HESI RN MEDICAL SURGICAL EXAM
PACK 2024 QUESTIONS AND
ANSWERS WITH RATIONALES
An bER bnurse bis bcompleting ban bassessment bon ba bpatient bthat bis balert bbut
bstruggles bto banswer bquestions. bWhen bshe battempts bto btalk, bshe bslurs bher bspeech
band bappears bvery bfrightened. bWhat badditional bclinical bmanifestation bdoes bthe
bnurse bexpect bto bfind bif bnacy's bsysmptoms bhave bbeen bcaused bby ba bbrain battack
b(stroke)?
A. bA bcarotid bbruit
B. bA bhypotensive bblood bpressure
C. bhyperreflexic bdeep btendon brelexes.
D. bDecreased bbowel bsounds b- bcorrect banswer✔✔A) bA bcarotid bbruit.
Rationale: bthe bcarotid bartery b(artery bto bthe bbrain) bis bnarrowed bin bclients bwith ba
bbrain battack. bA bbruit bis ban babnormal bsound bheard bon bauscultation bresulting bfrom
binterference bwith bnormal bblood bflow. bUsually bthe bblood bpressure bis bhypertensive.
bInitially bflaccid bparalysis boccurs, bresulting bin bhyporefkexic bdeep btendon breflexes.
bBowel bsounds bare bnot bindicative bof ba bbrain battack.
Which bclinical bmanifestation bfurther bsupports ban bassessment bof ba bleft-sided bbrain
battack?
A) bVisual bfield bdeficit bon bthe bleft bside.
B) bSpatial-perceptual bdeficits.
C) bParesthesia bof bthe bleft bside.
D) bGlobal baphasia.
D) bGlobal baphasia. b- bcorrect banswer✔✔D) bGlobal baphasia.
Rationale: bGlobal baphasia brefers bto bdifficulty bspeaking, blistening, band
bunderstanding, bas bwell bas bdifficulty breading band bwriting. bSymptoms bvary bfrom
bperson bto bperson. bAphasia bmay boccur bsecondary bto bany bbrain binjury binvolving
bthe bleft bhemisphere. bVisual bfield bdeficits, bspatial-perceptual bdeficits, band
bparesthsia bof bthe bleft bside busually boccur bwith bright-sided bbrain battack.
,When bpreparing ba bpatient bfor ba bnoncontrast bcomputed btomography b(CT) bscan
bSTAT, bwhat bnursing bintervention bshould bthe bnurse bimplement?
A) bDetermine bif bthe bclient bhas bany ballergies bto biodine
B) bExplain bthat bthe bclient bwill bnot bbe bable bto bmove bher bhead bthroughout bthe bCT
bscan.
C) bPremedicate bthe bclient bto bdecrease bpain bprior bto bhaving bthe bprocedure.
D) bProvide ban bexplanation bof brelaxation bexercises bprior bto bthe bprocedure. b-
bcorrect banswer✔✔B) bExplain bthat bthe bclient bwill bnot bbe bable bto bmove bher bhead
bthroughout bthe bCT bscan.
Rationale: bBecause bhead bmotion bwill bdistort bthe bimages, bNancy bwill bhave bto
bremain bstill bthroughout bthe bprocedure. bAllergies bto biodine bis bimportant bif bcontrast
bdye bis bbeing bused bfor bthe bCT bscan. bPremedicating bthe bclient bto bdecrease bpain
bprior bto bthe bprocedure bis bunnecessary bbecause bCT bscanning bis ba bnoninvasive
band bpainless bprocedure. bProviding ban bexplanation bof brelaxation bexercises bprior bto
bthe bprocedure bis ba bworthwhile bintervention bto bdecrease banxiety bbut bis bnot bof
bhighest bpriority.
A bneurologist bprescribes ba bmagnetic bresonance bimaging b(MRI) bof bthe bhead bSTAT
bfor ba bpatient. bWhich bdata bwarrants bimmediate bintervention bby bthe bnurse
bconcerning bthis bdiagnostic btest?
A) bElevated bblood bpressure.
B) bAllergy bto bshell bfish.
C) bRight bhip breplacement.
D) bHistory bof batrial bfibrillation. b- bcorrect banswer✔✔C) bRight bhip breplacement.
