HESI MED-SURG practice exam
1. An adult client who is hospitalized after surgery reports sudden onset of
chest pain and dyspnea. The client appears anxious, restless, and mildly
cyanotic. The nurse should further assess the client for which condition?
Pulmonary embolism.
Heart failure.
Tuberculosis.
Bronchitis.: Pulmonary embolism.
Post-surgical clients are at an increased risk for deep vein thrombosis (DVT), which may result in pulmonary embolism
if the clot breaks ott and travels to the lungs. Signs and symptoms of pulmonary embolism include chest pain, dyspnea,
anxiety, restlessness, and - in severe cases - cyanosis.
Jarvis, Physical Examination and Health Assessment, 7th ed., p.493
2. Which information should the nurse obtain when performing an initial
assessment of a client who presents to the emergency department with a
painful ankle injury? (Select all that apply.)
Quality of the pain.
Signs of inflammation.
Ankle range of motion.
Muscle strength testing.
Visible deformities of the joint.: Quality of the pain.
Signs of inflammation.
Ankle range of motion.
Visible deformities of the joint.
Initial assessment of a joint injury is performed to determine the extent of the damage. The nurse's initial assessment
of a painful ankle injury should include pain quality, the presence of deformities, evidence of inflammation, and range
of motion.
Jarvis Physical Examination and Health Assessment, 7th ed. p. 586-8
,3. Which description of pain is consistent with a diagnosis of rheumatoid
arthritis?
,Joint pain is worse in the morning and involves symmetric joints.
Joint pain is better in the morning and worsens throughout the day.
Joint pain is consistent throughout the day and is relieved by pain medication.
Joint pain is worse during the day and involves unilateral joints.: Joint pain is worse
in the morning and involves symmetric joints.
Rheumatoid arthritis (RA) is an autoimmune disease that causes joint pain and swelling. RA is characterized by pain
that is worse when arising and involves symmetric joints.
Jarvis. (2016), Physical Examination and Health Assessment, 7th Ed., Chapter 22; p. 586
4. Which physical assessment finding should the nurse anticipate in a client
with long-term gastroesophagealreflux disease (GERD)?
Hoarseness.
Dry mouth.
Mouth ulcers.
Weight loss.: Hoarseness.
Dyspepsia and regurgitation are the main symptoms of gastroesophageal reflux disease (GERD); however, hoarseness
is one of the most common long-term symptoms of GERD due to the irritation of the reflux of gastric secretions.
Ignatavicius, (2016). Medical-surgical nursing: Patient-centered collaborative care, eight edition., Ch. 49, p. 1111.
5. A client presents with chronic venous insufficiency. Which assessment find-
ing should the nurse anticipate?
Bilateral lower leg stasis dermatitis.
Clubbing of fingers and toes.
Intermittent claudication.
Peripheral cyanosis.: Bilateral lower leg stasis dermatitis.
Clients who sutter from chroninc venous insuflciency often develop statsis dermatitis in the lower extremities. Statis
dermatitis appear as brownish-red discoloration on the lower extremities at the ankles which can develop into stasis
ulcers due to the pooling of the venous blood flow back to the heart.
Ignatavicius, (2013). Medical-surgical nursing: Patient-centered collaborative care, 7th ed.., Ch. 33, p. 803.
, 6. A client has been hospitalized with a femur fracture and is being treated with
traction. Which action by the nurse is the priority when caring for this client?
Assess neurovascular status.
Change the client's position.
Inspect the traction equipment.
Review pain medication orders.: Assess neurovascular status.
The use of traction for long bone fractures reduces the potential for damage to the surrounding tissues. Reports
of increased pain may indicate circulatory compromise or tissue damage (compartment syndrome). Assessing the
client's neurovascular status is the nurse's highest priority.
Ignatavicius, (2016). Medical-surgical nursing: Patient-centered collaborative care, eight edition., Ch. 51, pp. 1051-80.
7. Which statement made by a client with chronic pancreatitis indicates that
further education is needed?
I will cut back on smoking cigarettes daily.
I will avoid drinking caffeinated beverages.
I will rest frequently and avoid vigorous exercise.
I will eat a bland, low-fat, high-protein diet.: I will cut back on smoking cigarettes daily.
To prevent exacerbations of chronic pancreatitis, clients should be instructed to avoid nicotine entirely. Additional
teaching includes avoiding catteinated beverages, resting frequently as needed, and eating a bland diet low fat and
high in protein.Ignatavicius, (2016). Medical-surgical nursing: Patient-centered collaborative care, 8th ed., Ch. 59,
pp. 1084-98.
8. The nurse is teaching a female client who uses a contraceptive diaphragm
about reducing the risk for toxic shock syndrome (TSS). Which information
should the nurse include? (Select all that apply.)
Remove the diaphragm immediately after intercourse.
Wash the diaphragm with an alcohol solution.
Use the diaphragm to prevent conception during the menstrual cycle.
Do not leave the diaphragm in place longer than 8 hours after intercourse.
