RN Evolve Hesi Medical Surgical Exam
Versions A & B
RN Evolve Hesi Medical Surgical Exam
Versions A & B Each Version with Verified
questions and Correct answers with Detailed
Rationales/ RN Hesi Med Surg Exam Prep Test
Bank / Hesi Medical Surgical Practice Test
Bank
A client is admitted to the hospital with a medical diagnosis of pneumococcal pneumonia. The nurse
knows that the prognosis for gram-negative pneumonias (such as E. coli, Klebsiella, Pseudomonas,
and Proteus) is very poor. Which information relates most directly to the prognosis for gram-negative
pneumonias?
A. The gram-negative infections occur in the lower lobe alveoli which are more sensitive to infection.
B. Gram-negative organisms are more resistant to antibiotic therapy.
C. Usually occur in healthy young adults who have recently been debilitated by an upper respiratory
infection.
D. Gram-negative pneumonias usually affect infants and small children. - Correct Answer :B. Gram-
negative organisms are more resistant to antibiotic therapy.
Rationale:
Gram-negative organisms are very resistant to drug therapy which makes recovery difficult. Antibiotic
resistance has become a world-wide concern and the World Health Organization is keeping a very
close surveillance on these occurrences.
The nurse is caring for a client who has been diagnosed with primary hyperaldosteronism. Which
laboratory test result should the nurse expect an increase in the serum level?
A+ TEST BANK 1
, RN Evolve Hesi Medical Surgical Exam
Versions A & B
A. Sodium.
B. Antidiuretic hormone.
C. Potassium.
D. Glucose. - Correct Answer :A. Sodium.
Rationale:
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 client with gastroesophageal reflux disease (GERD) has been experiencing severe reflux during
sleep. Which recommendation by the nurse is most effective to assist the client?
A. Losing weight.
B. Decreasing caffeine intake.
C. Avoiding large meals.
D. Raising the head of the bed on blocks. - Correct Answer :D. Raising the head of the bed on blocks.
Rationale:
A+ TEST BANK 2
, RN Evolve Hesi Medical Surgical Exam
Versions A & B
Raising the head of the bed on blocks (reverse Trendelenburg position) to reduce reflux and
subsequent aspiration is the most non-pharmacological effective recommendation for a client
experiencing severe gastroesophageal reflux during sleep.
A postmenopausal client asks the nurse why she is experiencing discomfort during intercourse. Which
response is best for the nurse to provide?
A. Estrogen deficiency causes the vaginal tissues to become dry and thinner.
B. Infrequent intercourse results in the vaginal tissues losing their elasticity.
C. Dehydration from inadequate fluid intake causes vulva tissue dryness.
D. Lack of adequate stimulation is the most common reason for dyspareunia. - Correct Answer :A.
Estrogen deficiency causes the vaginal tissues to become dry and thinner.
Rationale:
Estrogen deprivation decreases the moisture-secreting capacity of vaginal cells, so vaginal tissues tend
to become thinner, drier, and the rugae become smoother which reduces vaginal stretching that
contributes to dyspareunia. The discomfort during intercourse, primary cause can be contributed to
the decrease in estrogen hormone levels.
Which client should the nurse recognize as most likely to experience sleep apnea?
A. Middle-aged female who takes a diuretic nightly.
B. Obese older male client with a short, thick neck.
C. Adolescent female with a history of tonsillectomy.
A+ TEST BANK 3
, RN Evolve Hesi Medical Surgical Exam
Versions A & B
D. School-aged male with a history of hyperactivity disorder. - Correct Answer :B. Obese older male
client with a short, thick neck.
Rationale:
Sleep apnea is characterized by lack of respirations for 10 seconds or more during sleep and is due to
the loss of pharyngeal tone which allows the pharynx to collapse during inspiration and obstructs air
flow through the nose and mouth. Risk factors which increase the condition of sleep apnea include:
excessive weight, increases the risk 4 times more than normal weighing individuals; neck
circumference, thicker necks have narrower airways; individuals with inherited narrower airways; males
in general are more prone to sleep apnea; females risk increase with being overweight and post-
menopausal; increased age (geriatrics); family history; use of alcohol, sedatives or tranquilizers;
smokers and those who suffer from nasal allergies.
The nurse knows that lab values sometimes vary for the older client. Which data would the nurse
expect to find when reviewing laboratory values of an 80-year-old male?
A. Increased WBC, decreased RBC.
B. Increased serum bilirubin, slightly increased liver enzymes.
C. Increased protein in the urine, slightly increased serum glucose levels.
D. Decreased serum sodium, an increased urine specific gravity. - Correct Answer :C. Increased protein
in the urine, slightly increased serum glucose levels.
Rationale:
As older adults age, the protein found in urine slightly rises as a result of kidney changes, and the
serum glucose increases slightly, also due to changes in the kidney.
