypernatremia) and have profound decline in the serum levels of potassium
(hypokalemia)--hypertension is the most prominent and universal sign. Antidiuretic
hormone is decreased with diabetes insipidus. Glucose is not affected by primary
aldosteronism.
A 46-year-old female client is admitted for acute renal failure secondary to diabetes
and hypertension. Which test is the best indicator of adequate glomerular filtration?
Serum creatinine.
Blood Urea Nitrogen (BUN).
Sedimentation rate.
Urine specific gravity.
Serum Creatinine
Creatinine is a product of muscle metabolism that is filtered by the glomerulus, and
blood levels of this substance are not affected by dietary or fluid intake. An elevated
creatinine strongly indicates nephron loss, reducing filtration.
HESI practice Med-Surge
, 3
HESI practice Med-Surge
The nurse is teaching a female client about the best time to plan sexual intercourse in
order to conceive. Which information should the nurse provide?
Two weeks before menstruation.
Vaginal mucous discharge is thick.
Low basal temperature.
First thing in the morning.
Two weeks before menstruation.
Ovulation typically occurs 14 days before menstruation begins during a typical 28 day
cycle. Sexual intercourse should occur within 24 hours of ovulation for an increase
chance of conception to occur. High estrogen levels occur during ovulation and
increase the vaginal mucous membrane characteristics to become more "slippery" and
stretchy, along with a rise in basal temperature. The timing during the day is not as
significant in determining conception as the day before and after ovulation.
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?
"Check it again in one month, and if it is still there schedule an appointment."
"Most lumps are benign, but it is always best to come in for an examination."
"Try not to worry too much about it, because usually, most lumps are benign."
"If you are in your menstrual period it is not a good time to check for lumps."
"Most lumps are benign, but it is always best to come in for an examination."
The nurse advising the client to come in provides the best response because it
addresses the client's anxiety most effectively and encourages prompt and immediate
action for a potential problem.
An elderly 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 which is warm to
HESI practice Med-Surge
, 4
HESI practice Med-Surge
the touch and suspects it might be thrombophlebitis. Which type of pain would
further confirm this suspicion?
Pain in the calf awakening him from a sound sleep.
Calf pain on exertion which stops when standing in one place.
Pain in the calf upon exertion which is relieved by rest and elevating the extremity.
Pain upon arising in the morning which is relieved after some stretching and exercise.
Pain in the calf upon exertion which is relieved by rest and elevating the extremity.
Thrombophlebitis pain is relieved by rest and elevation of the extremity. It typically
occurs with exercise at the site of the thrombus, and is aggravated by placing the
extremity in a dependent position, such as standing in one place.
The nurse is teaching a female client who uses a contraceptive diaphragm about
reducing the risk for toxic shock syndrome (TSS). Which information should the nurse
include? (Select all that apply.)
Select all that apply
Remove the diaphragm immediately after intercourse.
Wash the diaphragm with an alcohol solution.
Use the diaphragm to prevent conception during the menstrual cycle.
Do not leave the diaphragm in place longer than 8 hours after intercourse.
Replace the old diaphragm every 3 months.
Do not leave the diaphragm in place longer than 8 hours after intercourse.
Replace the old diaphragm every 3 months.
The diaphragm needs to remain against the cervix for 6 to 8 hours to prevent
pregnancy but should not remain for longer than 8 hours to avoid the risk of TSS. The
diaphragm should be replaced every 3 months to maintain integrity.
HESI practice Med-Surge
HESI practice Med-Surge
HESI practice Med-Surge Exam Study
Guide Questions with Verified Solutions
2025
The nurse is assessing a client who smokes cigarettes and has been diagnosed with
emphysema. Which finding would the nurse expect this client to exhibit?
A decreased total lung capacity.
Normal arterial blood gases.
Normal skin coloring.
An absence of sputum.
Normal skin coloring.
The differentiation between the "pink puffer" and the "blue bloater" is a well-known
method of differentiating clients exhibiting symptoms of emphysema (normal color
but puffing respirations) from those exhibiting symptoms of chronic bronchitis
(edematous, cyanotic, shallow respirations).
A female client receiving IV vasopressin (Pitressin) for esophageal varice rupture
reports to the nurse that she feels substernal tightness and pressure across her chest.
Which PRN protocol should the nurse initiate?
