HESI PN
Med-Surg EXAM
(NGN-Style Questions & Case Scenarios)
400+ Qs & Ans to Pass the Exam
This Hesi test contains:
400+ Qs & Ans
passing score Guarantee
Format Set of Multiple-choice
questions with incorporating Next Generation NCLEX
(NGN) and Case Scenarios
Expert-Verified Explanations & Solutions
,---
#### 1. A client with prostate cancer undergoes brachytherapy (radioactive seed
implantation). What nursing action has the highest priority?
A. Follow radiation exposure precautions.
B. Encourage the client to consume regular meals.
C. Collect all urine in sealed containers.
D. Avoid touching the client.
Answer: A. Follow radiation exposure precautions.
Expert Rationale:
Radiation precautions protect healthcare workers, clients, and visitors from
unnecessary exposure. Protocols generally include time, distance, and shielding
measures. For brachytherapy, staff must maintain limited, computed exposure
times near the client.
---
#### 2. NGN-Style Case Scenario: A home health PN visits a client with
emphysema who is oxygen-dependent and independently manages self-care.
Recent findings reveal:
- Oxygen Saturation: 91% on 2 L/min oxygen.
- Weight: 5 lbs less than the last home visit (30 days ago).
- Reported Fatigue: Unchanged since the prior visit.
- Home Environment: Disheveled with dirty dishes and clothing scattered.
Based on this assessment, what requires immediate consultation with the RN case
manager?
A. Oxygen saturation of 91% on oxygen at 2 L/min.
,B. Weight loss of 5 pounds within the past month.
C. Report of unchanged fatigue from the prior visit.
D. Disheveled appearance of the home environment.
Answer: B. Weight loss of 5 pounds within the past month.
Expert Rationale:
Unintended weight loss in clients with COPD could indicate increased energy
expenditure and nutritional deficiencies requiring urgent dietary intervention.
Oxygen saturation of 91% is expected in COPD. Fatigue and disorganized
surroundings may also result from illness but are secondary concerns compared to
potential malnutrition.
---
#### 3. A client with diabetes mellitus is being educated on symptoms of diabetic
ketoacidosis (DKA). Which symptoms should the PN reinforce? (Select all that
apply.)
A. Fruity breath odor.
B. Rapid, weak pulse.
C. Cold, clammy skin.
D. Extreme thirst.
E. Urinary frequency.
F. Protruding eyeballs.
Answers:
A. Fruity breath odor.
B. Rapid, weak pulse.
D. Extreme thirst.
E. Urinary frequency.
,Expert Rationale:
DKA results from significant insulin deficiency, leading to hyperglycemia,
ketonemia, and dehydration. Symptoms include fruity breath, tachycardia (from
hypovolemia), polydipsia, polyuria, and hyperventilation. Cold, clammy skin is a
sign of hypoglycemia, not DKA.
#### 4. During a clinic visit, a client reports discovering a solid, painless mass in
their breast during self-examination. What instruction should the practical nurse
(PN) reinforce with the client?
A. Continue to monitor the mass until the next scheduled annual exam.
B. Notify the healthcare provider if the mass becomes painful or starts to drain.
C. Schedule an appointment with the healthcare provider for evaluation.
D. Breast masses are insignificant if they feel soft or are easily movable.
Answer: C. Schedule an appointment with the healthcare provider for evaluation.
Expert Rationale:
A painless breast mass is considered an abnormal finding and requires prompt
medical evaluation. Early detection of potential breast cancer is crucial. Delaying
evaluation may lead to progression of undiagnosed malignancy.
---
#### 5. A client with stage 4 liver cancer learns the metastasis has spread to the
spine but incorrectly states, "It's not malignant." What is the PN’s initial action?
A. Encourage the client to attend a cancer education program.
B. Perform a complete history and physical assessment.
C. Ask the client to explain their understanding of the term malignancy.
D. Offer the client emotional support to deal with the diagnosis.
,Answer: C. Ask the client to explain their understanding of the term malignancy.
