HESI RN MED SURG VERSION A &
VERSION B 2025 ACTUAL EXAM
CONTAINS 125 QUESTIONS AND
CORRECT DETAILED
ANSWERS.ALREADY PASSED!!!!
The vnurse vis vassessing va vclient vwith vacute vpancreatitis. vWhich vfinding vrequires vthe
vmost vimmediate vintervention vby vthe vnurse?
A. v
The vclient's vamylase vlevel vis vthree vtimes vhigher vthan vthe vnormal vlevel.
vB.
The vclient vhas va vcarpal vspasm vwhen vtaking va vblood vpressure.
vC.
On va v1 vto v10 vscale, vthe vclient vtells vthe vnurse vthat vher vepigastric vpain vis vat v7.
vD.
The vclient vstates vthat vshe vwill vcontinue vto vdrink valcohol vafter vgoing vhome. v- v
vcorrect vanswer- v vB
The vnurse vis vassessing va vclient vwith vacute vpancreatitis. vWhich vfinding vrequires vthe
vmost vimmediate vintervention vby vthe vnurse?
Rationale:A vpositive vTrousseau vsign vindicates vhypocalcemia vand valways vrequires
vfurther vassessment vand vintervention, vregardless vof vthe vcause v(40% vto v75% vof
,vthose vwith vacute vpancreatitis vexperience vhypocalcemia, vwhich vcan vhave vserious,
vsystemic veffects). vA vkey vdiagnostic vfinding vof vpancreatitis vis vserum vamylase vand
vlipase vlevels vthat vare vtwo vto vfive vtimes vhigher vthan vthe vnormal vvalue. vSevere
vboring vpain vis van vexpected vsymptom vfor vthis vdiagnosis, vbut vdealing vwith vthe
vhypocalcemia vis va vpriority vover vadministering van vanalgesic. vLong-term vplanning
vand vteaching vdo vnot vhave vthe vsame vimmediate vimportance vas va vpositive
vTrousseau vsign.
A v55-year-old vmale vclient vhas vbeen vadmitted vto vthe vhospital vwith va vmedical
vdiagnosis vof vchronic vobstructive vpulmonary vdisease v(COPD). vWhich vrisk vfactor vis
vthe vmost vsignificant vin vthe vdevelopment vof vthis vclient's vCOPD?
A.
The vclient's vfather vwas vdiagnosed vwith vCOPD vin vhis v50s.
vB.
A vclose vfamily vmember vcontracted vtuberculosis vlast vyear.
vC.
The vclient vsmokes vone vto vtwo vpacks vof vcigarettes vper vday.
vD.
The vclient vhas vbeen v40 vpounds voverweight vfor v15 vyears. v- v vcorrect vanswer- v vC
Rationale:Smoking, vconsidered vto vbe va vmodifiable vrisk vfactor, vis vthe vmost
vsignificant vrisk vfactor vfor vthe vdevelopment vof vCOPD. vThe vexact vmechanism vof
vgenetic vand vhereditary vimplications vfor vthe vdevelopment vof vCOPD vis vstill vunder
vinvestigation, valthough vexposure vto vsimilar vpredisposing vfactors v(e.g., vsmoking vor
vinhaling vsecondhand vsmoke) vmay vincrease vthe vlikelihood vof vCOPD vincidence
vamong vfamily vmembers. vOptions vB vand vD vdo vnot vexceed vthe vrisks vassociated
vwith vcigarette vsmoking vin vthe vdevelopment vof vCOPD.
In vassessing va vclient vdiagnosed vwith vprimary valdosteronism, vthe vnurse vexpects vthe
vlaboratory vtest vresults vto vindicate va vdecreased vserum vlevel vof vwhich vsubstance?
A.
Sodium
vB.
Phosphate
vC.
Potassium
vD.