Start an IV nitroglycerin infusion.
Nasogastric lavage with cool saline.
Increase the vasopressin infusion.
Prepare for endotracheal intubation.
Start an IV nitroglycerin infusion.
Vasopressin is used to promote vasoconstriction, thereby reducing bleeding from the
esophageal varice. Vasoconstriction of the coronary arteries can lead to angina and
HESI practice Med-Surge
, 2
HESI practice Med-Surge
myocardial infarction, and should be counteracted by IV nitroglycerin per prescribed
protocol.
In assessing a client diagnosed with primary hyperaldosteronism, the nurse expects the
laboratory test results to indicate an increased serum level of which substance?
Sodium.
Antidiuretic hormone.
Potassium.
Glucose.
Sodium
Clients with primary aldosteronism exhibit an increase in serum sodium levels
(hypernatremia) and have profound decline in the serum levels of potassium
(hypokalemia)--hypertension is the most prominent and universal sign. Antidiuretic
hormone is decreased with diabetes insipidus. Glucose is not affected by primary
aldosteronism.
A 46-year-old female client is admitted for acute renal failure secondary to diabetes
and hypertension. Which test is the best indicator of adequate glomerular filtration?
Serum creatinine.
Blood Urea Nitrogen (BUN).
Sedimentation rate.
Urine specific gravity.
Serum Creatinine
Creatinine is a product of muscle metabolism that is filtered by the glomerulus, and
blood levels of this substance are not affected by dietary or fluid intake. An elevated
creatinine strongly indicates nephron loss, reducing filtration.
HESI practice Med-Surge
, 3
HESI practice Med-Surge
The nurse is teaching a female client about the best time to plan sexual intercourse in
order to conceive. Which information should the nurse provide?
Two weeks before menstruation.
Vaginal mucous discharge is thick.
Low basal temperature.
First thing in the morning.
Two weeks before menstruation.
Ovulation typically occurs 14 days before menstruation begins during a typical 28 day
cycle. Sexual intercourse should occur within 24 hours of ovulation for an increase
chance of conception to occur. High estrogen levels occur during ovulation and
increase the vaginal mucous membrane characteristics to become more "slippery" and
stretchy, along with a rise in basal temperature. The timing during the day is not as
significant in determining conception as the day before and after ovulation.
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?
"Check it again in one month, and if it is still there schedule an appointment."
"Most lumps are benign, but it is always best to come in for an examination."
"Try not to worry too much about it, because usually, most lumps are benign."
"If you are in your menstrual period it is not a good time to check for lumps."
"Most lumps are benign, but it is always best to come in for an examination."
The nurse advising the client to come in provides the best response because it
addresses the client's anxiety most effectively and encourages prompt and immediate
action for a potential problem.
An elderly 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 which is warm to
HESI practice Med-Surge
, 4
HESI practice Med-Surge
the touch and suspects it might be thrombophlebitis. Which type of pain would
further confirm this suspicion?
Pain in the calf awakening him from a sound sleep.
Calf pain on exertion which stops when standing in one place.
Pain in the calf upon exertion which is relieved by rest and elevating the extremity.
Pain upon arising in the morning which is relieved after some stretching and exercise.
Pain in the calf upon exertion which is relieved by rest and elevating the extremity.
Thrombophlebitis pain is relieved by rest and elevation of the extremity. It typically
occurs with exercise at the site of the thrombus, and is aggravated by placing the
extremity in a dependent position, such as standing in one place.
The nurse is teaching a female client who uses a contraceptive diaphragm about
reducing the risk for toxic shock syndrome (TSS). Which information should the nurse
include? (Select all that apply.)
Select all that apply
Remove the diaphragm immediately after intercourse.
Wash the diaphragm with an alcohol solution.
Use the diaphragm to prevent conception during the menstrual cycle.
Do not leave the diaphragm in place longer than 8 hours after intercourse.
Replace the old diaphragm every 3 months.
Do not leave the diaphragm in place longer than 8 hours after intercourse.
Replace the old diaphragm every 3 months.
The diaphragm needs to remain against the cervix for 6 to 8 hours to prevent
pregnancy but should not remain for longer than 8 hours to avoid the risk of TSS. The
diaphragm should be replaced every 3 months to maintain integrity.
HESI practice Med-Surge