Expert Rationale:
Before providing further education or emotional support, the PN should assess the
client’s knowledge. This ensures clear communication and identifies knowledge gaps
or misconceptions, as malignant tumors are characterized by uncontrolled growth,
invasion, and potential metastasis.
---
#### 6. A client with osteoarthritis complains of joint stiffness and pain. Which
intervention is most appropriate for the PN to recommend?
A. Encourage weight-bearing exercises.
B. Teach the client to perform range-of-motion exercises.
C. Explain the use of ice and massage for pain relief.
D. Instruct the client to take an analgesic before walking daily.
Answer: D. Instruct the client to take an analgesic before walking daily.
Expert Rationale:
Pain control is essential for the effectiveness of exercise programs. Taking an
analgesic before scheduled activity facilitates movement and improves adherence to
the regimen aimed at maintaining mobility and decreasing stiffness.
---
---
#### 7. A client mentions they use garlic daily to lower cholesterol and
triglycerides. What nursing intervention is the priority?
,A. Monitor for signs of bleeding.
B. Instruct the client that garlic increases hypertension risk.
C. Advise the client that garlic relieves fever like acetaminophen.
D. Recommend tooth brushing and mouthwash for garlic odor.
Answer: A. Monitor for signs of bleeding.
Expert Rationale:
Garlic inhibits platelet aggregation, increasing bleeding risk, especially if combined
with anticoagulant or antiplatelet therapy. Garlic has no significant link to fever or
hypertension. Garlic odor, though unpleasant for some, is not a priority concern.
---
#### NGN Question: 8. Case Study – Development of Throat Cancer
Scenario: A 56-year-old client presents for a routine checkup. They report smoking
1 pack/day for 25 years, frequent alcohol consumption, and a persistent sore
throat. Vital Signs: BP 138/84 mmHg, HR 88 bpm.
Question: Based on the client’s history, what are the primary risk factors for throat
cancer? (Select all that apply.)
A. Tobacco use.
B. Excessive alcohol intake.
C. Intake of hot and spicy foods.
D. Human papillomavirus (HPV).
E. Lack of exercise.
F. Diet low in fiber.
Answers:
,A. Tobacco use.
B. Excessive alcohol intake.
D. Human papillomavirus (HPV).
Expert Rationale:
Risk factors for throat cancer include tobacco use, excessive alcohol, and HPV
infections. Spicy foods, insufficient exercise, or low fiber intake are not strong
causative factors for throat malignancy.
---
#### 9. A client post-craniotomy for a brain tumor exhibits new-onset confusion.
What is the most likely cause?
A. Blood pressure decrease from 128/70 to 124/68 mmHg.
B. Increased confusion compared to their baseline.
C. Sanguineous drainage from the surgical site.
D. Pulse rate increase from 70 to 82 bpm.
Answer: B. Increased confusion compared to their baseline.
Expert Rationale:
An early sign of increased intracranial pressure (ICP) is a change in the level of
consciousness. Other findings, such as vital sign changes, occur later in ICP
progression.
---
#### 10. NGN-Style Question: Administration of Metered Dose Inhaler (MDI)
Place the following steps for administering a metered dose inhaler (MDI) with a
spacer in the correct sequence.
,1. Exhale fully through the mouth to empty lungs.
2. Shake the inhaler well before use.
3. Attach the inhaler to the spacer device.
4. Place the spacer in the mouth and seal lips around it.
5. Press the inhaler while inhaling slowly and deeply.
6. Hold breath for 10 seconds, then exhale slowly.
Correct Sequence:
2, 3, 1, 4, 5, 6.
Expert Rationale:
Proper understanding ensures optimal medication delivery to the lungs.
### 21. Case Study Question: Understanding of Cancer Terminology
Scenario:
A healthcare provider informed a client diagnosed with stage 4 liver cancer that the
cancer had metastasized to their spine. The client tells the practical nurse (PN), "I
have cancer, but it's not malignant."
What is the best initial nursing action?
A. Encourage the client to attend a cancer education program.
B. Perform a complete history and physical assessment.
C. Ask the client to explain their understanding of the term "malignancy."
D. Offer the client emotional support to deal with their diagnosis.
Answer: C. Ask the client to explain their understanding of the term "malignancy."