Glucose v- v vcorrect vanswer- v vC
Rationale:Clients vwith vprimary valdosteronism vexhibit va vprofound vdecline vin vserum
vlevels vof vpotassium; vhypokalemia; vhypertension vis vthe vmost vprominent vand
vuniversal vsign. vThe vserum vsodium vlevel vis vnormal vor velevated, vdepending von vthe
vamount vof vwater vresorbed vwith vthe vsodium. vOption vB vis vinfluenced vby vparathyroid
vhormone v(PTH). vOption vD vis vnot vaffected vby vprimary valdosteronism.
The vnurse vis vcompleting van vadmission vinterview vfor va vclient vwith vParkinson
vdisease. vWhich vquestion vwill vprovide vadditional vinformation vabout vmanifestations
vthat vthe vclient vis vlikely vto vexperience?
,A.
"Have vyou vever vexperienced vany vparalysis vof vyour varms vor vlegs?"
vB.
"Do vyou vhave vfrequent vblackout vspells?"
vC.
"Have vyou vever vbeen vfrozen vin vone vspot, vunable vto vmove?"
vD.
"Do vyou vhave vheadaches, vespecially vones vwith vthrobbing vpain?" v- v vcorrect
vanswer- v vC
Rationale:Clients vwith vParkinson vdisease vfrequently vexperience vdifficulty vin
vinitiating, vmaintaining, vand vperforming vmotor vactivities. vThey vmay veven vexperience
vbeing vrooted vto vthe vspot vand vunable vto vmove. vParkinson vdisease vdoes vnot
vtypically vcause voption vA, vB, vor vD.
Client vcensus vis voften vused vto vdetermine vstaffing vneeds. vWhich vmethod vof
vobtaining vcensus vdetermination vfor va vparticular vunit vprovides vthe vbest vformula vfor
vdetermining vlong-range vstaffing vpatterns?
A.
Midnight vcensus
vB.
Oncoming vshift vcensus
vC.
Average vdaily vcensus
vD.
Hourly vcensus v- v vcorrect vanswer- v vC
Rationale:An vaverage vdaily vcensus vis vdetermined vby vtrend vdata vand vtakes vinto
vaccount vseasonal vand vdaily vfluctuations, vso vit vis vthe vbest vmethod vfor vdetermining
vstaffing vneeds. vOptions vA vand vB vprovide vdata vat va vcertain vpoint vin vtime, vand vthat
vdata vcould vchange vquickly. vIt vis vunrealistic vto vexpect vto vobtain van vhourly vcensus,
vand vsuch vdata vwould vonly vprovide vinformation vabout va vcertain vpoint vin vtime.
A vmale vclient vhas vjust vundergone va vlaryngectomy vand vhas va vcuffed vtracheostomy
vtube vin vplace. vWhen vinitiating vbolus vtube vfeedings vpostoperatively, vwhen vshould
vthe vnurse vinflate vthe vcuff?
A.
Immediately vafter vfeeding
vB.
Just vprior vto vtube vfeeding
vC.
Continuous vinflation vis vrequired
vD.
Inflation vis vnot vrequired v- v vcorrect vanswer- v vB
Rationale:The vcuff vshould vbe vinflated vbefore vthe vfeeding vto vblock vthe vtrachea vand
vprevent vfood vfrom ventering vif voral vfeedings vare vstarted vwhile va vcuffed
vtracheostomy vtube vis vin vplace. vIt vshould vremain vinflated vthroughout vthe vfeeding vto
vprevent vaspiration vof vfood vinto vthe vrespiratory vsystem. vOptions vA vand vD vplace
, vthe vclient vat vrisk vfor vaspiration. vOption vC vplaces vthe vclient vat vrisk vfor vtracheal
vwall vnecrosis.
A vclient vwith va vnasogastric vtube vattached vto vlow vsuction vstates vthat vshe vis
vnauseated. vThe vnurse vassesses vthat vthere vhas vbeen vno vdrainage vthrough vthe
vnasogastric vtube vin vthe vlast v2 vhours. vWhich vaction vshould vthe vnurse vtake vfirst?
A.
Irrigate vthe vnasogastric vtube vwith vsterile vnormal vsaline.
vB.
Reposition vthe vclient von vher vside.
vC.
Advance vthe vnasogastric vtube v5 vcm.
vD.
