HESI EXAM vc
Exam Solution vc
HESI Medical Surgical Cartes 2026 A+ GRADE ASSURED
vc vc vc vc vc vc vc vc
COMPLETE SOLUTIONS AND VERIFIED ANSWERS (23E2 vc vc vc vc vc
E)
QUESTION 1 vc
Which clinical manifestation further supports an assessment of a left-sided brain attack?
vc vc vc vc vc vc vc vc vc vc vc
A) Visual field deficit on the left side.
vc vc vc vc vc vc vc
B) Spatial-perceptual deficits.
vc vc
C) Paresthesia of the left side.
vc vc vc vc vc
D) Global aphasia.
vc vc
ANSWER
D) Global aphasia. Rationale: Global aphasia refers to difficulty speaking, listening, and understanding, a
vc vc vc vc vc vc vc vc vc vc vc vc vc
s well as difficulty reading and writing. Symptoms vary from person to person. Aphasia may occur secon
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
dary to any brain injury involving the left hemisphere. Visual field deficits, spatial-
vc vc vc vc vc vc vc vc vc vc vc vc
perceptual deficits, and paresthsia of the left side usually occur with right-sided brain attack.
vc vc vc vc vc vc vc vc vc vc vc vc vc
QUESTION 2 vc
A neurologist prescribes a magnetic resonance imaging (MRI) of the head STAT for a pati
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ent. Which data warrants immediate intervention by the nurse concerning this diagnosti
vc vc vc vc vc vc vc vc vc vc vc
c test?
vc
A) Elevated blood pressure.
vc vc vc
B) Allergy to shell fish.
vc vc vc vc
C) Right hip replacement.
vc vc vc
D) History of atrial fibrillation.
vc vc vc vc
ANSWER
C) Right hip replacement. The magnetic field generated by the MRI is so strong that metal-
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
containing items are strongly attracted to the magnet. Because the hip joint is made of metal, a lead shie
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ld must be used during the procedure. Elevated blood pressure, an allergy to shell fish, and a history of
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
atrial fibrillation would not affect the MRI.
vc vc vc vc vc vc
QUESTION 3 vc
,What is the normal range for cardiac output?
vc vc vc vc vc vc vc
ANSWER
The normal range for cardiac output to ensure cerebral blood flow and oxygen delivery is 4 to 8 L/min.
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
QUESTION 4 vc
A client was admitted with the diagnosis of a brain attack. Their symptoms began 24 hou
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
rs before being admitted. Why would this client not be a candidate for for thrombolytic t
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
herapy?
ANSWER
Thrombolytic therapy is contraindicated in clients with symptom onset longer than 3 hours prior to ad
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
mission. This client had symptoms for 24 hours before being brought to the medical center
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
QUESTION 5 vc
What are plate guards? vc vc vc
ANSWER
Plate guards prevent food from being pushed off the plate. Using plate guards and other assistive device
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
s will encourage independence in a client with a self-care deficit.
vc vc vc vc vc vc vc vc vc vc
QUESTION 6 vc
Which condition is considered a non-modifiable risk factor for a brain attack?
vc vc vc vc vc vc vc vc vc vc vc
A) High cholesterol levels.
vc vc vc
B) Obesity. vc
C) History of atrial fibrillation.
vc vc vc vc
D) Advanced age.
vc vc
ANSWER
D) Advanced age. Rationale: People over age 55 are a high-
vc vc vc vc vc vc vc vc vc vc
risk group for a brain attack because the incidence of stroke more than doubles in each successive deca
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
de of life. Non-
vc vc vc
modifiable means the client cannot do anything to change the risk factor. All the other options are modif
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
iable risk factors. vc vc
QUESTION 7 vc
The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SI
vc vc vc vc vc vc vc vc vc vc vc vc vc
ADH), which is manifested by which symptoms?
vc vc vc vc vc vc
A) Loss of thirst, weight gain.
vc vc vc vc vc
B) Dependent edema, fever.
vc vc vc
,C) Polydipsia, polyuria.
vc vc
D) Hypernatremia, tachypnea.
vc vc
ANSWER
A) Loss of thirst, weight gain. Rationale: SIADH occurs when the posterior pituitary gland releases too m
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
uch ADH, causing water retention, a urine output of less than 20 ml/hour, and dilutional hyponatremia.
