Medical-Surgical HESI Practice Test
A 32-year-old female client complains of severe abdominal pain each month before her
menstrual period, painful intercourse, and painful defecation. Which additional history should
the nurse obtain that is consistent with the client's complaints?
A. Frequent urinary tract infections
B. Inability to get pregnant
C. Premenstrual syndrome
D. Chronic use of laxatives - ANS-B. Inability to get pregnant
Rationale:
Dysmenorrhea, dyspareunia, and difficulty or painful defecation are common symptoms of
endometriosis, which is the abnormal displacement of endometrial tissue in the dependent
areas of the pelvic peritoneum. A history of infertility is another common finding associated
with endometriosis.
\A client has a staging procedure for breast cancer and asks the nurse which type of breast
cancer has the poorest prognosis. Which information should the nurse offer the client?
A. Stage II
B. Invasive infiltrating ductal carcinoma
C. T1N0M0
D. Inflammatory with peau d'orange - ANS-D. Inflammatory with peau d'orange
Rationale:
Inflammatory breast cancer onset is very rapid and a very rare form of breast cancer and is
considered the most aggressive form of breast malignancies. It is often mistaken for a breast
infection because it has a thickened appearance like an orange peel (peau d'orange),
causing the breast to become swollen and tender.
\A client is admitted for further testing to confirm sarcoidosis. Which diagnostic test provides
definitive information that the nurse should report to the healthcare provider?
A. Lung tissue biopsy
B. Positive blood cultures
C. Magnetic resonance imaging (MRI)
D. Computerized tomography (CT) of the thorax - ANS-A. Lung tissue biopsy
Rationale:
Sarcoidosis is an inflammatory condition that is characterized by the formation of widespread
granulomatous lesions involving a pulmonary primary site. Although chest radiography
identifies sarcoidosis, lung tissue biopsy obtained by bronchoscopy or bronchoalveolar
lavage provides definitive confirmation.
\A client is admitted to the medical intensive care unit with a diagnosis of myocardial
infarction. The client's history indicates the infarction occurred ten hours ago. Which
laboratory test result would the nurse expect this client to exhibit?
, A. Elevated LDH
B. Elevated serum amylase
C. Elevated CK-MB
D. Elevated hematocrit - ANS-C. Elevated CK-MB
Rationale:
The cardiac isoenzyme CK-MB (C) is the one of the cardiac markers to indicate myocardial
damage in the presence of MI symptoms and after a positive troponin. The troponin levels
will elevate within 2-3 hours indicating myocardial ischemia, followed by the CK-MB cardiac
markers within 6-9 hours, peaking within 12 to 20 hours after myocardial infarction (MI).
\A client taking a thiazide diuretic for the past six months has a serum potassium level of 3.
The nurse anticipates which change in prescription for the client?
A. The dosage of the diuretic will be decreased
B. The diuretic will be discontinued
C. A potassium supplement will be prescribed
D. The dosage of the diuretic will be increased - ANS-C. A potassium supplement will be
prescribed
Rationale:
This client's potassium level is too low (normal is 3.5 to 5). Taking a thiazide diuretic often
results in a loss of potassium, so a potassium supplement needs to be prescribed to restore
a normal serum potassium level.
\A client who is fully awake after a gastroscopy asks the nurse for something to drink. After
confirming that liquids are allowed, which assessment action should the nurse consider a
priority?
A. Listen to bilateral lung and bowel sounds
B. Obtain the client's pulse and blood pressure
C. Assist the client to the bathroom to void
D. Check the client's gag and swallow reflexes - ANS-D. Check the client's gag and swallow
reflexes
Rationale:
Following gastroscopy, a client should remain nothing by mouth until the effects of local
anesthesia have dissipated and the airway's protective reflexes, gag and swallow reflexes
have returned.
\A client who was in a motor vehicle collision was admitted to the hospital and the right knee
was placed in skeletal traction. The nurse has documented this nursing diagnosis in the
client's medical record: "Potential for impairment of skin integrity related to immobility from
traction." Which nursing intervention is indicated based on this diagnosis statement?
A. Release the traction q4h to provide skin care
B. Turn the client for back care while suspending traction
C. Provide back and skin care while maintaining the traction
D. Give back care after the client is released from traction - ANS-C. Provide back and skin
care while maintaining the traction
A 32-year-old female client complains of severe abdominal pain each month before her
menstrual period, painful intercourse, and painful defecation. Which additional history should
the nurse obtain that is consistent with the client's complaints?