The bmagnetic bfield bgenerated bby bthe bMRI bis bso bstrong bthat bmetal-containing
bitems bare bstrongly battracted bto bthe bmagnet. bBecause bthe bhip bjoint bis bmade bof
bmetal, ba blead bshield bmust bbe bused bduring bthe bprocedure. bElevated bblood
bpressure, ban ballergy bto bshell bfish, band ba bhistory bof batrial bfibrillation bwould bnot
baffect bthe bMRI.
A bclient's bdaughter bis bsitting bby bher bmother's bbedside bwho bwas brecently
btransferred bto bthe bIntermediate bCare bUnit. bShe bstates b"I bdon't bunderstand bwhat ba
bbrain battack bis. bThe bhealthcare bprovider btold bme bmy bmother bis bin bserious
bcondition band bthey bare bgoing bto brun bseveral btests. bI bjust bdon't bknow bwhat bis
bgoing bon. bWhat bhappened bto bmy bmother?" bWhat bis bthe bbest bresponse bby bthe
bnurse?
A) b"I bam bsorry, bbut baccording bto bthe bHealth bInsurance bPortability band bAccounting
bAct b(HIPAA), bI bcannot bgive byou bany binformation."
B) b"Your bmother bhas bhad ba bstroke, band bthe bblood bsupply bto bthe bbrain bhas bbeen
bblocked."
C) b"How bdo byou bfeel babout bwhat bthe bhealthcare bprovider bsaid?"
,D) b"I bwill bcall bthe bhealthcare bprovider bso bhe/she bcan btalk bto byou babout byour
bmother's bserious bcondition." b- bcorrect banswer✔✔B) b"Your bmother bhas bhad ba
bstroke, band bthe bblood bsupply bto bthe bbrain bhas bbeen bblocked."
Rationale: bThe bnurse bcan bdiscuss bwhat ba bdiagnosis bmeans. bNancy bis bunable bto
bmake bdecisions, bso bthe bnext bof bkin, bher bdaughter, bGail, bneeds bsufficient
binformation bto bmake binformed bdecisions. bThe bnurse bhas bthe bknowledge, band bthe
bresponsibility, bto bexplain bNancy's bcondition bto bGail. bThe bnurse bshould bgive bfacts
bfirst, band bthen baddress bher bfeelings bafter bthe binformation bis bprovided.
What bis bthe bnormal brange bfor bcardiac boutput? b- bcorrect banswer✔✔The bnormal
brange bfor bcardiac boutput bto bensure bcerebral bblood bflow band boxygen bdelivery bis b4
bto b8 bL/min.
A bclient bwas badmitted bwith bthe bdiagnosis bof ba bbrain battack. bTheir bsymptoms
bbegan b24 bhours bbefore bbeing badmitted. bWhy bwould bthis bclient bnot bbe ba
bcandidate bfor bfor bthrombolytic btherapy? b- bcorrect banswer✔✔Thrombolytic btherapy
bis bcontraindicated bin bclients bwith bsymptom bonset blonger bthan b3 bhours bprior bto
badmission. bThis bclient bhad bsymptoms bfor b24 bhours bbefore bbeing bbrought bto bthe
bmedical bcenter
What bare bplate bguards? b- bcorrect banswer✔✔Plate bguards bprevent bfood bfrom
bbeing bpushed boff bthe bplate. bUsing bplate bguards band bother bassistive bdevices bwill
bencourage bindependence bin ba bclient bwith ba bself-care bdeficit.
Which bcondition bis bconsidered ba bnon-modifiable brisk bfactor bfor ba bbrain battack?
A) bHigh bcholesterol blevels.
B) bObesity.
C) bHistory bof batrial bfibrillation.
D) bAdvanced bage. b- bcorrect banswer✔✔D) bAdvanced bage.
Rationale: bPeople bover bage b55 bare ba bhigh-risk bgroup bfor ba bbrain battack bbecause
bthe bincidence bof bstroke bmore bthan bdoubles bin beach bsuccessive bdecade bof blife.
bNon-modifiable bmeans bthe bclient bcannot bdo banything bto bchange bthe brisk bfactor.
bAll bthe bother boptions bare bmodifiable brisk bfactors.
A bclient bis bexperiencing bhomonymous bhemianopsia bas bthe bresult bof ba bbrain
battack. bWhich bnursing bintervention bwould bthe bnurse bimplement bto baddress bthis
bcondition?
