HESI RN MED SURG VERSION A &
VERSION B 2024-2025 | HESI RN MED
SURG Version A & B 2025-2026 Actual
Exams Questions & Answers with
Correct Detailed Rationales| 2025
/The nurse is assessing a client with acute pancreatitis. Which finding requires the most
immediate intervention by the nurse?
A.
The client's amylase level is three times higher than the normal level.
B.
The client has a carpal spasm when taking a blood pressure.
C.
On a 1 to 10 scale, the client tells the nurse that her epigastric pain is at 7.
D.
The client states that she will continue to drink alcohol after going home. - Answer-B
The nurse is assessing a client with acute pancreatitis. Which finding requires the most
immediate intervention by the nurse?
Rationale:A positive Trousseau sign indicates hypocalcemia and always requires further
assessment and intervention, regardless of the cause (40% to 75% of those with acute
pancreatitis experience hypocalcemia, which can have serious, systemic effects). A key
diagnostic finding of pancreatitis is serum amylase and lipase levels that are two to five
times higher than the normal value. Severe boring pain is an expected symptom for this
diagnosis, but dealing with the hypocalcemia is a priority over administering an
analgesic. Long-term planning and teaching do not have the same immediate
importance as a positive Trousseau sign.
/.A 55-year-old male client has been admitted to the hospital with a medical diagnosis of
chronic obstructive pulmonary disease (COPD). Which risk factor is the most significant
in the development of this client's COPD?
A.
The client's father was diagnosed with COPD in his 50s.
B.
A close family member contracted tuberculosis last year.
C.
The client smokes one to two packs of cigarettes per day.
D.
The client has been 40 pounds overweight for 15 years. - Answer-C
Rationale:Smoking, considered to be a modifiable risk factor, is the most significant risk
factor for the development of COPD. The exact mechanism of genetic and hereditary
,implications for the development of COPD is still under investigation, although exposure
to similar predisposing factors (e.g., smoking or inhaling secondhand smoke) may
increase the likelihood of COPD incidence among family members. Options B and D do
not exceed the risks associated with cigarette smoking in the development of COPD.
/.In assessing a client diagnosed with primary aldosteronism, the nurse expects the
laboratory test results to indicate a decreased serum level of which substance?
A.
Sodium
B.
Phosphate
C.
Potassium
D.
Glucose - Answer-C
Rationale:Clients with primary aldosteronism exhibit a profound decline in serum levels
of potassium; hypokalemia; hypertension is the most prominent and universal sign. The
serum sodium level is normal or elevated, depending on the amount of water resorbed
with the sodium. Option B is influenced by parathyroid hormone (PTH). Option D is not
affected by primary aldosteronism.
/.The nurse is completing an admission interview for a client with Parkinson disease.
Which question will provide additional information about manifestations that the client is
likely to experience?
A.
"Have you ever experienced any paralysis of your arms or legs?"
B.
"Do you have frequent blackout spells?"
C.
"Have you ever been frozen in one spot, unable to move?"
D.
"Do you have headaches, especially ones with throbbing pain?" - Answer-C
Rationale:Clients with Parkinson disease frequently experience difficulty in initiating,
maintaining, and performing motor activities. They may even experience being rooted to
the spot and unable to move. Parkinson disease does not typically cause option A, B, or
D.
/.Client census is often used to determine staffing needs. Which method of obtaining
census determination for a particular unit provides the best formula for determining
long-range staffing patterns?
A.
Midnight census
B.
Oncoming shift census
C.
Average daily census
, D.
Hourly census - Answer-C
Rationale:An average daily census is determined by trend data and takes into account
seasonal and daily fluctuations, so it is the best method for determining staffing needs.
Options A and B provide data at a certain point in time, and that data could change
quickly. It is unrealistic to expect to obtain an hourly census, and such data would only
provide information about a certain point in time.
/.A male client has just undergone a laryngectomy and has a cuffed tracheostomy tube
in place. When initiating bolus tube feedings postoperatively, when should the nurse
inflate the cuff?
A.
Immediately after feeding
B.
Just prior to tube feeding
C.
Continuous inflation is required
D.
Inflation is not required - Answer-B
Rationale:The cuff should be inflated before the feeding to block the trachea and
prevent food from entering if oral feedings are started while a cuffed tracheostomy tube
is in place. It should remain inflated throughout the feeding to prevent aspiration of food
into the respiratory system. Options A and D place the client at risk for aspiration.
Option C places the client at risk for tracheal wall necrosis.
/.A client with a nasogastric tube attached to low suction states that she is nauseated.
The nurse assesses that there has been no drainage through the nasogastric tube in
the last 2 hours. Which action should the nurse take first?
A.
Irrigate the nasogastric tube with sterile normal saline.
B.
Reposition the client on her side.
C.
Advance the nasogastric tube 5 cm.
D.