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
Other indications of SIADH are loss of thirst, weight gain (A), irritability, muscle weakness, and decrease
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
d level of consciousness. (
vc vc vc vc
B) is not associated with SIADH. (
vc vc vc vc vc vc
C) is a finding associated with diabetes insipidus (a water metabolism problem caused by an ADH defici
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ency), not SIADH. The increase in plasma volume causes an increase in the glomerular filtration rate tha
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
t inhibits the release of rennin and aldosterone, which results in an increased sodium loss in urine, leadi
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ng to greater hyponatremia, not (D).
vc vc vc vc vc
QUESTION 8 vc
The nurse is caring for a client who has taken a large quantity of furosemide (Lasix) to p
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
romote weight loss. The nurse anticipates the finding of which acid-base imbalance?
vc vc vc vc vc vc vc vc vc vc vc
A) PO2 of 78 mm Hg
vc vc vc vc vc
B) HCO3 of 34 mEq/L
vc vc vc vc
C) PCO2 of 56 mm Hg
vc vc vc vc vc
D) pH of 7.31 vc vc vc
ANSWER
B) HCO3 of 34 mEq/L Rationale: Diuretics (non-potassium sparing) cause metabolic alkalosis.
vc vc vc vc vc vc vc vc vc vc vc
A) PO2 of 78 mm Hg: This Po2 demonstrates mild hypoxemia, consistent with respiratory disorders, not
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
with diuretic use.
vc vc vc
C) PCO2 of 56 mm Hg: CO2 retention results from hypoventilation, which is not consistent with diuretic
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
use.
D) pH of 7.31: This pH is acidotic; diuretics promote metabolic alkalosis.
vc vc vc vc vc vc vc vc vc vc vc
QUESTION 9 vc
Which reaction should the nurse identify in a client who is responding to stimulation of t
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
he sympathetic nervous system?
vc vc vc
A) Pupil constriction.
vc vc
B) Increased heart rate.
vc vc vc
C) Bronchial constriction.
vc vc
D) Decreased blood pressure.
vc vc vc
ANSWER
B) Increased heart rate. Rationale: Any stressor that is perceived as threatening to homeostasis acts to s
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
timulate the sympathetic nervous system and manifests as a flight-or-
vc vc vc vc vc vc vc vc vc
fight response, which includes an increase in heart rate (B). (A, C, and
vc vc vc vc vc vc vc vc vc vc vc vc
D) are responses of the parasympathetic nervous system.
vc vc vc vc vc vc vc
, QUESTION 10 vc
To decrease the risk of acid-
vc vc vc vc vc
base imbalance, what goal must the client with diabetes mellitus strive for?
vc vc vc vc vc vc vc vc vc vc vc
A) Checking blood glucose levels once daily
vc vc vc vc vc vc
B) Drinking 3 L of fluid per day
vc vc vc vc vc vc vc
C) Eating regularly, every 4 to 8 hours
vc vc vc vc vc vc vc
D) Maintaining blood glucose level within normal limits
vc vc vc vc vc vc vc
ANSWER
D) Maintaining blood glucose level within normal limits Rationale: Maintaining blood glucose levels with
vc vc vc vc vc vc vc vc vc vc vc vc vc
in normal limits is the best way to decrease the risk of acid-base imbalance.
vc vc vc vc vc vc vc vc vc vc vc vc vc
A) Blood glucose levels must be checked several times a day.
vc vc vc vc vc vc vc vc vc vc
B) Drinking 3 L of fluid per day is not necessary to maintain acid-base balance.
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
C) Eating regularly is a way to achieve acid-base balance but is not the goal itself.
