HESI MED SURG EXIT EXAM
2025-2026 WITH CORRECT
ANSWERS GRADED A+
1. While assessing a client with diabetes mellitus, the nurse observes an
absence of hair growth
on the client's legs. What additional assessment provides further data to
support this
finding?
a. Palpate for the presence of femoral pulses bilaterally.
b. Assess for the presence of a positive Homan's sign.
c. Observe the appearance of the skin on the client's legs.
d. Watch the client's posture and balance during ambulation ( correct
answers ) ANS: C
Signs of chronic arterial insufficiency include decreased hair growth in the
legs and feet,
absent or decreased pedal pulses, infection in the foot, poor wound healing,
thickened nails,
and a shiny appearance of the skin (C). Femoral pulses (A) should still be
palpable in the
diabetic with chronic arterial insufficiency. A positive Homan's sign is an
indicator of deep
vein thrombosis (B). (D) would probably not be affected significantly by
chronic arterial
insufficiency.
2. The healthcare provider prescribes 15 mg/kg of Streptomycin for an infant
weighing 4 pounds.
,The drug is diluted in 25 ml of D5W to run over 8 hours. How much
Streptomycin will the
infant receive?
a. 9 mg.
b. 18 mg.
c. 27 mg.
d. 36 mg ( correct answers ) ANS: C
4 lbs / 2.2 = 1.8 kg. 1.8 x 15 = 27 mg (C).
NOTE, the fact that the drug is diluted in 25 ml of D5W, is not relevant to the
calculation
requested
In assessing a client with preeclampsia who is receiving magnesium sulfate,
the nurse
determines that her deep tendon reflexes are 1+; respiratory rate is 12
breaths/minute;
urinary output is 90 ml in 4 hours; magnesium sulfate level is 9 mg/dl. Based
on these
findings, what intervention should the nurse implement?
a. Continue the magnesium sulfate infusion as prescribed.
b. Decrease the magnesium sulfate infusion by one-half.
c. Stop the magnesium sulfate infusion immediately.
d. Administer calcium gluconate immediately. ( correct answers ) ANS: C
The client is exhibiting symptoms of magnesium sulfate toxicity--decreased
reflexes (normal is
+2), a low normal respiratory rate (normal is 12 to 20 breaths/min), a less
than average
urinary output (30 ml/hour is average), and a low magnesium sulfate level
(normal is 4 to
8mg/dl). Based on these findings, the nurse should stop the infusion (C). (A)
is
,contraindicated. (B) would not fully alleviate the magnesium sulfate toxicity
symptoms. (D)
(the antagonist for magnesium sulfate) would be indicated if the respiratory
rate were less
than 12 breaths/minute.
A client is on a mechanical ventilator. Which client response indicates that
the neuromuscular
blocker tubocurarine chloride (Tubarine) is effective?
a. The client's expremities are paralyzed.
b. The peripheral nerve stimulator causes twitching.
c. The client clinches fist upon command.
d. The client's Glagow Coma Scale score is 14 ( correct answers ) ANS: A
This medication causes paralysis (A) following intravenous injection. Peak
effects persist for
35 to 60 minutes. (B and C) would not be possible if the medication is
effective. The Glasgow
coma scale is used to evaluate the neurological status of the client and does
not evaluate the
effectiveness (D) of this medication.
5. An elderly female client comes to the clinic for a regular check-up. The
client tells the nurse
that she has increased her daily doses of acetaminophen (Tylenol) for the
past month to
control joint pain. Based on this client's comment, what previous lab values
should the nurse
compare with today's lab report?
a. Look at last quarter's hemoglobin and hematocrit, expecting an increase
today due
to dehydration.
, b. Look for an increase in today's LDH compared to the previous one to
assess
for possible liver damage. c. Expect to find an increase in today's APTT as
compared to last quarter's due
to bleeding.
d. Determine if there is a decrease in serum potassium due to renal
compromise. ( correct answers ) ANS: B
Frequent and/or large doses of acetaminophen can cause an increase in liver
enzymes,
indicating possible liver damage (B). If the client reported unusual bleeding,
or an increase in
aspirin usage, it would be important for the nurse to assess for increased
bleeding and monitor
(A and/or C). (D) is not affected by increases in acetaminophen doses.