A) bTurn bNancy bevery btwo bhours band bperform bactive brange bof bmotion bexercises.
B) bPlace bthe bobjects bNancy bneeds bfor bactivities bof bdaily bliving bon bthe bleft bside bof
bthe btable.
C) bSpeak bslowly band bclearly bto bassist bNancy bin bforming bsounds bto bwords.
, D) bRequest bthat bthe bdietary bdepartment bthicken ball bliquids bon bNancy's bmeal band
bsnack btrays. b- bcorrect banswer✔✔B) bPlace bthe bobjects bNancy bneeds bfor bactivities
bof bdaily bliving bon bthe bleft bside bof bthe btable.
Rationale: bHomonymous bhemianopsia bis bloss bof bthe bvisual bfield bon bthe bsame bside
bas bthe bparalyzed bside. bThis bresults bin bthe bclient bneglecting bthat bside bof bthe
bbody, bso bit bis bbeneficial bto bplace bobjects bon bthat bside. bNancy bhad ba bleft-
hemisphere bbrain battack bso bher bright bside bis bthe bweak bside. bSpeaking bslowly band
bclearly bwould baddress bthe bclient's bverbal bdeficits bdue bto baphasia. bRequesting ball
bliquids bto bbe bthickened bwould baddress bdysphagia. bTurning bthe bclient bevery b2
bhours band bperforming bactive brange bof bmotion bexercises bwould baddress bthe
bclient's brisk bfor bimmobility bdue bto bparalysis.
A bphysical btherapist b(PT) bplaces ba bgait bbelt bon ba bclient band bis bassisting bthem
bwith bambulation bfrom bthe bbed bto bthe bchair. bAs bthey bget bup bout bof bthe bbed, bthey
breport bbeing bdizzy band bbegin bto bfall. bThe bPT bcarefully ballows bthem bto bfall bback
bto bthe bbed band bnotifies bthe bprimary bnurse. bWhich bwritten bdocumentation bshould
bthe bnurse bput bin bthe bclient's brecord? b
A) bClient bexperienced borthostatic bhypotension bwhen bgetting bout bof bbed.
B) bPT breported bclient bcomplained bof bdizziness bwhen bgetting bout bof bbed, band bgait
bbelt bwas bused bto ballow bclient bto bfall bback bonto bthe bbed.
C) bPT bnotified bthe bprimary bnurse bthat bthe bclient bcould bnot bambulate bat bthis btime
bbecause bof bdizziness.
D) bClient bhad bdifficulty bambulating bfrom bthe bbed bto bthe bchair bwhen baccompanied
bby bthe bPT, bvariance breport bcompleted. b- bcorrect banswer✔✔B) bPT breported bclient
bcomplained bof bdizziness bwhen bgetting bout bof bbed, band bgait bbelt bwas bused bto
ballow bclient bto bfall bback bonto bthe bbed.
Rationale: bThis bdocumentation bprovides bthe bfactual bdata bof bthe bevents bthat
boccurred. bA)The bnurse bis bmaking ban bassumption bthat bthe bdizziness bwas bcaused
bby borthostatic bhypotension. bC) bNot ball bthe bpertinent bfacts bare bincluded bin bthis
bdocumentation.
D) bA bvariance breport bshould bnever bbe bdocumented bin bthe bclient's brecord.
A bnew bnurse bgraduate bis bcaring bfor ba bpostoperative bclient bwith bthe bfollowing
barterial bblood bgases b(ABGs): bpH, b7.30; bPCO2, b60 bmm bHg; bPO2, b80 bmm bHg;
bbicarbonate, b24 bmEq/L; band bO2 bsaturation, b96%. bWhich bof bthese bactions bby bthe
bnew bgraduate bis bindicated?
A) bEncourage bthe bclient bto buse bthe bincentive bspirometer band bto bcough.
B) bAdminister boxygen bby bnasal bcannula.
C) bRequest ba bprescription bfor bsodium bbicarbonate bfrom bthe bhealth bcare bprovider.
D) bInform bthe bcharge bnurse bthat bno bchanges bin btherapy bare bneeded. b- bcorrect
banswer✔✔A) bEncourage bthe bclient bto buse bthe bincentive bspirometer band bto bcough.