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
QUESTION 11 vc
The nurse is caring for a client with an oxygen saturation of 88% and accessory muscle u
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
se. The nurse provides oxygen and anticipates which of these physician orders?
vc vc vc vc vc vc vc vc vc vc vc
A) Administration of IV sodium bicarbonate
vc vc vc vc vc
B) Computed tomography (CT) of the chest, stat
vc vc vc vc vc vc vc
C) Intubation and mechanical ventilation
vc vc vc vc
D) Administration of concentrated potassium chloride solution
vc vc vc vc vc vc
ANSWER
C) Intubation and mechanical ventilation Rationale: Support with mechanical ventilation may be needed
vc vc vc vc vc vc vc vc vc vc vc vc v
cfor clients who cannot keep their oxygen saturation at 90% or who have respiratory muscle fatigue.
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
A) Sodium bicarbonate is used to treat metabolic acidosis; this client displays hypoxemia.
vc vc vc vc vc vc vc vc vc vc vc vc
B) Although the underlying reason for this client's hypoxemia may eventually require a diagnostic study
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
, the priority is to restore oxygenation.
vc vc vc vc vc vc
D) No indication suggests that this client has hypokalemia. Signs of hypoxemia and work of breathing ar
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
e present, requiring correction with intubation and mechanical ventilation.
vc vc vc vc vc vc vc vc
QUESTION 12 vc
The nurse is caring for a group of clients with acidosis. The nurse recognizes that Kussm
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
aul respirations are consistent with which situation?
vc vc vc vc vc vc
A) Client receiving mechanical ventilation
vc vc vc vc
B) Use of hydrochlorothiazide
vc vc vc
C) Aspirin overdose
vc vc
D) Administration of sodium bicarbonate
vc vc vc vc
ANSWER
C) Aspirin overdose Rationale: If acidosis is metabolic in origin, the rate and depth of breathing increase
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
as the hydrogen ion level rises; this is known as Kussmaul respirations. Metabolic acidosis is caused by
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
alcoholic beverages, methyl alcohol, and acetylsalicylic acid (aspirin).
vc vc vc vc vc vc vc
Exam Solution vc
HESI Medical Surgical Cartes 2026 A+ GRADE ASSURED
vc vc vc vc vc vc vc vc
COMPLETE SOLUTIONS AND VERIFIED ANSWERS (23E2 vc vc vc vc vc
E)
QUESTION 1 vc
Which clinical manifestation further supports an assessment of a left-sided brain attack?
vc vc vc vc vc vc vc vc vc vc vc
A) Visual field deficit on the left side.
vc vc vc vc vc vc vc
B) Spatial-perceptual deficits.
vc vc
C) Paresthesia of the left side.
vc vc vc vc vc
D) Global aphasia.
vc vc
ANSWER
D) Global aphasia. Rationale: Global aphasia refers to difficulty speaking, listening, and understanding, a
vc vc vc vc vc vc vc vc vc vc vc vc vc
s well as difficulty reading and writing. Symptoms vary from person to person. Aphasia may occur secon
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
dary to any brain injury involving the left hemisphere. Visual field deficits, spatial-
vc vc vc vc vc vc vc vc vc vc vc vc
perceptual deficits, and paresthsia of the left side usually occur with right-sided brain attack.
vc vc vc vc vc vc vc vc vc vc vc vc vc
QUESTION 2 vc
A neurologist prescribes a magnetic resonance imaging (MRI) of the head STAT for a pati
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ent. Which data warrants immediate intervention by the nurse concerning this diagnosti
vc vc vc vc vc vc vc vc vc vc vc
c test?
vc
A) Elevated blood pressure.
vc vc vc
B) Allergy to shell fish.
vc vc vc vc
C) Right hip replacement.
vc vc vc
D) History of atrial fibrillation.
vc vc vc vc
ANSWER
C) Right hip replacement. The magnetic field generated by the MRI is so strong that metal-
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
containing items are strongly attracted to the magnet. Because the hip joint is made of metal, a lead shie
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ld must be used during the procedure. Elevated blood pressure, an allergy to shell fish, and a history of
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
atrial fibrillation would not affect the MRI.
vc vc vc vc vc vc
QUESTION 3 vc
,What is the normal range for cardiac output?
vc vc vc vc vc vc vc
ANSWER
The normal range for cardiac output to ensure cerebral blood flow and oxygen delivery is 4 to 8 L/min.