Expert Rationale:
,The most appropriate initial action is to assess the client's understanding of
"malignancy," as their comment indicates a misunderstanding. Stage 4 cancer is
metastatic, meaning it has spread to distant parts of the body, which categorizes it
as malignant. Clarifying knowledge gaps helps provide accurate education and care.
---
### 22. Prioritizing Care for a Client with Advanced Parkinson’s Disease
Scenario:
A client with severe Parkinson's disease is admitted with anorexia, dysphagia,
drooling, generalized weakness, and slurred speech.
What should the PN implement first?
A. Provide the client with a word board for communication.
B. Set up suction and a Yankauer at the bedside.
C. Encourage the client to perform range-of-motion exercises.
D. Offer the client nutritional milkshakes every 2 hours.
Answer: B. Set up suction and a Yankauer at the bedside.
Expert Rationale:
Clients with dysphagia and drooling are at high risk for aspiration, which can lead to
aspiration pneumonia. The priority is ensuring airway clearance with suction readily
available to manage secretions effectively. Other interventions are secondary once
the airway is managed.
---
### 23. Seizure Protocol
, A client with epilepsy is admitted. During the hospital stay, the client experiences a
seizure.
What intervention should the PN implement during the seizure?
A. Observe the length and activity of the seizure.
B. Insert an oral airway to open the airway.
C. Gently restrain the client to prevent injury.
D. Notify the code team immediately.
Answer: A. Observe the length and activity of the seizure.
Expert Rationale:
During a seizure, the priority is observation and safety. Documenting the seizure's
duration and activity provides vital information to guide future treatment. Inserting
an airway or restraining the client may cause harm. A code team is only necessary
if the seizure becomes status epilepticus.
---
### 24. Case-Based Question: Radiation Effects on Brain Tumor
A client is undergoing radiation therapy for a right frontal brain tumor.
Which problem should the PN monitor for during early post-therapy days?
A. Hemiplegia
B. Headache
C. Hearing loss
D. Dysphagia
Answer: B. Headache
Med-Surg EXAM
(NGN-Style Questions & Case Scenarios)
400+ Qs & Ans to Pass the Exam
This Hesi test contains:
400+ Qs & Ans
passing score Guarantee
Format Set of Multiple-choice
questions with incorporating Next Generation NCLEX
(NGN) and Case Scenarios
Expert-Verified Explanations & Solutions
,---
#### 1. A client with prostate cancer undergoes brachytherapy (radioactive seed
implantation). What nursing action has the highest priority?
A. Follow radiation exposure precautions.
B. Encourage the client to consume regular meals.
C. Collect all urine in sealed containers.
D. Avoid touching the client.
Answer: A. Follow radiation exposure precautions.
Expert Rationale:
Radiation precautions protect healthcare workers, clients, and visitors from
unnecessary exposure. Protocols generally include time, distance, and shielding
measures. For brachytherapy, staff must maintain limited, computed exposure
times near the client.
---
#### 2. NGN-Style Case Scenario: A home health PN visits a client with
emphysema who is oxygen-dependent and independently manages self-care.
Recent findings reveal:
- Oxygen Saturation: 91% on 2 L/min oxygen.
- Weight: 5 lbs less than the last home visit (30 days ago).
- Reported Fatigue: Unchanged since the prior visit.
- Home Environment: Disheveled with dirty dishes and clothing scattered.
Based on this assessment, what requires immediate consultation with the RN case
manager?
A. Oxygen saturation of 91% on oxygen at 2 L/min.
,B. Weight loss of 5 pounds within the past month.
C. Report of unchanged fatigue from the prior visit.
D. Disheveled appearance of the home environment.
Answer: B. Weight loss of 5 pounds within the past month.
Expert Rationale:
Unintended weight loss in clients with COPD could indicate increased energy
expenditure and nutritional deficiencies requiring urgent dietary intervention.
Oxygen saturation of 91% is expected in COPD. Fatigue and disorganized
surroundings may also result from illness but are secondary concerns compared to
potential malnutrition.
