MED SURG HESI 2025- LATEST
Exam questions
An adult client is admitted with diabetic ketoacidosis (DKA) and a urinary tract infection
(UTI). Prescriptions for intravenous antibiotics and an insulin infusion are initiated.
Which serum laboratory value warrants the most immediate intervention by the nurse?
A. Glucose of 350 mg/dl
B. White blood cell count of 15, 000 mm3
C. Blood PH of 7.30
D. Potassium of 2.5 mEq/L
D. Potassium of 2.5 mEq/L
A client with acute renal injury (AKI) who weighs 50 kg and has potassium level of 6.7
mEq/L (6.7 mmol/l) is admitted to the hospital. Which prescribed medication should the
nurse administer first
A. Sevelamer (RenaGel) one tablet PO.
B. Epoetin alfa, recombinant (Epogen) 2, 500 units SUBQ
C. Sodium polystyrene (Kayexalate) 15 grams PO
D. Calcium acetate (Phos-Lo) one tablet PO
C. Sodium polystyrene (Kayexalate) 15 grams PO
Two days after a nephrectomy, the client reports abdominal pressure and nausea,
which assessment should the nurse implement?
A. Palpate the abdomen
B. Measure hourly urine output
C. Ambulate client in hallway
D. Auscultate bowels sounds
D. Auscultate bowel sounds
An older female client with long term type 2 diabetes mellitus (DM) is seen in the clinic
for a routine health assessment. To determine if the client is experiencing any long-term
complication of DM, which assessments should the nurse obtain? (select all that apply)
A. Serum creatinine and blood urea nitrogen (BUN)
B. Sensation in feet and legs
C. Skin condition of lower extremities
D. Visual acuity
E Signs of respiratory tract infection
A. Serum creatinine and blood urea nitrogen
(BUN)
B. Sensation in feet and legs
C. Skin condition of lower extremities
D. Visual acuity
A hospitalized client with chemotherapy-induced stomatitis complains of mouth pain.
What is the best initial nursing action?
A. Encourage frequent mouth care
B. Cleanse the tongue and mouth with glycerin swabs
C. Obtain a soft diet for the client
,D. Administer a topical analgesic per PRN protocol.
D. Administer a topical analgesic per PRN protocol
The nurse is preparing a client for discharge who recently diagnosed with Addison's
disease. Which instruction is most important for the nurse to include in the client's
discharge teaching plan?
A. Use a walker when weakness occurs
B. Avoid extreme environmental temperatures
C. Increase daily intake of sodium in diet
D. Take prescribed cortisone accurately
C. Increase daily intake of sodium in diet
To reduce the risk for pulmonary complication for a client with Amyotrophic Lateral
Sclerosis (ALS), what interventions should the nurse implement? (Select all that apply)
A. Initiate passive range of motion exercises
B. Establish a regular bladder routine
C. Teach the client breathing exercises
D. Perform chest physiotherapy
E. Encourage use of incentive spirometer
C. Teach the client breathing exercises
D. Perform chest physiotherapy
E. Encourage use of incentive spirometer
A male client who reports feeling chronically fatigued has a hemoglobin of 11.0 grams/dl
(110mmol/L), hematocrit of 34%, and microcytic and hypochromic red blood cells
(RBCs). Based on these findings, which dinner selection should the nurse suggest to
the client?
A. Cheese pasta and a lettuce and tomato salad
B. Beef steak with steamed broccoli and orange slices
C. Broiled white fish with a baked sweet potato
D. Grilled shrimp and season rice with asparagus salad
B. Beef steak with steamed broccoli and orange slices
A client who suffered an electrical injury with the entrance site on the left hand and the
exit site on the left foot is admitted to the burn unit. Which intervention is most important
for the nurse to include in this client plan of care?
A. Continuous cardiac monitoring
B. Perform passive range of motion
C. Evaluate level of consciousness
D. Assess lung sounds q4 hours
A. Continuous cardiac monitoring
An adult female with multiple sclerosis (MS) fells while walking to the bathroom. On
transfer to the intensive care unit, she is confused and has had projectile vomiting twice.
Which intervention should the nurse implement first?
