Med-Surg HESI Exam 2026/2027 COMPREHENSIVE
REVIEW AND DETAILED EXPLANATIONS
• An older female client is admitted with atrophic vaginitis and perineal cutaneous
candidiasis. What is the priority nursing diagnosis for this client?
A) Risk for injury.
B) Impaired comfort.
C) Disturbed body image.
D) Ineffective health maintenance. . CORRECT ANSWER: B) Impaired comfort.
In menopausal women, the vaginal mucous membrane responds to low estrogen
levels causing the vaginal walls to become thinner, drier, and susceptible to
infection which leads to atrophic vaginitis. Perineal cutaneous candidiasis
contributes to other manifestations of vaginal infections, such as vaginal irritation,
burning, pruritus, increased leukorrhea, bleeding, and dyspareunia, and support the
primary nursing diagnosis, Impaired comfort (B). Risk for injury (A), body image
(C), and ineffective health maintenance (D) are secondary and linked to impaired
comfort.
• A man who smokes two packs of cigarettes a day wants to know if smoking is
contributing to the difficulty that he and his wife are having getting pregnant. What
information is best for the nurse to provide? (Select all that apply.)
A) Only marijuana cigarettes affect sperm count.
B) Smoking can decrease the quantity and quality of sperm.
C) The first semen analysis should be repeated to confirm sperm counts.
D) Cessation of smoking improves general health and fertility.
E) Sperm specimens should be collected in 2 subsequent days.
Correct Answer(s): B, C, D . CORRECT ANSWER: B) Smoking can decrease the
quantity and quality of sperm.
C) The first semen analysis should be repeated to confirm sperm counts.
, D) Cessation of smoking improves general health and fertility.
Correct selections are (B, C, and D). Use of tobacco, alcohol, and marijuana may
affect sperm counts (B). Sperm counts vary from day to day and are dependent on
emotional and physical status and sexual activity, so a single analysis may be
inconclusive (C). A minimum of two analyses should be performed several weeks
apart to assess male fertility, not (E). (A and D) contain inaccurate information.
• The nurse should explain to a client with lung cancer that pleurodesis is
performed to achieve which expected outcome?
A) Prevent the formation of effusion fluid.
B) Remove fluid from the intrapleural space.
C) Debulk tumor to maintain patency of air passages.
D) Relieve empyema after pneumonectomy. . CORRECT ANSWER: A) Prevent
the formation of effusion fluid.
Instillation of a sclerosing agent to create pleurodesis (adherence of the parietal
and visceral pleura) is aimed at preventing the formation of pleural effusion fluid
(A). (B) refers to thoracentesis. (C) is achieved by surgical resection. (D) is treated
by closed-chest drainage.
• The nurse is caring for a client who returns to the unit following a colonoscopy.
Which finding should the nurse report to the healthcare provider immediately?
A) Large amounts of expelled flatus with mucus.
B) Tympanic abdomen and hyperactive bowel sounds.
C) Increased abdominal pain with rebound tenderness.
D) Complaint of feeling weak with watery diarrheal stools. . CORRECT
ANSWER: C) Increased abdominal pain with rebound tenderness.
REVIEW AND DETAILED EXPLANATIONS
• An older female client is admitted with atrophic vaginitis and perineal cutaneous
candidiasis. What is the priority nursing diagnosis for this client?
A) Risk for injury.
B) Impaired comfort.
C) Disturbed body image.
D) Ineffective health maintenance. . CORRECT ANSWER: B) Impaired comfort.
In menopausal women, the vaginal mucous membrane responds to low estrogen
levels causing the vaginal walls to become thinner, drier, and susceptible to
infection which leads to atrophic vaginitis. Perineal cutaneous candidiasis
contributes to other manifestations of vaginal infections, such as vaginal irritation,
burning, pruritus, increased leukorrhea, bleeding, and dyspareunia, and support the
primary nursing diagnosis, Impaired comfort (B). Risk for injury (A), body image
(C), and ineffective health maintenance (D) are secondary and linked to impaired
comfort.
• A man who smokes two packs of cigarettes a day wants to know if smoking is
contributing to the difficulty that he and his wife are having getting pregnant. What
information is best for the nurse to provide? (Select all that apply.)
A) Only marijuana cigarettes affect sperm count.
B) Smoking can decrease the quantity and quality of sperm.
C) The first semen analysis should be repeated to confirm sperm counts.
D) Cessation of smoking improves general health and fertility.
E) Sperm specimens should be collected in 2 subsequent days.
Correct Answer(s): B, C, D . CORRECT ANSWER: B) Smoking can decrease the
quantity and quality of sperm.
C) The first semen analysis should be repeated to confirm sperm counts.
, D) Cessation of smoking improves general health and fertility.
Correct selections are (B, C, and D). Use of tobacco, alcohol, and marijuana may
affect sperm counts (B). Sperm counts vary from day to day and are dependent on
emotional and physical status and sexual activity, so a single analysis may be
inconclusive (C). A minimum of two analyses should be performed several weeks
apart to assess male fertility, not (E). (A and D) contain inaccurate information.
• The nurse should explain to a client with lung cancer that pleurodesis is
performed to achieve which expected outcome?
A) Prevent the formation of effusion fluid.
B) Remove fluid from the intrapleural space.
C) Debulk tumor to maintain patency of air passages.
D) Relieve empyema after pneumonectomy. . CORRECT ANSWER: A) Prevent
the formation of effusion fluid.
Instillation of a sclerosing agent to create pleurodesis (adherence of the parietal
and visceral pleura) is aimed at preventing the formation of pleural effusion fluid
(A). (B) refers to thoracentesis. (C) is achieved by surgical resection. (D) is treated
by closed-chest drainage.
• The nurse is caring for a client who returns to the unit following a colonoscopy.
Which finding should the nurse report to the healthcare provider immediately?
A) Large amounts of expelled flatus with mucus.
B) Tympanic abdomen and hyperactive bowel sounds.
C) Increased abdominal pain with rebound tenderness.
D) Complaint of feeling weak with watery diarrheal stools. . CORRECT
ANSWER: C) Increased abdominal pain with rebound tenderness.