---
#### 3. A client with diabetes mellitus is being educated on symptoms of diabetic
ketoacidosis (DKA). Which symptoms should the PN reinforce? (Select all that
apply.)
A. Fruity breath odor.
B. Rapid, weak pulse.
C. Cold, clammy skin.
D. Extreme thirst.
E. Urinary frequency.
F. Protruding eyeballs.
Answers:
A. Fruity breath odor.
B. Rapid, weak pulse.
D. Extreme thirst.
E. Urinary frequency.
,Expert Rationale:
DKA results from significant insulin deficiency, leading to hyperglycemia,
ketonemia, and dehydration. Symptoms include fruity breath, tachycardia (from
hypovolemia), polydipsia, polyuria, and hyperventilation. Cold, clammy skin is a
sign of hypoglycemia, not DKA.
#### 4. During a clinic visit, a client reports discovering a solid, painless mass in
their breast during self-examination. What instruction should the practical nurse
(PN) reinforce with the client?
A. Continue to monitor the mass until the next scheduled annual exam.
B. Notify the healthcare provider if the mass becomes painful or starts to drain.
C. Schedule an appointment with the healthcare provider for evaluation.
D. Breast masses are insignificant if they feel soft or are easily movable.
Answer: C. Schedule an appointment with the healthcare provider for evaluation.
Expert Rationale:
A painless breast mass is considered an abnormal finding and requires prompt
medical evaluation. Early detection of potential breast cancer is crucial. Delaying
evaluation may lead to progression of undiagnosed malignancy.
---
#### 5. A client with stage 4 liver cancer learns the metastasis has spread to the
spine but incorrectly states, "It's not malignant." What is the PN’s initial action?
A. Encourage the client to attend a cancer education program.
B. Perform a complete history and physical assessment.
C. Ask the client to explain their understanding of the term malignancy.
D. Offer the client emotional support to deal with the diagnosis.
,Answer: C. Ask the client to explain their understanding of the term malignancy.
Expert Rationale:
Before providing further education or emotional support, the PN should assess the
client’s knowledge. This ensures clear communication and identifies knowledge gaps
or misconceptions, as malignant tumors are characterized by uncontrolled growth,
invasion, and potential metastasis.
---
#### 6. A client with osteoarthritis complains of joint stiffness and pain. Which
intervention is most appropriate for the PN to recommend?
A. Encourage weight-bearing exercises.
B. Teach the client to perform range-of-motion exercises.
C. Explain the use of ice and massage for pain relief.
D. Instruct the client to take an analgesic before walking daily.
Answer: D. Instruct the client to take an analgesic before walking daily.
Expert Rationale:
Pain control is essential for the effectiveness of exercise programs. Taking an
analgesic before scheduled activity facilitates movement and improves adherence to
the regimen aimed at maintaining mobility and decreasing stiffness.
---
---
#### 7. A client mentions they use garlic daily to lower cholesterol and
triglycerides. What nursing intervention is the priority?
,A. Monitor for signs of bleeding.
B. Instruct the client that garlic increases hypertension risk.
C. Advise the client that garlic relieves fever like acetaminophen.
D. Recommend tooth brushing and mouthwash for garlic odor.
Answer: A. Monitor for signs of bleeding.
Expert Rationale:
Garlic inhibits platelet aggregation, increasing bleeding risk, especially if combined
with anticoagulant or antiplatelet therapy. Garlic has no significant link to fever or
hypertension. Garlic odor, though unpleasant for some, is not a priority concern.
---
#### NGN Question: 8. Case Study – Development of Throat Cancer
Scenario: A 56-year-old client presents for a routine checkup. They report smoking
1 pack/day for 25 years, frequent alcohol consumption, and a persistent sore
throat. Vital Signs: BP 138/84 mmHg, HR 88 bpm.
Question: Based on the client’s history, what are the primary risk factors for throat
cancer? (Select all that apply.)
A. Tobacco use.
B. Excessive alcohol intake.
C. Intake of hot and spicy foods.
D. Human papillomavirus (HPV).
E. Lack of exercise.
F. Diet low in fiber.
Answers:
,A. Tobacco use.