A+ TEST BANK 4
Versions A & B
RN Evolve Hesi Medical Surgical Exam
Versions A & B Each Version with Verified
questions and Correct answers with Detailed
Rationales/ RN Hesi Med Surg Exam Prep Test
Bank / Hesi Medical Surgical Practice Test
Bank
A client is admitted to the hospital with a medical diagnosis of pneumococcal pneumonia. The nurse
knows that the prognosis for gram-negative pneumonias (such as E. coli, Klebsiella, Pseudomonas,
and Proteus) is very poor. Which information relates most directly to the prognosis for gram-negative
pneumonias?
A. The gram-negative infections occur in the lower lobe alveoli which are more sensitive to infection.
B. Gram-negative organisms are more resistant to antibiotic therapy.
C. Usually occur in healthy young adults who have recently been debilitated by an upper respiratory
infection.
D. Gram-negative pneumonias usually affect infants and small children. - Correct Answer :B. Gram-
negative organisms are more resistant to antibiotic therapy.
Rationale:
Gram-negative organisms are very resistant to drug therapy which makes recovery difficult. Antibiotic
resistance has become a world-wide concern and the World Health Organization is keeping a very
close surveillance on these occurrences.
The nurse is caring for a client who has been diagnosed with primary hyperaldosteronism. Which
laboratory test result should the nurse expect an increase in the serum level?
A+ TEST BANK 1
, RN Evolve Hesi Medical Surgical Exam
Versions A & B
A. Sodium.
B. Antidiuretic hormone.
C. Potassium.
D. Glucose. - Correct Answer :A. Sodium.
Rationale:
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 client with gastroesophageal reflux disease (GERD) has been experiencing severe reflux during
sleep. Which recommendation by the nurse is most effective to assist the client?
A. Losing weight.
B. Decreasing caffeine intake.
C. Avoiding large meals.
D. Raising the head of the bed on blocks. - Correct Answer :D. Raising the head of the bed on blocks.
Rationale:
A+ TEST BANK 2
, RN Evolve Hesi Medical Surgical Exam
Versions A & B
Raising the head of the bed on blocks (reverse Trendelenburg position) to reduce reflux and
subsequent aspiration is the most non-pharmacological effective recommendation for a client
experiencing severe gastroesophageal reflux during sleep.
A postmenopausal client asks the nurse why she is experiencing discomfort during intercourse. Which
response is best for the nurse to provide?
A. Estrogen deficiency causes the vaginal tissues to become dry and thinner.
B. Infrequent intercourse results in the vaginal tissues losing their elasticity.
C. Dehydration from inadequate fluid intake causes vulva tissue dryness.
D. Lack of adequate stimulation is the most common reason for dyspareunia. - Correct Answer :A.
Estrogen deficiency causes the vaginal tissues to become dry and thinner.
Rationale:
Estrogen deprivation decreases the moisture-secreting capacity of vaginal cells, so vaginal tissues tend
to become thinner, drier, and the rugae become smoother which reduces vaginal stretching that
contributes to dyspareunia. The discomfort during intercourse, primary cause can be contributed to
the decrease in estrogen hormone levels.
Which client should the nurse recognize as most likely to experience sleep apnea?
A. Middle-aged female who takes a diuretic nightly.
B. Obese older male client with a short, thick neck.
C. Adolescent female with a history of tonsillectomy.
A+ TEST BANK 3
, RN Evolve Hesi Medical Surgical Exam
Versions A & B
D. School-aged male with a history of hyperactivity disorder. - Correct Answer :B. Obese older male
client with a short, thick neck.
Rationale:
Sleep apnea is characterized by lack of respirations for 10 seconds or more during sleep and is due to
the loss of pharyngeal tone which allows the pharynx to collapse during inspiration and obstructs air
flow through the nose and mouth. Risk factors which increase the condition of sleep apnea include:
excessive weight, increases the risk 4 times more than normal weighing individuals; neck
circumference, thicker necks have narrower airways; individuals with inherited narrower airways; males
in general are more prone to sleep apnea; females risk increase with being overweight and post-
menopausal; increased age (geriatrics); family history; use of alcohol, sedatives or tranquilizers;
smokers and those who suffer from nasal allergies.
The nurse knows that lab values sometimes vary for the older client. Which data would the nurse
expect to find when reviewing laboratory values of an 80-year-old male?
A. Increased WBC, decreased RBC.
B. Increased serum bilirubin, slightly increased liver enzymes.
C. Increased protein in the urine, slightly increased serum glucose levels.
D. Decreased serum sodium, an increased urine specific gravity. - Correct Answer :C. Increased protein
in the urine, slightly increased serum glucose levels.
Rationale:
As older adults age, the protein found in urine slightly rises as a result of kidney changes, and the
serum glucose increases slightly, also due to changes in the kidney.
A+ TEST BANK 4