A. Determine clients last dose of corticosteroids
B. Determine neurological baseline prior to the fall
, C. Administer a PRN IV antiemetic as prescribed
D. Complete head to toe neurological assessment
D. Complete head to toe neurological assessment
A client who has a history of long-standing back pain treated with methadone
(Dolophines), is admitted to the surgical unit following urological surgery. Which
modifications in the plan of care should the nurse make for this client's pain
management during the postoperative period?
A. Consult with surgeon about increasing methadone in lieu of parenteral opioids.
B. Use minimal parenteral opioids for surgical pain, in addition to oral methadone
C. Maintain client's methadone, and medicate surgical pain based on pain rating
D. Make no changes in the standard pain management for the surgery and hold
methadone
C. Maintain clients methadone, and medicate surgical pain based on pain rating
When planning care for a client with rheumatoid arthritis, which intervention is most
important for the nurse to include in the plan of care?
A. Provide assistive devices to empower client independence
B. Implement measures to manage chronic pain
C. Teach coping skills for living with a chronic illness
D. Schedule rest periods between activates to minimize fatigue.
C. Teach coping skills for living with
A client with a productive cough has obtained a sputum specimen for culture as
instructed. What is the best initial nursing action?
A. Administer the first dose of antibiotic therapy
B. Observe the color, consistency, and amount of sputum
C. Encourage the client to consume plenty of warm liquids
D. Send the specimen to the lab for analysis
B. Observe the color, consistency, and
amount of sputum
A client is brought to the ED by ambulance in cardiac arrest with cardiopulmonary
resuscitation (CPR) in progress. The client is intubated and is receiving 100% oxygen
per self-inflating (ambu) bag. The nurse determines that the client is cyanotic, cold, and
diaphoretic. Which assessment is most important for the nurse to obtain?
A. Breath sounds over bilateral lung fields.
B. Carotid pulsation during compressions
C. Deep tendon reflexes
D. Core body temperature
A. Breath sounds over bilateral lung fields
After a hospitalization for Syndrome of Inappropriate Antidiuretic Hormone (SIADH), a
client develops pontine myselinolysis. Which intervention should the nurse implement
first?
A. Reorient client to his room
B. Place a patch on one eye
C. Evaluate client's ability to swallow
D. Perform range of motion exercises
Exam questions
An adult client is admitted with diabetic ketoacidosis (DKA) and a urinary tract infection
(UTI). Prescriptions for intravenous antibiotics and an insulin infusion are initiated.
Which serum laboratory value warrants the most immediate intervention by the nurse?
A. Glucose of 350 mg/dl
B. White blood cell count of 15, 000 mm3
C. Blood PH of 7.30
D. Potassium of 2.5 mEq/L
D. Potassium of 2.5 mEq/L
A client with acute renal injury (AKI) who weighs 50 kg and has potassium level of 6.7
mEq/L (6.7 mmol/l) is admitted to the hospital. Which prescribed medication should the
nurse administer first
A. Sevelamer (RenaGel) one tablet PO.
B. Epoetin alfa, recombinant (Epogen) 2, 500 units SUBQ
C. Sodium polystyrene (Kayexalate) 15 grams PO
D. Calcium acetate (Phos-Lo) one tablet PO
C. Sodium polystyrene (Kayexalate) 15 grams PO
Two days after a nephrectomy, the client reports abdominal pressure and nausea,
which assessment should the nurse implement?
A. Palpate the abdomen
B. Measure hourly urine output
C. Ambulate client in hallway
D. Auscultate bowels sounds
D. Auscultate bowel sounds
An older female client with long term type 2 diabetes mellitus (DM) is seen in the clinic
for a routine health assessment. To determine if the client is experiencing any long-term
complication of DM, which assessments should the nurse obtain? (select all that apply)
A. Serum creatinine and blood urea nitrogen (BUN)
B. Sensation in feet and legs
C. Skin condition of lower extremities
D. Visual acuity
E Signs of respiratory tract infection
A. Serum creatinine and blood urea nitrogen
(BUN)
B. Sensation in feet and legs
C. Skin condition of lower extremities
D. Visual acuity
A hospitalized client with chemotherapy-induced stomatitis complains of mouth pain.
What is the best initial nursing action?
A. Encourage frequent mouth care
B. Cleanse the tongue and mouth with glycerin swabs
C. Obtain a soft diet for the client
,D. Administer a topical analgesic per PRN protocol.
