HESI MEDICAL-SURGICAL EXAM BANK: 200 PRACTICE
QUESTIONS WITH CORRECT ANSWERS & DETAILED
RATIONALES
1. A client with heart failure is prescribed furosemide 40 mg IV push.
Which assessment finding requires immediate intervention?
A. Serum potassium 3.2 mEq/L
B. Blood pressure 138/86 mm Hg
C. Urine output 60 mL/hr
D. Weight gain of 0.5 kg in 24 hours
Correct Answer: A
Rationale: Hypokalemia (potassium <3.5 mEq/L) increases the risk of
digoxin toxicity and cardiac arrhythmias. Furosemide is a loop diuretic
that causes potassium wasting. The nurse should hold the dose, notify
the healthcare provider, and prepare to administer potassium
supplementation. Options B, C, and D are not immediate priorities.
2. Which symptom is characteristic of trigeminal neuralgia?
A. Facial muscle spasms
B. Unilateral facial weakness
C. Tinnitus
D. Difficulty swallowing
Correct Answer: A
Rationale: Trigeminal neuralgia is characterized by paroxysms of pain,
similar to an electric shock, in the area innervated by one or more
,branches of the trigeminal nerve (cranial V). Facial muscle spasms may
occur along with the pain. Unilateral facial weakness is associated with
Bell's palsy or stroke. Tinnitus and difficulty swallowing are not related
to trigeminal neuralgia.
3. A client with acute diverticulitis has a rigid, hard abdomen and
elevated WBC. What is the priority nursing action?
A. Administer prescribed antibiotics
B. Encourage oral fluids
C. Notify the healthcare provider immediately
D. Apply a heating pad to the abdomen
Correct Answer: C
Rationale: A rigid, hard abdomen with elevated WBC is indicative of
peritonitis, a medical emergency that requires immediate surgical
evaluation. The nurse should notify the healthcare provider
immediately. Administering antibiotics, encouraging fluids, or applying
heat would delay necessary intervention for a life-threatening
complication.
4. A client on ramipril for hypertension has a blood pressure of 120/70
mm Hg at 0830, with the dose scheduled for 0900. What should the
nurse do?
A. Administer the prescribed dose at the scheduled time
B. Hold the dose and contact the healthcare provider
C. Hold the dose and recheck blood pressure in 1 hour
D. Check the healthcare provider's prescription to clarify the dose
Correct Answer: A
,Rationale: The client's blood pressure is within normal limits, indicating
that the ramipril is having the desired effect. The medication should be
administered as prescribed. Holding the dose would be appropriate
only if the blood pressure were excessively low (<100 mm Hg systolic) or
if the client exhibited signs of hypotension. The prescribed dose is
within the normal range.
5. A client with a fractured right elbow complains of deep, unrelenting
pain in the right arm that is not relieved by opioids. What is the
priority nursing action?
A. Apply an ice pack to the elbow
B. Elevate the right arm above heart level
C. Notify the healthcare provider immediately
D. Administer additional pain medication
Correct Answer: C
Rationale: Deep, unrelenting pain unrelieved by opioids is a classic sign
of compartment syndrome, a medical emergency caused by increased
pressure within a confined anatomical space. Immediate notification of
the healthcare provider is required to prevent permanent neurovascular
damage. Ice, elevation, and additional pain medication are not
appropriate interventions for compartment syndrome.
6. A client scheduled for surgery has an elevated blood urea nitrogen
(BUN) level. Which condition most likely contributed to this finding?
A. Myocardial infarction 2 months ago
B. Anorexia and vomiting for the past 2 days
C. Recently diagnosed type 2 diabetes mellitus
D. Skeletal traction for a right hip fracture
Correct Answer: B
, Rationale: The BUN level indicates the effectiveness of the kidneys in
filtering waste from the blood. Dehydration, which can be caused by
vomiting and anorexia, leads to an increased BUN level due to reduced
renal perfusion. Myocardial infarction, diabetes, and skeletal traction do
not directly cause elevated BUN.
7. A client with COPD has an oxygen saturation of 88% on room air.
Which action should the nurse take first?
A. Increase oxygen to 4 L/min via nasal cannula
B. Assess the client's respiratory rate and lung sounds
C. Administer a bronchodilator immediately
D. Notify the respiratory therapist
Correct Answer: B
Rationale: The priority action is to assess the client's respiratory status,
including respiratory rate, depth, and lung sounds, to determine the
underlying cause of hypoxemia. Increasing oxygen to 4 L/min may be
appropriate for some clients but can suppress the respiratory drive in
COPD clients with chronic hypercapnia. Assessment must precede
intervention.
8. Which finding in a client with heart failure indicates improved
cardiac output?