PACK 2024 QUESTIONS AND
ANSWERS WITH RATIONALES
An bER bnurse bis bcompleting ban bassessment bon ba bpatient bthat bis balert bbut
bstruggles bto banswer bquestions. bWhen bshe battempts bto btalk, bshe bslurs bher bspeech
band bappears bvery bfrightened. bWhat badditional bclinical bmanifestation bdoes bthe
bnurse bexpect bto bfind bif bnacy's bsysmptoms bhave bbeen bcaused bby ba bbrain battack
b(stroke)?
A. bA bcarotid bbruit
B. bA bhypotensive bblood bpressure
C. bhyperreflexic bdeep btendon brelexes.
D. bDecreased bbowel bsounds b- bcorrect banswer✔✔A) bA bcarotid bbruit.
Rationale: bthe bcarotid bartery b(artery bto bthe bbrain) bis bnarrowed bin bclients bwith ba
bbrain battack. bA bbruit bis ban babnormal bsound bheard bon bauscultation bresulting bfrom
binterference bwith bnormal bblood bflow. bUsually bthe bblood bpressure bis bhypertensive.
bInitially bflaccid bparalysis boccurs, bresulting bin bhyporefkexic bdeep btendon breflexes.
bBowel bsounds bare bnot bindicative bof ba bbrain battack.
Which bclinical bmanifestation bfurther bsupports ban bassessment bof ba bleft-sided bbrain
battack?
A) bVisual bfield bdeficit bon bthe bleft bside.
B) bSpatial-perceptual bdeficits.
C) bParesthesia bof bthe bleft bside.
D) bGlobal baphasia.
D) bGlobal baphasia. b- bcorrect banswer✔✔D) bGlobal baphasia.
Rationale: bGlobal baphasia brefers bto bdifficulty bspeaking, blistening, band
bunderstanding, bas bwell bas bdifficulty breading band bwriting. bSymptoms bvary bfrom
bperson bto bperson. bAphasia bmay boccur bsecondary bto bany bbrain binjury binvolving
bthe bleft bhemisphere. bVisual bfield bdeficits, bspatial-perceptual bdeficits, band
bparesthsia bof bthe bleft bside busually boccur bwith bright-sided bbrain battack.
,When bpreparing ba bpatient bfor ba bnoncontrast bcomputed btomography b(CT) bscan
bSTAT, bwhat bnursing bintervention bshould bthe bnurse bimplement?
A) bDetermine bif bthe bclient bhas bany ballergies bto biodine
B) bExplain bthat bthe bclient bwill bnot bbe bable bto bmove bher bhead bthroughout bthe bCT
bscan.
C) bPremedicate bthe bclient bto bdecrease bpain bprior bto bhaving bthe bprocedure.
D) bProvide ban bexplanation bof brelaxation bexercises bprior bto bthe bprocedure. b-
bcorrect banswer✔✔B) bExplain bthat bthe bclient bwill bnot bbe bable bto bmove bher bhead
bthroughout bthe bCT bscan.
Rationale: bBecause bhead bmotion bwill bdistort bthe bimages, bNancy bwill bhave bto
bremain bstill bthroughout bthe bprocedure. bAllergies bto biodine bis bimportant bif bcontrast
bdye bis bbeing bused bfor bthe bCT bscan. bPremedicating bthe bclient bto bdecrease bpain
bprior bto bthe bprocedure bis bunnecessary bbecause bCT bscanning bis ba bnoninvasive
band bpainless bprocedure. bProviding ban bexplanation bof brelaxation bexercises bprior bto
bthe bprocedure bis ba bworthwhile bintervention bto bdecrease banxiety bbut bis bnot bof
bhighest bpriority.
A bneurologist bprescribes ba bmagnetic bresonance bimaging b(MRI) bof bthe bhead bSTAT
bfor ba bpatient. bWhich bdata bwarrants bimmediate bintervention bby bthe bnurse
bconcerning bthis bdiagnostic btest?
A) bElevated bblood bpressure.
B) bAllergy bto bshell bfish.
C) bRight bhip breplacement.
D) bHistory bof batrial bfibrillation. b- bcorrect banswer✔✔C) bRight bhip breplacement.