D. Administer a topical analgesic per PRN protocol
The nurse is preparing a client for discharge who recently diagnosed with Addison's
disease. Which instruction is most important for the nurse to include in the client's
discharge teaching plan?
A. Use a walker when weakness occurs
B. Avoid extreme environmental temperatures
C. Increase daily intake of sodium in diet
D. Take prescribed cortisone accurately
C. Increase daily intake of sodium in diet
To reduce the risk for pulmonary complication for a client with Amyotrophic Lateral
Sclerosis (ALS), what interventions should the nurse implement? (Select all that apply)
A. Initiate passive range of motion exercises
B. Establish a regular bladder routine
C. Teach the client breathing exercises
D. Perform chest physiotherapy
E. Encourage use of incentive spirometer
C. Teach the client breathing exercises
D. Perform chest physiotherapy
E. Encourage use of incentive spirometer
A male client who reports feeling chronically fatigued has a hemoglobin of 11.0 grams/dl
(110mmol/L), hematocrit of 34%, and microcytic and hypochromic red blood cells
(RBCs). Based on these findings, which dinner selection should the nurse suggest to
the client?
A. Cheese pasta and a lettuce and tomato salad
B. Beef steak with steamed broccoli and orange slices
C. Broiled white fish with a baked sweet potato
D. Grilled shrimp and season rice with asparagus salad
B. Beef steak with steamed broccoli and orange slices
A client who suffered an electrical injury with the entrance site on the left hand and the
exit site on the left foot is admitted to the burn unit. Which intervention is most important
for the nurse to include in this client plan of care?
A. Continuous cardiac monitoring
B. Perform passive range of motion
C. Evaluate level of consciousness
D. Assess lung sounds q4 hours
A. Continuous cardiac monitoring
An adult female with multiple sclerosis (MS) fells while walking to the bathroom. On
transfer to the intensive care unit, she is confused and has had projectile vomiting twice.
Which intervention should the nurse implement first?
A. Determine clients last dose of corticosteroids
B. Determine neurological baseline prior to the fall
, C. Administer a PRN IV antiemetic as prescribed
D. Complete head to toe neurological assessment
D. Complete head to toe neurological assessment
A client who has a history of long-standing back pain treated with methadone
(Dolophines), is admitted to the surgical unit following urological surgery. Which
modifications in the plan of care should the nurse make for this client's pain
management during the postoperative period?
A. Consult with surgeon about increasing methadone in lieu of parenteral opioids.
B. Use minimal parenteral opioids for surgical pain, in addition to oral methadone
C. Maintain client's methadone, and medicate surgical pain based on pain rating
D. Make no changes in the standard pain management for the surgery and hold
methadone
C. Maintain clients methadone, and medicate surgical pain based on pain rating
When planning care for a client with rheumatoid arthritis, which intervention is most
important for the nurse to include in the plan of care?
A. Provide assistive devices to empower client independence
B. Implement measures to manage chronic pain
C. Teach coping skills for living with a chronic illness
D. Schedule rest periods between activates to minimize fatigue.
C. Teach coping skills for living with
A client with a productive cough has obtained a sputum specimen for culture as
instructed. What is the best initial nursing action?
A. Administer the first dose of antibiotic therapy
B. Observe the color, consistency, and amount of sputum
C. Encourage the client to consume plenty of warm liquids
D. Send the specimen to the lab for analysis
B. Observe the color, consistency, and
amount of sputum
A client is brought to the ED by ambulance in cardiac arrest with cardiopulmonary
resuscitation (CPR) in progress. The client is intubated and is receiving 100% oxygen
per self-inflating (ambu) bag. The nurse determines that the client is cyanotic, cold, and
diaphoretic. Which assessment is most important for the nurse to obtain?
A. Breath sounds over bilateral lung fields.
B. Carotid pulsation during compressions
C. Deep tendon reflexes
D. Core body temperature
A. Breath sounds over bilateral lung fields
After a hospitalization for Syndrome of Inappropriate Antidiuretic Hormone (SIADH), a
client develops pontine myselinolysis. Which intervention should the nurse implement
first?
A. Reorient client to his room
B. Place a patch on one eye
C. Evaluate client's ability to swallow
D. Perform range of motion exercises