Replace the old diaphragm every 3 months.: Do not leave the diaphragm in place longer than
1. An adult client who is hospitalized after surgery reports sudden onset of
chest pain and dyspnea. The client appears anxious, restless, and mildly
cyanotic. The nurse should further assess the client for which condition?
Pulmonary embolism.
Heart failure.
Tuberculosis.
Bronchitis.: Pulmonary embolism.
Post-surgical clients are at an increased risk for deep vein thrombosis (DVT), which may result in pulmonary embolism
if the clot breaks ott and travels to the lungs. Signs and symptoms of pulmonary embolism include chest pain, dyspnea,
anxiety, restlessness, and - in severe cases - cyanosis.
Jarvis, Physical Examination and Health Assessment, 7th ed., p.493
2. Which information should the nurse obtain when performing an initial
assessment of a client who presents to the emergency department with a
painful ankle injury? (Select all that apply.)
Quality of the pain.
Signs of inflammation.
Ankle range of motion.
Muscle strength testing.
Visible deformities of the joint.: Quality of the pain.
Signs of inflammation.
Ankle range of motion.
Visible deformities of the joint.
Initial assessment of a joint injury is performed to determine the extent of the damage. The nurse's initial assessment
of a painful ankle injury should include pain quality, the presence of deformities, evidence of inflammation, and range
of motion.
Jarvis Physical Examination and Health Assessment, 7th ed. p. 586-8
,3. Which description of pain is consistent with a diagnosis of rheumatoid
arthritis?
,Joint pain is worse in the morning and involves symmetric joints.
Joint pain is better in the morning and worsens throughout the day.
Joint pain is consistent throughout the day and is relieved by pain medication.
Joint pain is worse during the day and involves unilateral joints.: Joint pain is worse
in the morning and involves symmetric joints.
Rheumatoid arthritis (RA) is an autoimmune disease that causes joint pain and swelling. RA is characterized by pain
that is worse when arising and involves symmetric joints.
Jarvis. (2016), Physical Examination and Health Assessment, 7th Ed., Chapter 22; p. 586
4. Which physical assessment finding should the nurse anticipate in a client
with long-term gastroesophagealreflux disease (GERD)?
Hoarseness.
Dry mouth.
Mouth ulcers.
Weight loss.: Hoarseness.
Dyspepsia and regurgitation are the main symptoms of gastroesophageal reflux disease (GERD); however, hoarseness
is one of the most common long-term symptoms of GERD due to the irritation of the reflux of gastric secretions.
Ignatavicius, (2016). Medical-surgical nursing: Patient-centered collaborative care, eight edition., Ch. 49, p. 1111.
5. A client presents with chronic venous insufficiency. Which assessment find-
ing should the nurse anticipate?
Bilateral lower leg stasis dermatitis.
Clubbing of fingers and toes.
Intermittent claudication.
Peripheral cyanosis.: Bilateral lower leg stasis dermatitis.
Clients who sutter from chroninc venous insuflciency often develop statsis dermatitis in the lower extremities. Statis
dermatitis appear as brownish-red discoloration on the lower extremities at the ankles which can develop into stasis
ulcers due to the pooling of the venous blood flow back to the heart.
Ignatavicius, (2013). Medical-surgical nursing: Patient-centered collaborative care, 7th ed.., Ch. 33, p. 803.
, 6. A client has been hospitalized with a femur fracture and is being treated with
traction. Which action by the nurse is the priority when caring for this client?
Assess neurovascular status.
Change the client's position.
Inspect the traction equipment.
Review pain medication orders.: Assess neurovascular status.
The use of traction for long bone fractures reduces the potential for damage to the surrounding tissues. Reports
of increased pain may indicate circulatory compromise or tissue damage (compartment syndrome). Assessing the
client's neurovascular status is the nurse's highest priority.
Ignatavicius, (2016). Medical-surgical nursing: Patient-centered collaborative care, eight edition., Ch. 51, pp. 1051-80.
7. Which statement made by a client with chronic pancreatitis indicates that
further education is needed?
I will cut back on smoking cigarettes daily.
I will avoid drinking caffeinated beverages.
I will rest frequently and avoid vigorous exercise.
I will eat a bland, low-fat, high-protein diet.: I will cut back on smoking cigarettes daily.
To prevent exacerbations of chronic pancreatitis, clients should be instructed to avoid nicotine entirely. Additional
teaching includes avoiding catteinated beverages, resting frequently as needed, and eating a bland diet low fat and
high in protein.Ignatavicius, (2016). Medical-surgical nursing: Patient-centered collaborative care, 8th ed., Ch. 59,
pp. 1084-98.
8. The nurse is teaching a female client who uses a contraceptive diaphragm
about reducing the risk for toxic shock syndrome (TSS). Which information
should the nurse include? (Select all that apply.)
Remove the diaphragm immediately after intercourse.
Wash the diaphragm with an alcohol solution.
Use the diaphragm to prevent conception during the menstrual cycle.
Do not leave the diaphragm in place longer than 8 hours after intercourse.
Replace the old diaphragm every 3 months.: Do not leave the diaphragm in place longer than