B. Excessive alcohol intake.
D. Human papillomavirus (HPV).
Expert Rationale:
Risk factors for throat cancer include tobacco use, excessive alcohol, and HPV
infections. Spicy foods, insufficient exercise, or low fiber intake are not strong
causative factors for throat malignancy.
---
#### 9. A client post-craniotomy for a brain tumor exhibits new-onset confusion.
What is the most likely cause?
A. Blood pressure decrease from 128/70 to 124/68 mmHg.
B. Increased confusion compared to their baseline.
C. Sanguineous drainage from the surgical site.
D. Pulse rate increase from 70 to 82 bpm.
Answer: B. Increased confusion compared to their baseline.
Expert Rationale:
An early sign of increased intracranial pressure (ICP) is a change in the level of
consciousness. Other findings, such as vital sign changes, occur later in ICP
progression.
---
#### 10. NGN-Style Question: Administration of Metered Dose Inhaler (MDI)
Place the following steps for administering a metered dose inhaler (MDI) with a
spacer in the correct sequence.
,1. Exhale fully through the mouth to empty lungs.
2. Shake the inhaler well before use.
3. Attach the inhaler to the spacer device.
4. Place the spacer in the mouth and seal lips around it.
5. Press the inhaler while inhaling slowly and deeply.
6. Hold breath for 10 seconds, then exhale slowly.
Correct Sequence:
2, 3, 1, 4, 5, 6.
Expert Rationale:
Proper understanding ensures optimal medication delivery to the lungs.
### 21. Case Study Question: Understanding of Cancer Terminology
Scenario:
A healthcare provider informed a client diagnosed with stage 4 liver cancer that the
cancer had metastasized to their spine. The client tells the practical nurse (PN), "I
have cancer, but it's not malignant."
What is the best initial nursing action?
A. Encourage the client to attend a cancer education program.
B. Perform a complete history and physical assessment.
C. Ask the client to explain their understanding of the term "malignancy."
D. Offer the client emotional support to deal with their diagnosis.
Answer: C. Ask the client to explain their understanding of the term "malignancy."
Expert Rationale:
,The most appropriate initial action is to assess the client's understanding of
"malignancy," as their comment indicates a misunderstanding. Stage 4 cancer is
metastatic, meaning it has spread to distant parts of the body, which categorizes it
as malignant. Clarifying knowledge gaps helps provide accurate education and care.
---
### 22. Prioritizing Care for a Client with Advanced Parkinson’s Disease
Scenario:
A client with severe Parkinson's disease is admitted with anorexia, dysphagia,
drooling, generalized weakness, and slurred speech.
What should the PN implement first?
A. Provide the client with a word board for communication.
B. Set up suction and a Yankauer at the bedside.
C. Encourage the client to perform range-of-motion exercises.
D. Offer the client nutritional milkshakes every 2 hours.
Answer: B. Set up suction and a Yankauer at the bedside.
Expert Rationale:
Clients with dysphagia and drooling are at high risk for aspiration, which can lead to
aspiration pneumonia. The priority is ensuring airway clearance with suction readily
available to manage secretions effectively. Other interventions are secondary once
the airway is managed.
---
### 23. Seizure Protocol
, A client with epilepsy is admitted. During the hospital stay, the client experiences a
seizure.
What intervention should the PN implement during the seizure?
A. Observe the length and activity of the seizure.
B. Insert an oral airway to open the airway.
C. Gently restrain the client to prevent injury.
D. Notify the code team immediately.
Answer: A. Observe the length and activity of the seizure.
Expert Rationale:
During a seizure, the priority is observation and safety. Documenting the seizure's
duration and activity provides vital information to guide future treatment. Inserting
an airway or restraining the client may cause harm. A code team is only necessary
if the seizure becomes status epilepticus.
---
### 24. Case-Based Question: Radiation Effects on Brain Tumor
A client is undergoing radiation therapy for a right frontal brain tumor.
Which problem should the PN monitor for during early post-therapy days?
A. Hemiplegia
B. Headache
C. Hearing loss
D. Dysphagia
Answer: B. Headache