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
QUESTION 4 vc
A client was admitted with the diagnosis of a brain attack. Their symptoms began 24 hou
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
rs before being admitted. Why would this client not be a candidate for for thrombolytic t
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
herapy?
ANSWER
Thrombolytic therapy is contraindicated in clients with symptom onset longer than 3 hours prior to ad
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
mission. This client had symptoms for 24 hours before being brought to the medical center
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
QUESTION 5 vc
What are plate guards? vc vc vc
ANSWER
Plate guards prevent food from being pushed off the plate. Using plate guards and other assistive device
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
s will encourage independence in a client with a self-care deficit.
vc vc vc vc vc vc vc vc vc vc
QUESTION 6 vc
Which condition is considered a non-modifiable risk factor for a brain attack?
vc vc vc vc vc vc vc vc vc vc vc
A) High cholesterol levels.
vc vc vc
B) Obesity. vc
C) History of atrial fibrillation.
vc vc vc vc
D) Advanced age.
vc vc
ANSWER
D) Advanced age. Rationale: People over age 55 are a high-
vc vc vc vc vc vc vc vc vc vc
risk group for a brain attack because the incidence of stroke more than doubles in each successive deca
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
de of life. Non-
vc vc vc
modifiable means the client cannot do anything to change the risk factor. All the other options are modif
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
iable risk factors. vc vc
QUESTION 7 vc
The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SI
vc vc vc vc vc vc vc vc vc vc vc vc vc
ADH), which is manifested by which symptoms?
vc vc vc vc vc vc
A) Loss of thirst, weight gain.
vc vc vc vc vc
B) Dependent edema, fever.
vc vc vc
,C) Polydipsia, polyuria.
vc vc
D) Hypernatremia, tachypnea.
vc vc
ANSWER
A) Loss of thirst, weight gain. Rationale: SIADH occurs when the posterior pituitary gland releases too m
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
uch ADH, causing water retention, a urine output of less than 20 ml/hour, and dilutional hyponatremia.
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
Other indications of SIADH are loss of thirst, weight gain (A), irritability, muscle weakness, and decrease
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
d level of consciousness. (
vc vc vc vc
B) is not associated with SIADH. (
vc vc vc vc vc vc
C) is a finding associated with diabetes insipidus (a water metabolism problem caused by an ADH defici
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ency), not SIADH. The increase in plasma volume causes an increase in the glomerular filtration rate tha
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
t inhibits the release of rennin and aldosterone, which results in an increased sodium loss in urine, leadi
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
ng to greater hyponatremia, not (D).
vc vc vc vc vc
QUESTION 8 vc
The nurse is caring for a client who has taken a large quantity of furosemide (Lasix) to p
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
romote weight loss. The nurse anticipates the finding of which acid-base imbalance?
vc vc vc vc vc vc vc vc vc vc vc
A) PO2 of 78 mm Hg
vc vc vc vc vc
B) HCO3 of 34 mEq/L
vc vc vc vc
C) PCO2 of 56 mm Hg
vc vc vc vc vc
D) pH of 7.31 vc vc vc
ANSWER
B) HCO3 of 34 mEq/L Rationale: Diuretics (non-potassium sparing) cause metabolic alkalosis.
vc vc vc vc vc vc vc vc vc vc vc
A) PO2 of 78 mm Hg: This Po2 demonstrates mild hypoxemia, consistent with respiratory disorders, not
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
with diuretic use.
vc vc vc
C) PCO2 of 56 mm Hg: CO2 retention results from hypoventilation, which is not consistent with diuretic
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
use.