A. Frequent urinary tract infections
B. Inability to get pregnant
C. Premenstrual syndrome
D. Chronic use of laxatives - ANS-B. Inability to get pregnant
Rationale:
Dysmenorrhea, dyspareunia, and difficulty or painful defecation are common symptoms of
endometriosis, which is the abnormal displacement of endometrial tissue in the dependent
areas of the pelvic peritoneum. A history of infertility is another common finding associated
with endometriosis.
\A client has a staging procedure for breast cancer and asks the nurse which type of breast
cancer has the poorest prognosis. Which information should the nurse offer the client?
A. Stage II
B. Invasive infiltrating ductal carcinoma
C. T1N0M0
D. Inflammatory with peau d'orange - ANS-D. Inflammatory with peau d'orange
Rationale:
Inflammatory breast cancer onset is very rapid and a very rare form of breast cancer and is
considered the most aggressive form of breast malignancies. It is often mistaken for a breast
infection because it has a thickened appearance like an orange peel (peau d'orange),
causing the breast to become swollen and tender.
\A client is admitted for further testing to confirm sarcoidosis. Which diagnostic test provides
definitive information that the nurse should report to the healthcare provider?
A. Lung tissue biopsy
B. Positive blood cultures
C. Magnetic resonance imaging (MRI)
D. Computerized tomography (CT) of the thorax - ANS-A. Lung tissue biopsy
Rationale:
Sarcoidosis is an inflammatory condition that is characterized by the formation of widespread
granulomatous lesions involving a pulmonary primary site. Although chest radiography
identifies sarcoidosis, lung tissue biopsy obtained by bronchoscopy or bronchoalveolar
lavage provides definitive confirmation.
\A client is admitted to the medical intensive care unit with a diagnosis of myocardial
infarction. The client's history indicates the infarction occurred ten hours ago. Which
laboratory test result would the nurse expect this client to exhibit?
, A. Elevated LDH
B. Elevated serum amylase
C. Elevated CK-MB
D. Elevated hematocrit - ANS-C. Elevated CK-MB
Rationale:
The cardiac isoenzyme CK-MB (C) is the one of the cardiac markers to indicate myocardial
damage in the presence of MI symptoms and after a positive troponin. The troponin levels
will elevate within 2-3 hours indicating myocardial ischemia, followed by the CK-MB cardiac
markers within 6-9 hours, peaking within 12 to 20 hours after myocardial infarction (MI).
\A client taking a thiazide diuretic for the past six months has a serum potassium level of 3.
The nurse anticipates which change in prescription for the client?
A. The dosage of the diuretic will be decreased
B. The diuretic will be discontinued
C. A potassium supplement will be prescribed
D. The dosage of the diuretic will be increased - ANS-C. A potassium supplement will be
prescribed
Rationale:
This client's potassium level is too low (normal is 3.5 to 5). Taking a thiazide diuretic often
results in a loss of potassium, so a potassium supplement needs to be prescribed to restore
a normal serum potassium level.
\A client who is fully awake after a gastroscopy asks the nurse for something to drink. After
confirming that liquids are allowed, which assessment action should the nurse consider a
priority?
A. Listen to bilateral lung and bowel sounds
B. Obtain the client's pulse and blood pressure
C. Assist the client to the bathroom to void
D. Check the client's gag and swallow reflexes - ANS-D. Check the client's gag and swallow
reflexes
Rationale:
Following gastroscopy, a client should remain nothing by mouth until the effects of local
anesthesia have dissipated and the airway's protective reflexes, gag and swallow reflexes
have returned.
\A client who was in a motor vehicle collision was admitted to the hospital and the right knee
was placed in skeletal traction. The nurse has documented this nursing diagnosis in the
client's medical record: "Potential for impairment of skin integrity related to immobility from
traction." Which nursing intervention is indicated based on this diagnosis statement?
A. Release the traction q4h to provide skin care
B. Turn the client for back care while suspending traction
C. Provide back and skin care while maintaining the traction
D. Give back care after the client is released from traction - ANS-C. Provide back and skin
care while maintaining the traction