The bmagnetic bfield bgenerated bby bthe bMRI bis bso bstrong bthat bmetal-containing
bitems bare bstrongly battracted bto bthe bmagnet. bBecause bthe bhip bjoint bis bmade bof
bmetal, ba blead bshield bmust bbe bused bduring bthe bprocedure. bElevated bblood
bpressure, ban ballergy bto bshell bfish, band ba bhistory bof batrial bfibrillation bwould bnot
baffect bthe bMRI.
A bclient's bdaughter bis bsitting bby bher bmother's bbedside bwho bwas brecently
btransferred bto bthe bIntermediate bCare bUnit. bShe bstates b"I bdon't bunderstand bwhat ba
bbrain battack bis. bThe bhealthcare bprovider btold bme bmy bmother bis bin bserious
bcondition band bthey bare bgoing bto brun bseveral btests. bI bjust bdon't bknow bwhat bis
bgoing bon. bWhat bhappened bto bmy bmother?" bWhat bis bthe bbest bresponse bby bthe
bnurse?
A) b"I bam bsorry, bbut baccording bto bthe bHealth bInsurance bPortability band bAccounting
bAct b(HIPAA), bI bcannot bgive byou bany binformation."
B) b"Your bmother bhas bhad ba bstroke, band bthe bblood bsupply bto bthe bbrain bhas bbeen
bblocked."
C) b"How bdo byou bfeel babout bwhat bthe bhealthcare bprovider bsaid?"
,D) b"I bwill bcall bthe bhealthcare bprovider bso bhe/she bcan btalk bto byou babout byour
bmother's bserious bcondition." b- bcorrect banswer✔✔B) b"Your bmother bhas bhad ba
bstroke, band bthe bblood bsupply bto bthe bbrain bhas bbeen bblocked."
Rationale: bThe bnurse bcan bdiscuss bwhat ba bdiagnosis bmeans. bNancy bis bunable bto
bmake bdecisions, bso bthe bnext bof bkin, bher bdaughter, bGail, bneeds bsufficient
binformation bto bmake binformed bdecisions. bThe bnurse bhas bthe bknowledge, band bthe
bresponsibility, bto bexplain bNancy's bcondition bto bGail. bThe bnurse bshould bgive bfacts
bfirst, band bthen baddress bher bfeelings bafter bthe binformation bis bprovided.
What bis bthe bnormal brange bfor bcardiac boutput? b- bcorrect banswer✔✔The bnormal
brange bfor bcardiac boutput bto bensure bcerebral bblood bflow band boxygen bdelivery bis b4
bto b8 bL/min.
A bclient bwas badmitted bwith bthe bdiagnosis bof ba bbrain battack. bTheir bsymptoms
bbegan b24 bhours bbefore bbeing badmitted. bWhy bwould bthis bclient bnot bbe ba
bcandidate bfor bfor bthrombolytic btherapy? b- bcorrect banswer✔✔Thrombolytic btherapy
bis bcontraindicated bin bclients bwith bsymptom bonset blonger bthan b3 bhours bprior bto
badmission. bThis bclient bhad bsymptoms bfor b24 bhours bbefore bbeing bbrought bto bthe
bmedical bcenter
What bare bplate bguards? b- bcorrect banswer✔✔Plate bguards bprevent bfood bfrom
bbeing bpushed boff bthe bplate. bUsing bplate bguards band bother bassistive bdevices bwill
bencourage bindependence bin ba bclient bwith ba bself-care bdeficit.
Which bcondition bis bconsidered ba bnon-modifiable brisk bfactor bfor ba bbrain battack?
A) bHigh bcholesterol blevels.
B) bObesity.
C) bHistory bof batrial bfibrillation.
D) bAdvanced bage. b- bcorrect banswer✔✔D) bAdvanced bage.
Rationale: bPeople bover bage b55 bare ba bhigh-risk bgroup bfor ba bbrain battack bbecause
bthe bincidence bof bstroke bmore bthan bdoubles bin beach bsuccessive bdecade bof blife.
bNon-modifiable bmeans bthe bclient bcannot bdo banything bto bchange bthe brisk bfactor.
bAll bthe bother boptions bare bmodifiable brisk bfactors.
A bclient bis bexperiencing bhomonymous bhemianopsia bas bthe bresult bof ba bbrain
battack. bWhich bnursing bintervention bwould bthe bnurse bimplement bto baddress bthis
bcondition?