6. Aspirin is prescribed for a 9-year-old child with rheumatic fever to control
the inflammatory
process, promote comfort, and reduce fever. What intervention is most
important for the
nurse to implement?
a. Instruct the parents to hold the aspirin until the child has first had a tepid
sponge
bath.
b. Administer the aspirin with at least two ounces of water or juice.
c. Notify the healthcare provider if the child complains of ringing in the ears.
d. Advise the parents to question the child about seeing yellow halos around
objects ( correct answers ) ANS: C
Ringing in the ears (tinnitus) (C) is an important sign of aspirin overdosage
and should be
reported immediately. Though a tepid sponge bath may lower the child's
temperature, the
2025-2026 WITH CORRECT
ANSWERS GRADED A+
1. While assessing a client with diabetes mellitus, the nurse observes an
absence of hair growth
on the client's legs. What additional assessment provides further data to
support this
finding?
a. Palpate for the presence of femoral pulses bilaterally.
b. Assess for the presence of a positive Homan's sign.
c. Observe the appearance of the skin on the client's legs.
d. Watch the client's posture and balance during ambulation ( correct
answers ) ANS: C
Signs of chronic arterial insufficiency include decreased hair growth in the
legs and feet,
absent or decreased pedal pulses, infection in the foot, poor wound healing,
thickened nails,
and a shiny appearance of the skin (C). Femoral pulses (A) should still be
palpable in the
diabetic with chronic arterial insufficiency. A positive Homan's sign is an
indicator of deep
vein thrombosis (B). (D) would probably not be affected significantly by
chronic arterial
insufficiency.
2. The healthcare provider prescribes 15 mg/kg of Streptomycin for an infant
weighing 4 pounds.
,The drug is diluted in 25 ml of D5W to run over 8 hours. How much
Streptomycin will the
infant receive?
a. 9 mg.
b. 18 mg.
c. 27 mg.
d. 36 mg ( correct answers ) ANS: C
4 lbs / 2.2 = 1.8 kg. 1.8 x 15 = 27 mg (C).
NOTE, the fact that the drug is diluted in 25 ml of D5W, is not relevant to the
calculation
requested
In assessing a client with preeclampsia who is receiving magnesium sulfate,
the nurse
determines that her deep tendon reflexes are 1+; respiratory rate is 12
breaths/minute;
urinary output is 90 ml in 4 hours; magnesium sulfate level is 9 mg/dl. Based
on these
findings, what intervention should the nurse implement?
a. Continue the magnesium sulfate infusion as prescribed.
b. Decrease the magnesium sulfate infusion by one-half.
c. Stop the magnesium sulfate infusion immediately.
d. Administer calcium gluconate immediately. ( correct answers ) ANS: C
The client is exhibiting symptoms of magnesium sulfate toxicity--decreased
reflexes (normal is
+2), a low normal respiratory rate (normal is 12 to 20 breaths/min), a less
than average
urinary output (30 ml/hour is average), and a low magnesium sulfate level
(normal is 4 to
8mg/dl). Based on these findings, the nurse should stop the infusion (C). (A)
is
,contraindicated. (B) would not fully alleviate the magnesium sulfate toxicity
symptoms. (D)
(the antagonist for magnesium sulfate) would be indicated if the respiratory
rate were less
than 12 breaths/minute.
A client is on a mechanical ventilator. Which client response indicates that
the neuromuscular
blocker tubocurarine chloride (Tubarine) is effective?
a. The client's expremities are paralyzed.
b. The peripheral nerve stimulator causes twitching.
c. The client clinches fist upon command.
d. The client's Glagow Coma Scale score is 14 ( correct answers ) ANS: A
This medication causes paralysis (A) following intravenous injection. Peak
effects persist for
35 to 60 minutes. (B and C) would not be possible if the medication is
effective. The Glasgow
coma scale is used to evaluate the neurological status of the client and does
not evaluate the
effectiveness (D) of this medication.
5. An elderly female client comes to the clinic for a regular check-up. The
client tells the nurse
that she has increased her daily doses of acetaminophen (Tylenol) for the
past month to
control joint pain. Based on this client's comment, what previous lab values
should the nurse
compare with today's lab report?
a. Look at last quarter's hemoglobin and hematocrit, expecting an increase
today due
to dehydration.
, b. Look for an increase in today's LDH compared to the previous one to
assess
for possible liver damage. c. Expect to find an increase in today's APTT as
compared to last quarter's due
to bleeding.
d. Determine if there is a decrease in serum potassium due to renal
compromise. ( correct answers ) ANS: B
Frequent and/or large doses of acetaminophen can cause an increase in liver
enzymes,
indicating possible liver damage (B). If the client reported unusual bleeding,
or an increase in
aspirin usage, it would be important for the nurse to assess for increased
bleeding and monitor
(A and/or C). (D) is not affected by increases in acetaminophen doses.
6. Aspirin is prescribed for a 9-year-old child with rheumatic fever to control
the inflammatory
process, promote comfort, and reduce fever. What intervention is most
important for the
nurse to implement?
a. Instruct the parents to hold the aspirin until the child has first had a tepid
sponge
bath.
b. Administer the aspirin with at least two ounces of water or juice.
c. Notify the healthcare provider if the child complains of ringing in the ears.
d. Advise the parents to question the child about seeing yellow halos around
objects ( correct answers ) ANS: C
Ringing in the ears (tinnitus) (C) is an important sign of aspirin overdosage
and should be
reported immediately. Though a tepid sponge bath may lower the child's
temperature, the