D) pH of 7.31: This pH is acidotic; diuretics promote metabolic alkalosis.
vc vc vc vc vc vc vc vc vc vc vc
QUESTION 9 vc
Which reaction should the nurse identify in a client who is responding to stimulation of t
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
he sympathetic nervous system?
vc vc vc
A) Pupil constriction.
vc vc
B) Increased heart rate.
vc vc vc
C) Bronchial constriction.
vc vc
D) Decreased blood pressure.
vc vc vc
ANSWER
B) Increased heart rate. Rationale: Any stressor that is perceived as threatening to homeostasis acts to s
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
timulate the sympathetic nervous system and manifests as a flight-or-
vc vc vc vc vc vc vc vc vc
fight response, which includes an increase in heart rate (B). (A, C, and
vc vc vc vc vc vc vc vc vc vc vc vc
D) are responses of the parasympathetic nervous system.
vc vc vc vc vc vc vc
, QUESTION 10 vc
To decrease the risk of acid-
vc vc vc vc vc
base imbalance, what goal must the client with diabetes mellitus strive for?
vc vc vc vc vc vc vc vc vc vc vc
A) Checking blood glucose levels once daily
vc vc vc vc vc vc
B) Drinking 3 L of fluid per day
vc vc vc vc vc vc vc
C) Eating regularly, every 4 to 8 hours
vc vc vc vc vc vc vc
D) Maintaining blood glucose level within normal limits
vc vc vc vc vc vc vc
ANSWER
D) Maintaining blood glucose level within normal limits Rationale: Maintaining blood glucose levels with
vc vc vc vc vc vc vc vc vc vc vc vc vc
in normal limits is the best way to decrease the risk of acid-base imbalance.
vc vc vc vc vc vc vc vc vc vc vc vc vc
A) Blood glucose levels must be checked several times a day.
vc vc vc vc vc vc vc vc vc vc
B) Drinking 3 L of fluid per day is not necessary to maintain acid-base balance.
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
C) Eating regularly is a way to achieve acid-base balance but is not the goal itself.
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
QUESTION 11 vc
The nurse is caring for a client with an oxygen saturation of 88% and accessory muscle u
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
se. The nurse provides oxygen and anticipates which of these physician orders?
vc vc vc vc vc vc vc vc vc vc vc
A) Administration of IV sodium bicarbonate
vc vc vc vc vc
B) Computed tomography (CT) of the chest, stat
vc vc vc vc vc vc vc
C) Intubation and mechanical ventilation
vc vc vc vc
D) Administration of concentrated potassium chloride solution
vc vc vc vc vc vc
ANSWER
C) Intubation and mechanical ventilation Rationale: Support with mechanical ventilation may be needed
vc vc vc vc vc vc vc vc vc vc vc vc v
cfor clients who cannot keep their oxygen saturation at 90% or who have respiratory muscle fatigue.
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
A) Sodium bicarbonate is used to treat metabolic acidosis; this client displays hypoxemia.
vc vc vc vc vc vc vc vc vc vc vc vc
B) Although the underlying reason for this client's hypoxemia may eventually require a diagnostic study
vc vc vc vc vc vc vc vc vc vc vc vc vc vc
, the priority is to restore oxygenation.
vc vc vc vc vc vc
D) No indication suggests that this client has hypokalemia. Signs of hypoxemia and work of breathing ar
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
e present, requiring correction with intubation and mechanical ventilation.
vc vc vc vc vc vc vc vc
QUESTION 12 vc
The nurse is caring for a group of clients with acidosis. The nurse recognizes that Kussm
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
aul respirations are consistent with which situation?
vc vc vc vc vc vc
A) Client receiving mechanical ventilation
vc vc vc vc
B) Use of hydrochlorothiazide
vc vc vc
C) Aspirin overdose
vc vc
D) Administration of sodium bicarbonate
vc vc vc vc
ANSWER
C) Aspirin overdose Rationale: If acidosis is metabolic in origin, the rate and depth of breathing increase
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
as the hydrogen ion level rises; this is known as Kussmaul respirations. Metabolic acidosis is caused by
vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc vc
alcoholic beverages, methyl alcohol, and acetylsalicylic acid (aspirin).
vc vc vc vc vc vc vc