A. Jugular venous distension
B. Peripheral edema
C. Decreased dyspnea
D. Weight gain of 2 kg in 24 hours
Correct Answer: C
QUESTIONS WITH CORRECT ANSWERS & DETAILED
RATIONALES
1. A client with heart failure is prescribed furosemide 40 mg IV push.
Which assessment finding requires immediate intervention?
A. Serum potassium 3.2 mEq/L
B. Blood pressure 138/86 mm Hg
C. Urine output 60 mL/hr
D. Weight gain of 0.5 kg in 24 hours
Correct Answer: A
Rationale: Hypokalemia (potassium <3.5 mEq/L) increases the risk of
digoxin toxicity and cardiac arrhythmias. Furosemide is a loop diuretic
that causes potassium wasting. The nurse should hold the dose, notify
the healthcare provider, and prepare to administer potassium
supplementation. Options B, C, and D are not immediate priorities.
2. Which symptom is characteristic of trigeminal neuralgia?
A. Facial muscle spasms
B. Unilateral facial weakness
C. Tinnitus
D. Difficulty swallowing
Correct Answer: A
Rationale: Trigeminal neuralgia is characterized by paroxysms of pain,
similar to an electric shock, in the area innervated by one or more
,branches of the trigeminal nerve (cranial V). Facial muscle spasms may
occur along with the pain. Unilateral facial weakness is associated with
Bell's palsy or stroke. Tinnitus and difficulty swallowing are not related
to trigeminal neuralgia.
3. A client with acute diverticulitis has a rigid, hard abdomen and
elevated WBC. What is the priority nursing action?
A. Administer prescribed antibiotics
B. Encourage oral fluids
C. Notify the healthcare provider immediately
D. Apply a heating pad to the abdomen
Correct Answer: C
Rationale: A rigid, hard abdomen with elevated WBC is indicative of
peritonitis, a medical emergency that requires immediate surgical
evaluation. The nurse should notify the healthcare provider
immediately. Administering antibiotics, encouraging fluids, or applying
heat would delay necessary intervention for a life-threatening
complication.
4. A client on ramipril for hypertension has a blood pressure of 120/70
mm Hg at 0830, with the dose scheduled for 0900. What should the
nurse do?
A. Administer the prescribed dose at the scheduled time
B. Hold the dose and contact the healthcare provider
C. Hold the dose and recheck blood pressure in 1 hour
D. Check the healthcare provider's prescription to clarify the dose
Correct Answer: A
,Rationale: The client's blood pressure is within normal limits, indicating
that the ramipril is having the desired effect. The medication should be
administered as prescribed. Holding the dose would be appropriate
only if the blood pressure were excessively low (<100 mm Hg systolic) or
if the client exhibited signs of hypotension. The prescribed dose is
within the normal range.
5. A client with a fractured right elbow complains of deep, unrelenting
pain in the right arm that is not relieved by opioids. What is the
priority nursing action?
A. Apply an ice pack to the elbow
B. Elevate the right arm above heart level
C. Notify the healthcare provider immediately
D. Administer additional pain medication
Correct Answer: C
Rationale: Deep, unrelenting pain unrelieved by opioids is a classic sign
of compartment syndrome, a medical emergency caused by increased
pressure within a confined anatomical space. Immediate notification of
the healthcare provider is required to prevent permanent neurovascular
damage. Ice, elevation, and additional pain medication are not
appropriate interventions for compartment syndrome.
6. A client scheduled for surgery has an elevated blood urea nitrogen
(BUN) level. Which condition most likely contributed to this finding?
A. Myocardial infarction 2 months ago
B. Anorexia and vomiting for the past 2 days
C. Recently diagnosed type 2 diabetes mellitus
D. Skeletal traction for a right hip fracture
Correct Answer: B
, Rationale: The BUN level indicates the effectiveness of the kidneys in
filtering waste from the blood. Dehydration, which can be caused by
vomiting and anorexia, leads to an increased BUN level due to reduced
renal perfusion. Myocardial infarction, diabetes, and skeletal traction do
not directly cause elevated BUN.
7. A client with COPD has an oxygen saturation of 88% on room air.
Which action should the nurse take first?
A. Increase oxygen to 4 L/min via nasal cannula
B. Assess the client's respiratory rate and lung sounds
C. Administer a bronchodilator immediately
D. Notify the respiratory therapist
Correct Answer: B
Rationale: The priority action is to assess the client's respiratory status,
including respiratory rate, depth, and lung sounds, to determine the
underlying cause of hypoxemia. Increasing oxygen to 4 L/min may be
appropriate for some clients but can suppress the respiratory drive in
COPD clients with chronic hypercapnia. Assessment must precede
intervention.
8. Which finding in a client with heart failure indicates improved
cardiac output?
A. Jugular venous distension
B. Peripheral edema
C. Decreased dyspnea
D. Weight gain of 2 kg in 24 hours
Correct Answer: C
