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HESI Med Surg Test Bank Newest Exam Preparation With
Complete Questions And Correct Answers With Rationales
Already Graded A+ Brand New Version!!
QUESTION 1
A client with chronic obstructive pulmonary disease (COPD) presents
with worsening dyspnea and a productive cough. The nurse notes
decreased breath sounds in the left lower lobe and increased anterior-
posterior chest diameter. Which assessment finding is most indicative
of an acute exacerbation?
A) Barrel-shaped chest
B) Pursed-lip breathing
C) Use of accessory muscles
D) Peripheral cyanosis
Answer: C
Explanation: The use of accessory muscles during respiration indicates
significant respiratory distress and is a classic sign of an acute
exacerbation of COPD. Barrel-shaped chest and pursed-lip breathing are
chronic adaptations seen in COPD. Peripheral cyanosis is a late sign of
hypoxemia and not specific to an acute exacerbation. Accessory muscle
use suggests increased work of breathing, which requires immediate
intervention.
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QUESTION 2
A client is admitted with heart failure and has been prescribed
furosemide. Which laboratory value should the nurse monitor most
closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
Answer: B
Explanation: Furosemide is a loop diuretic that promotes excretion of
potassium, sodium, and water. Hypokalemia is a common adverse
effect and can lead to serious cardiac dysrhythmias. Monitoring serum
potassium is essential to prevent complications. While sodium, calcium,
and magnesium may also be affected, potassium imbalance poses the
most immediate risk.
QUESTION 3
A client with diabetes mellitus type 2 is scheduled for a coronary artery
bypass graft. The nurse administers preoperative medications. Which
medication, if ordered, should the nurse question?
A) Metformin
B) Lisinopril
C) Aspirin
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D) Atorvastatin
Answer: A
Explanation: Metformin should be held 24 to 48 hours before and after
surgery due to the risk of lactic acidosis, especially in clients undergoing
major procedures with potential renal impairment. Lisinopril, aspirin,
and atorvastatin are often continued perioperatively but may be
adjusted based on the surgical protocol. The nurse must verify the order
with the provider.
QUESTION 4
A client is postoperative day 2 after a total hip replacement. The nurse
notes swelling and pain in the left calf. The client's left leg is warm to
the touch and appears reddened. What is the priority nursing action?
A) Apply a warm compress to the calf
B) Massage the calf to improve circulation
C) Measure the circumference of both calves
D) Notify the healthcare provider immediately
Answer: D
Explanation: The signs of calf swelling, pain, warmth, and redness are
suspicious for a deep vein thrombosis (DVT). The priority is to notify the
healthcare provider immediately to arrange for diagnostic studies such
as Doppler ultrasound. Massaging the calf or applying warm
compresses could dislodge a thrombus, leading to pulmonary embolism.
, 4|Page
Measuring calf circumference is appropriate but should not delay
notification.
QUESTION 5
A client with chronic kidney disease is receiving erythropoietin therapy.
Which laboratory finding indicates that the therapy is effective?
A) Increased white blood cell count
B) Increased hemoglobin level
C) Decreased platelet count
D) Decreased serum creatinine
Answer: B
Explanation: Erythropoietin stimulates red blood cell production in the
bone marrow. An increased hemoglobin level indicates that the therapy
is effective in treating anemia associated with chronic kidney disease.
White blood cell count and platelet count are not directly affected.
Serum creatinine reflects renal function, not erythropoiesis.
QUESTION 6
A client is receiving a continuous heparin infusion for a pulmonary
embolism. The nurse reviews the laboratory results. Which result
requires immediate action?
A) Partial thromboplastin time 68 seconds
B) Platelet count 150,000
HESI Med Surg Test Bank Newest Exam Preparation With
Complete Questions And Correct Answers With Rationales
Already Graded A+ Brand New Version!!
QUESTION 1
A client with chronic obstructive pulmonary disease (COPD) presents
with worsening dyspnea and a productive cough. The nurse notes
decreased breath sounds in the left lower lobe and increased anterior-
posterior chest diameter. Which assessment finding is most indicative
of an acute exacerbation?
A) Barrel-shaped chest
B) Pursed-lip breathing
C) Use of accessory muscles
D) Peripheral cyanosis
Answer: C
Explanation: The use of accessory muscles during respiration indicates
significant respiratory distress and is a classic sign of an acute
exacerbation of COPD. Barrel-shaped chest and pursed-lip breathing are
chronic adaptations seen in COPD. Peripheral cyanosis is a late sign of
hypoxemia and not specific to an acute exacerbation. Accessory muscle
use suggests increased work of breathing, which requires immediate
intervention.
,2|Page
QUESTION 2
A client is admitted with heart failure and has been prescribed
furosemide. Which laboratory value should the nurse monitor most
closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
Answer: B
Explanation: Furosemide is a loop diuretic that promotes excretion of
potassium, sodium, and water. Hypokalemia is a common adverse
effect and can lead to serious cardiac dysrhythmias. Monitoring serum
potassium is essential to prevent complications. While sodium, calcium,
and magnesium may also be affected, potassium imbalance poses the
most immediate risk.
QUESTION 3
A client with diabetes mellitus type 2 is scheduled for a coronary artery
bypass graft. The nurse administers preoperative medications. Which
medication, if ordered, should the nurse question?
A) Metformin
B) Lisinopril
C) Aspirin
,3|Page
D) Atorvastatin
Answer: A
Explanation: Metformin should be held 24 to 48 hours before and after
surgery due to the risk of lactic acidosis, especially in clients undergoing
major procedures with potential renal impairment. Lisinopril, aspirin,
and atorvastatin are often continued perioperatively but may be
adjusted based on the surgical protocol. The nurse must verify the order
with the provider.
QUESTION 4
A client is postoperative day 2 after a total hip replacement. The nurse
notes swelling and pain in the left calf. The client's left leg is warm to
the touch and appears reddened. What is the priority nursing action?
A) Apply a warm compress to the calf
B) Massage the calf to improve circulation
C) Measure the circumference of both calves
D) Notify the healthcare provider immediately
Answer: D
Explanation: The signs of calf swelling, pain, warmth, and redness are
suspicious for a deep vein thrombosis (DVT). The priority is to notify the
healthcare provider immediately to arrange for diagnostic studies such
as Doppler ultrasound. Massaging the calf or applying warm
compresses could dislodge a thrombus, leading to pulmonary embolism.
, 4|Page
Measuring calf circumference is appropriate but should not delay
notification.
QUESTION 5
A client with chronic kidney disease is receiving erythropoietin therapy.
Which laboratory finding indicates that the therapy is effective?
A) Increased white blood cell count
B) Increased hemoglobin level
C) Decreased platelet count
D) Decreased serum creatinine
Answer: B
Explanation: Erythropoietin stimulates red blood cell production in the
bone marrow. An increased hemoglobin level indicates that the therapy
is effective in treating anemia associated with chronic kidney disease.
White blood cell count and platelet count are not directly affected.
Serum creatinine reflects renal function, not erythropoiesis.
QUESTION 6
A client is receiving a continuous heparin infusion for a pulmonary
embolism. The nurse reviews the laboratory results. Which result
requires immediate action?
A) Partial thromboplastin time 68 seconds
B) Platelet count 150,000