Administer an intravenous antiemetic as prescribed. - Answer-B
Rationale:The immediate priority is to determine if the tube is functioning correctly,
which would then relieve the client's nausea. The least invasive intervention,
repositioning the client, should be attempted first, followed by options A and C, unless
either of these interventions is contraindicated. If these measures are unsuccessful, the
client may require option D.
/.The nurse is conducting an osteoporosis screening clinic at a health fair. What
information should the nurse provide to individuals who are at risk for osteoporosis?
(Select all that apply.)
A.
, Encourage alcohol and smoking cessation.
B.
Suggest supplementing diet with vitamin E.
C.
Promote regular weight-bearing exercises.
D.
Implement a home safety plan to prevent falls.
E.
Propose a regular sleep pattern of 8 hours nightly. - Answer-A, C, D
Rationale:Options A, C, and D are factors that decrease the risk for developing
osteoporosis. Vitamin D and calcium are important supplements to aid in the decrease
of bone loss. Regular sleep patterns are important to overall health but are not identified
with a decreasing risk for osteoporosis.
/.Which nursing action would be appropriate for a client who is newly diagnosed with
Cushing syndrome?
A.
Monitor blood glucose levels daily.
B.
Increase intake of fluids high in potassium.
C.
Encourage adequate rest between activities.
D.
Offer the client a sodium-enriched menu. - Answer-A
Rationale:Cushing syndrome results from a hypersecretion of glucocorticoids in the
adrenal cortex. Clients with Cushing syndrome often develop diabetes mellitus.
Monitoring of serum glucose levels assesses for increased blood glucose levels so that
treatment can begin early. A common finding in Cushing syndrome is generalized
edema. Although potassium is needed, it is generally obtained from food intake, not by
offering potassium-enhanced fluids. Fatigue is usually not an overwhelming factor in
Cushing syndrome, so an emphasis on the need for rest is not indicated. A low-calorie,
low-carbohydrate, low-sodium diet is not recommended.
/.A 58-year-old client who has no health problems asks the nurse about receiving the
pneumococcal vaccine. Which statement given by the nurse would offer the client
accurate information about this vaccine?
A.
The vaccine is given annually before the flu season to those older than 50 years.
B.
The immunization is administered once to older adults or those at risk for illness.
C.
The vaccine is for all ages and is given primarily to those persons traveling overseas to
areas of infection.
D.
The vaccine will prevent the occurrence of pneumococcal pneumonia for up to 5 years.
- Answer-B
VERSION B 2024-2025 | HESI RN MED
SURG Version A & B 2025-2026 Actual
Exams Questions & Answers with
Correct Detailed Rationales| 2025
/The nurse is assessing a client with acute pancreatitis. Which finding requires the most
immediate intervention by the nurse?
A.
The client's amylase level is three times higher than the normal level.
B.
The client has a carpal spasm when taking a blood pressure.
C.
On a 1 to 10 scale, the client tells the nurse that her epigastric pain is at 7.
D.
The client states that she will continue to drink alcohol after going home. - Answer-B
The nurse is assessing a client with acute pancreatitis. Which finding requires the most
immediate intervention by the nurse?
Rationale:A positive Trousseau sign indicates hypocalcemia and always requires further
assessment and intervention, regardless of the cause (40% to 75% of those with acute
pancreatitis experience hypocalcemia, which can have serious, systemic effects). A key
diagnostic finding of pancreatitis is serum amylase and lipase levels that are two to five
times higher than the normal value. Severe boring pain is an expected symptom for this
diagnosis, but dealing with the hypocalcemia is a priority over administering an
analgesic. Long-term planning and teaching do not have the same immediate
importance as a positive Trousseau sign.
/.A 55-year-old male client has been admitted to the hospital with a medical diagnosis of
chronic obstructive pulmonary disease (COPD). Which risk factor is the most significant
in the development of this client's COPD?
A.
The client's father was diagnosed with COPD in his 50s.
B.
A close family member contracted tuberculosis last year.
C.
The client smokes one to two packs of cigarettes per day.
D.
The client has been 40 pounds overweight for 15 years. - Answer-C
Rationale:Smoking, considered to be a modifiable risk factor, is the most significant risk
factor for the development of COPD. The exact mechanism of genetic and hereditary
,implications for the development of COPD is still under investigation, although exposure
to similar predisposing factors (e.g., smoking or inhaling secondhand smoke) may
increase the likelihood of COPD incidence among family members. Options B and D do
not exceed the risks associated with cigarette smoking in the development of COPD.
/.In assessing a client diagnosed with primary aldosteronism, the nurse expects the
laboratory test results to indicate a decreased serum level of which substance?
A.
Sodium
B.
Phosphate
C.
Potassium
D.