A) bTurn bNancy bevery btwo bhours band bperform bactive brange bof bmotion bexercises.
B) bPlace bthe bobjects bNancy bneeds bfor bactivities bof bdaily bliving bon bthe bleft bside bof
bthe btable.
C) bSpeak bslowly band bclearly bto bassist bNancy bin bforming bsounds bto bwords.
, D) bRequest bthat bthe bdietary bdepartment bthicken ball bliquids bon bNancy's bmeal band
bsnack btrays. b- bcorrect banswer✔✔B) bPlace bthe bobjects bNancy bneeds bfor bactivities
bof bdaily bliving bon bthe bleft bside bof bthe btable.
Rationale: bHomonymous bhemianopsia bis bloss bof bthe bvisual bfield bon bthe bsame bside
bas bthe bparalyzed bside. bThis bresults bin bthe bclient bneglecting bthat bside bof bthe
bbody, bso bit bis bbeneficial bto bplace bobjects bon bthat bside. bNancy bhad ba bleft-
hemisphere bbrain battack bso bher bright bside bis bthe bweak bside. bSpeaking bslowly band
bclearly bwould baddress bthe bclient's bverbal bdeficits bdue bto baphasia. bRequesting ball
bliquids bto bbe bthickened bwould baddress bdysphagia. bTurning bthe bclient bevery b2
bhours band bperforming bactive brange bof bmotion bexercises bwould baddress bthe
bclient's brisk bfor bimmobility bdue bto bparalysis.
A bphysical btherapist b(PT) bplaces ba bgait bbelt bon ba bclient band bis bassisting bthem
bwith bambulation bfrom bthe bbed bto bthe bchair. bAs bthey bget bup bout bof bthe bbed, bthey
breport bbeing bdizzy band bbegin bto bfall. bThe bPT bcarefully ballows bthem bto bfall bback
bto bthe bbed band bnotifies bthe bprimary bnurse. bWhich bwritten bdocumentation bshould
bthe bnurse bput bin bthe bclient's brecord? b
A) bClient bexperienced borthostatic bhypotension bwhen bgetting bout bof bbed.
B) bPT breported bclient bcomplained bof bdizziness bwhen bgetting bout bof bbed, band bgait
bbelt bwas bused bto ballow bclient bto bfall bback bonto bthe bbed.
C) bPT bnotified bthe bprimary bnurse bthat bthe bclient bcould bnot bambulate bat bthis btime
bbecause bof bdizziness.
D) bClient bhad bdifficulty bambulating bfrom bthe bbed bto bthe bchair bwhen baccompanied
bby bthe bPT, bvariance breport bcompleted. b- bcorrect banswer✔✔B) bPT breported bclient
bcomplained bof bdizziness bwhen bgetting bout bof bbed, band bgait bbelt bwas bused bto
ballow bclient bto bfall bback bonto bthe bbed.
Rationale: bThis bdocumentation bprovides bthe bfactual bdata bof bthe bevents bthat
boccurred. bA)The bnurse bis bmaking ban bassumption bthat bthe bdizziness bwas bcaused
bby borthostatic bhypotension. bC) bNot ball bthe bpertinent bfacts bare bincluded bin bthis
bdocumentation.
D) bA bvariance breport bshould bnever bbe bdocumented bin bthe bclient's brecord.
A bnew bnurse bgraduate bis bcaring bfor ba bpostoperative bclient bwith bthe bfollowing
barterial bblood bgases b(ABGs): bpH, b7.30; bPCO2, b60 bmm bHg; bPO2, b80 bmm bHg;
bbicarbonate, b24 bmEq/L; band bO2 bsaturation, b96%. bWhich bof bthese bactions bby bthe
bnew bgraduate bis bindicated?
A) bEncourage bthe bclient bto buse bthe bincentive bspirometer band bto bcough.
B) bAdminister boxygen bby bnasal bcannula.
C) bRequest ba bprescription bfor bsodium bbicarbonate bfrom bthe bhealth bcare bprovider.
D) bInform bthe bcharge bnurse bthat bno bchanges bin btherapy bare bneeded. b- bcorrect
banswer✔✔A) bEncourage bthe bclient bto buse bthe bincentive bspirometer band bto bcough.