Administer van vintravenous vantiemetic vas vprescribed. v- v vcorrect vanswer- v vB
Rationale:The vimmediate vpriority vis vto vdetermine vif vthe vtube vis vfunctioning
vcorrectly, vwhich vwould vthen vrelieve vthe vclient's vnausea. vThe vleast vinvasive
vintervention, vrepositioning vthe vclient, vshould vbe vattempted vfirst, vfollowed vby
voptions vA vand vC, vunless veither vof vthese vinterventions vis vcontraindicated. vIf vthese
vmeasures vare vunsuccessful, vthe vclient vmay vrequire voption vD.
The vnurse vis vconducting van vosteoporosis vscreening vclinic vat va vhealth vfair. vWhat
vinformation vshould vthe vnurse vprovide vto vindividuals vwho vare vat vrisk vfor
vosteoporosis? v(Select vall vthat vapply.)
A.
Encourage valcohol vand vsmoking vcessation.
vB.
Suggest vsupplementing vdiet vwith vvitamin vE.
vC.
Promote vregular vweight-bearing vexercises.
vD.
Implement va vhome vsafety vplan vto vprevent vfalls.
vE.
Propose va vregular vsleep vpattern vof v8 vhours vnightly. v- v vcorrect vanswer- v vA, vC, vD
Rationale:Options vA, vC, vand vD vare vfactors vthat vdecrease vthe vrisk vfor vdeveloping
vosteoporosis. vVitamin vD vand vcalcium vare vimportant vsupplements vto vaid vin vthe
vdecrease vof vbone vloss. vRegular vsleep vpatterns vare vimportant vto voverall vhealth vbut
vare vnot videntified vwith va vdecreasing vrisk vfor vosteoporosis.
Which vnursing vaction vwould vbe vappropriate vfor va vclient vwho vis vnewly vdiagnosed
vwith vCushing vsyndrome?
A.
Monitor vblood vglucose vlevels vdaily.
vB.
Increase vintake vof vfluids vhigh vin vpotassium.
vC.
Encourage vadequate vrest vbetween vactivities.
VERSION B 2025 ACTUAL EXAM
CONTAINS 125 QUESTIONS AND
CORRECT DETAILED
ANSWERS.ALREADY PASSED!!!!
The vnurse vis vassessing va vclient vwith vacute vpancreatitis. vWhich vfinding vrequires vthe
vmost vimmediate vintervention vby vthe vnurse?
A. v
The vclient's vamylase vlevel vis vthree vtimes vhigher vthan vthe vnormal vlevel.
vB.
The vclient vhas va vcarpal vspasm vwhen vtaking va vblood vpressure.
vC.
On va v1 vto v10 vscale, vthe vclient vtells vthe vnurse vthat vher vepigastric vpain vis vat v7.
vD.
The vclient vstates vthat vshe vwill vcontinue vto vdrink valcohol vafter vgoing vhome. v- v
vcorrect vanswer- v vB
The vnurse vis vassessing va vclient vwith vacute vpancreatitis. vWhich vfinding vrequires vthe
vmost vimmediate vintervention vby vthe vnurse?
Rationale:A vpositive vTrousseau vsign vindicates vhypocalcemia vand valways vrequires
vfurther vassessment vand vintervention, vregardless vof vthe vcause v(40% vto v75% vof
,vthose vwith vacute vpancreatitis vexperience vhypocalcemia, vwhich vcan vhave vserious,
vsystemic veffects). vA vkey vdiagnostic vfinding vof vpancreatitis vis vserum vamylase vand
vlipase vlevels vthat vare vtwo vto vfive vtimes vhigher vthan vthe vnormal vvalue. vSevere
vboring vpain vis van vexpected vsymptom vfor vthis vdiagnosis, vbut vdealing vwith vthe
vhypocalcemia vis va vpriority vover vadministering van vanalgesic. vLong-term vplanning
vand vteaching vdo vnot vhave vthe vsame vimmediate vimportance vas va vpositive
vTrousseau vsign.