Glucose - Answer-C
Rationale:Clients with primary aldosteronism exhibit a profound decline in serum levels
of potassium; hypokalemia; hypertension is the most prominent and universal sign. The
serum sodium level is normal or elevated, depending on the amount of water resorbed
with the sodium. Option B is influenced by parathyroid hormone (PTH). Option D is not
affected by primary aldosteronism.
/.The nurse is completing an admission interview for a client with Parkinson disease.
Which question will provide additional information about manifestations that the client is
likely to experience?
A.
"Have you ever experienced any paralysis of your arms or legs?"
B.
"Do you have frequent blackout spells?"
C.
"Have you ever been frozen in one spot, unable to move?"
D.
"Do you have headaches, especially ones with throbbing pain?" - Answer-C
Rationale:Clients with Parkinson disease frequently experience difficulty in initiating,
maintaining, and performing motor activities. They may even experience being rooted to
the spot and unable to move. Parkinson disease does not typically cause option A, B, or
D.
/.Client census is often used to determine staffing needs. Which method of obtaining
census determination for a particular unit provides the best formula for determining
long-range staffing patterns?
A.
Midnight census
B.
Oncoming shift census
C.
Average daily census
, D.
Hourly census - Answer-C
Rationale:An average daily census is determined by trend data and takes into account
seasonal and daily fluctuations, so it is the best method for determining staffing needs.
Options A and B provide data at a certain point in time, and that data could change
quickly. It is unrealistic to expect to obtain an hourly census, and such data would only
provide information about a certain point in time.
/.A male client has just undergone a laryngectomy and has a cuffed tracheostomy tube
in place. When initiating bolus tube feedings postoperatively, when should the nurse
inflate the cuff?
A.
Immediately after feeding
B.
Just prior to tube feeding
C.
Continuous inflation is required
D.
Inflation is not required - Answer-B
Rationale:The cuff should be inflated before the feeding to block the trachea and
prevent food from entering if oral feedings are started while a cuffed tracheostomy tube
is in place. It should remain inflated throughout the feeding to prevent aspiration of food
into the respiratory system. Options A and D place the client at risk for aspiration.
Option C places the client at risk for tracheal wall necrosis.
/.A client with a nasogastric tube attached to low suction states that she is nauseated.
The nurse assesses that there has been no drainage through the nasogastric tube in
the last 2 hours. Which action should the nurse take first?
A.
Irrigate the nasogastric tube with sterile normal saline.
B.
Reposition the client on her side.
C.
Advance the nasogastric tube 5 cm.
D.
Administer an intravenous antiemetic as prescribed. - Answer-B
Rationale:The immediate priority is to determine if the tube is functioning correctly,
which would then relieve the client's nausea. The least invasive intervention,
repositioning the client, should be attempted first, followed by options A and C, unless
either of these interventions is contraindicated. If these measures are unsuccessful, the
client may require option D.
/.The nurse is conducting an osteoporosis screening clinic at a health fair. What
information should the nurse provide to individuals who are at risk for osteoporosis?
(Select all that apply.)
A.
, Encourage alcohol and smoking cessation.
B.
Suggest supplementing diet with vitamin E.
C.
Promote regular weight-bearing exercises.
D.
Implement a home safety plan to prevent falls.
E.
Propose a regular sleep pattern of 8 hours nightly. - Answer-A, C, D
Rationale:Options A, C, and D are factors that decrease the risk for developing
osteoporosis. Vitamin D and calcium are important supplements to aid in the decrease
of bone loss. Regular sleep patterns are important to overall health but are not identified
with a decreasing risk for osteoporosis.
/.Which nursing action would be appropriate for a client who is newly diagnosed with
Cushing syndrome?
A.
Monitor blood glucose levels daily.
B.
Increase intake of fluids high in potassium.
C.
Encourage adequate rest between activities.
D.
Offer the client a sodium-enriched menu. - Answer-A
Rationale:Cushing syndrome results from a hypersecretion of glucocorticoids in the
adrenal cortex. Clients with Cushing syndrome often develop diabetes mellitus.
Monitoring of serum glucose levels assesses for increased blood glucose levels so that
treatment can begin early. A common finding in Cushing syndrome is generalized
edema. Although potassium is needed, it is generally obtained from food intake, not by
offering potassium-enhanced fluids. Fatigue is usually not an overwhelming factor in
Cushing syndrome, so an emphasis on the need for rest is not indicated. A low-calorie,
low-carbohydrate, low-sodium diet is not recommended.
/.A 58-year-old client who has no health problems asks the nurse about receiving the
pneumococcal vaccine. Which statement given by the nurse would offer the client
accurate information about this vaccine?
A.
The vaccine is given annually before the flu season to those older than 50 years.
B.
The immunization is administered once to older adults or those at risk for illness.
C.
The vaccine is for all ages and is given primarily to those persons traveling overseas to
areas of infection.
D.
The vaccine will prevent the occurrence of pneumococcal pneumonia for up to 5 years.
- Answer-B