A v55-year-old vmale vclient vhas vbeen vadmitted vto vthe vhospital vwith va vmedical
vdiagnosis vof vchronic vobstructive vpulmonary vdisease v(COPD). vWhich vrisk vfactor vis
vthe vmost vsignificant vin vthe vdevelopment vof vthis vclient's vCOPD?
A.
The vclient's vfather vwas vdiagnosed vwith vCOPD vin vhis v50s.
vB.
A vclose vfamily vmember vcontracted vtuberculosis vlast vyear.
vC.
The vclient vsmokes vone vto vtwo vpacks vof vcigarettes vper vday.
vD.
The vclient vhas vbeen v40 vpounds voverweight vfor v15 vyears. v- v vcorrect vanswer- v vC
Rationale:Smoking, vconsidered vto vbe va vmodifiable vrisk vfactor, vis vthe vmost
vsignificant vrisk vfactor vfor vthe vdevelopment vof vCOPD. vThe vexact vmechanism vof
vgenetic vand vhereditary vimplications vfor vthe vdevelopment vof vCOPD vis vstill vunder
vinvestigation, valthough vexposure vto vsimilar vpredisposing vfactors v(e.g., vsmoking vor
vinhaling vsecondhand vsmoke) vmay vincrease vthe vlikelihood vof vCOPD vincidence
vamong vfamily vmembers. vOptions vB vand vD vdo vnot vexceed vthe vrisks vassociated
vwith vcigarette vsmoking vin vthe vdevelopment vof vCOPD.
In vassessing va vclient vdiagnosed vwith vprimary valdosteronism, vthe vnurse vexpects vthe
vlaboratory vtest vresults vto vindicate va vdecreased vserum vlevel vof vwhich vsubstance?
A.
Sodium
vB.
Phosphate
vC.
Potassium
vD.
Glucose v- v vcorrect vanswer- v vC
Rationale:Clients vwith vprimary valdosteronism vexhibit va vprofound vdecline vin vserum
vlevels vof vpotassium; vhypokalemia; vhypertension vis vthe vmost vprominent vand
vuniversal vsign. vThe vserum vsodium vlevel vis vnormal vor velevated, vdepending von vthe
vamount vof vwater vresorbed vwith vthe vsodium. vOption vB vis vinfluenced vby vparathyroid
vhormone v(PTH). vOption vD vis vnot vaffected vby vprimary valdosteronism.
The vnurse vis vcompleting van vadmission vinterview vfor va vclient vwith vParkinson
vdisease. vWhich vquestion vwill vprovide vadditional vinformation vabout vmanifestations
vthat vthe vclient vis vlikely vto vexperience?
,A.
"Have vyou vever vexperienced vany vparalysis vof vyour varms vor vlegs?"
vB.
"Do vyou vhave vfrequent vblackout vspells?"
vC.
"Have vyou vever vbeen vfrozen vin vone vspot, vunable vto vmove?"
vD.
"Do vyou vhave vheadaches, vespecially vones vwith vthrobbing vpain?" v- v vcorrect
vanswer- v vC
Rationale:Clients vwith vParkinson vdisease vfrequently vexperience vdifficulty vin
vinitiating, vmaintaining, vand vperforming vmotor vactivities. vThey vmay veven vexperience
vbeing vrooted vto vthe vspot vand vunable vto vmove. vParkinson vdisease vdoes vnot
vtypically vcause voption vA, vB, vor vD.
Client vcensus vis voften vused vto vdetermine vstaffing vneeds. vWhich vmethod vof
vobtaining vcensus vdetermination vfor va vparticular vunit vprovides vthe vbest vformula vfor
vdetermining vlong-range vstaffing vpatterns?
A.
Midnight vcensus
vB.
Oncoming vshift vcensus
vC.
Average vdaily vcensus
vD.
Hourly vcensus v- v vcorrect vanswer- v vC
Rationale:An vaverage vdaily vcensus vis vdetermined vby vtrend vdata vand vtakes vinto
vaccount vseasonal vand vdaily vfluctuations, vso vit vis vthe vbest vmethod vfor vdetermining
vstaffing vneeds. vOptions vA vand vB vprovide vdata vat va vcertain vpoint vin vtime, vand vthat
vdata vcould vchange vquickly. vIt vis vunrealistic vto vexpect vto vobtain van vhourly vcensus,
vand vsuch vdata vwould vonly vprovide vinformation vabout va vcertain vpoint vin vtime.
A vmale vclient vhas vjust vundergone va vlaryngectomy vand vhas va vcuffed vtracheostomy
vtube vin vplace. vWhen vinitiating vbolus vtube vfeedings vpostoperatively, vwhen vshould
vthe vnurse vinflate vthe vcuff?
A.
Immediately vafter vfeeding
vB.
Just vprior vto vtube vfeeding
vC.
Continuous vinflation vis vrequired
vD.
Inflation vis vnot vrequired v- v vcorrect vanswer- v vB
Rationale:The vcuff vshould vbe vinflated vbefore vthe vfeeding vto vblock vthe vtrachea vand
vprevent vfood vfrom ventering vif voral vfeedings vare vstarted vwhile va vcuffed
vtracheostomy vtube vis vin vplace. vIt vshould vremain vinflated vthroughout vthe vfeeding vto
vprevent vaspiration vof vfood vinto vthe vrespiratory vsystem. vOptions vA vand vD vplace
, vthe vclient vat vrisk vfor vaspiration. vOption vC vplaces vthe vclient vat vrisk vfor vtracheal
vwall vnecrosis.
A vclient vwith va vnasogastric vtube vattached vto vlow vsuction vstates vthat vshe vis
vnauseated. vThe vnurse vassesses vthat vthere vhas vbeen vno vdrainage vthrough vthe
vnasogastric vtube vin vthe vlast v2 vhours. vWhich vaction vshould vthe vnurse vtake vfirst?
A.
Irrigate vthe vnasogastric vtube vwith vsterile vnormal vsaline.
vB.
Reposition vthe vclient von vher vside.
vC.
Advance vthe vnasogastric vtube v5 vcm.
vD.
Administer van vintravenous vantiemetic vas vprescribed. v- v vcorrect vanswer- v vB
Rationale:The vimmediate vpriority vis vto vdetermine vif vthe vtube vis vfunctioning
vcorrectly, vwhich vwould vthen vrelieve vthe vclient's vnausea. vThe vleast vinvasive
vintervention, vrepositioning vthe vclient, vshould vbe vattempted vfirst, vfollowed vby
voptions vA vand vC, vunless veither vof vthese vinterventions vis vcontraindicated. vIf vthese
vmeasures vare vunsuccessful, vthe vclient vmay vrequire voption vD.
The vnurse vis vconducting van vosteoporosis vscreening vclinic vat va vhealth vfair. vWhat
vinformation vshould vthe vnurse vprovide vto vindividuals vwho vare vat vrisk vfor
vosteoporosis? v(Select vall vthat vapply.)
A.
Encourage valcohol vand vsmoking vcessation.
vB.
Suggest vsupplementing vdiet vwith vvitamin vE.
vC.
Promote vregular vweight-bearing vexercises.
vD.
Implement va vhome vsafety vplan vto vprevent vfalls.
vE.
Propose va vregular vsleep vpattern vof v8 vhours vnightly. v- v vcorrect vanswer- v vA, vC, vD
Rationale:Options vA, vC, vand vD vare vfactors vthat vdecrease vthe vrisk vfor vdeveloping
vosteoporosis. vVitamin vD vand vcalcium vare vimportant vsupplements vto vaid vin vthe
vdecrease vof vbone vloss. vRegular vsleep vpatterns vare vimportant vto voverall vhealth vbut
vare vnot videntified vwith va vdecreasing vrisk vfor vosteoporosis.
Which vnursing vaction vwould vbe vappropriate vfor va vclient vwho vis vnewly vdiagnosed
vwith vCushing vsyndrome?
A.
Monitor vblood vglucose vlevels vdaily.
vB.
Increase vintake vof vfluids vhigh vin vpotassium.
vC.
Encourage vadequate vrest vbetween vactivities.
