2023/2024 Hesi Med Surg Questions And
Answers LATEST VERIFIED VERSION
1. A client is scheduled for surgery in 2 hours. Which finding should the nurse report to the
surgeon immediately?
A. Hemoglobin 13.2 g/dL
B. Temperature 101.8°F (38.8°C)
C. Blood pressure 118/76 mm Hg
D. NPO status since midnight
Answer: B
Rationale: An elevated temperature suggests infection, which may necessitate postponing
surgery. The other values are within normal limits or expected.
2. Which instruction is most important for the nurse to give a client scheduled for outpatient
surgery?
A. "Eat a light breakfast the morning of surgery."
B. "Arrange for a responsible adult to drive you home."
C. "Take your aspirin with a sip of water."
D. "You may drive yourself if you feel alert."
Answer: B
Rationale: Sedation/anesthesia impairs driving; a responsible adult escort is required.
Aspirin increases bleeding risk; NPO is typically required.
3. (SATA) Which findings indicate the client is ready for discharge from the PACU? Select all that
apply.
A. Alert and oriented
B. Oxygen saturation 94% on room air
C. Uncontrolled shivering
D. Stable vital signs for 30 minutes
E. Pain rating 8/10
F. Protective airway reflexes present
Answer: A, B, D, F
Rationale: Discharge criteria include alertness, adequate oxygenation, stable vitals, and
intact airway reflexes. Uncontrolled shivering and severe pain require intervention first.
,4. A postoperative client reports sudden shortness of breath and chest pain. Which action
should the nurse take first?
A. Administer the prescribed analgesic
B. Raise the head of the bed and apply oxygen
C. Assist the client to ambulate
D. Document the findings
Answer: B
Rationale: These signs suggest pulmonary embolism; immediate oxygenation and
positioning are priorities. Ambulation would be dangerous.
5. Which client is at greatest risk for malignant hyperthermia during surgery?
A. Client with a history of asthma
B. Client with a family history of malignant hyperthermia
C. Client with type 2 diabetes
D. Client with hypertension
Answer: B
Rationale: Malignant hyperthermia is an autosomal dominant genetic disorder triggered by
inhaled anesthetics and succinylcholine.
6. The nurse is teaching a client about using an incentive spirometer. Which statement indicates
correct understanding?
A. "I will use it once a day."
B. "I will take slow, deep breaths and hold them."
C. "I will exhale forcefully into the device."
D. "I will use it only when I feel short of breath."
Answer: B
Rationale: The spirometer encourages sustained maximal inspiration to prevent atelectasis;
it should be used 10 times per hour while awake.
7. Which finding at a surgical incision should the nurse report?
A. Slight redness at the edges
B. Serosanguineous drainage on day 1
C. Dehiscence with evisceration
D. Mild tenderness
Answer: C
Rationale: Evisceration is a surgical emergency requiring immediate intervention. The
others are expected findings.
,8. A client is 24 hours postoperative and has not voided. Which action should the nurse
take first?
A. Insert a Foley catheter
B. Palpate the bladder and assist the client to the bathroom
C. Restrict fluids
D. Administer a diuretic
Answer: B
Rationale: Noninvasive measures are attempted first; bladder distention should be assessed
and the client assisted to void.
9. (SATA) Which are risk factors for postoperative complications? Select all that apply.
A. Obesity
B. Smoking
C. Age 30
D. Diabetes mellitus
E. Malnutrition
F. Regular exercise
Answer: A, B, D, E
Rationale: Obesity, smoking, diabetes, and malnutrition impair healing and increase risk.
Age 30 and regular exercise are not risk factors.
10. Which position is most appropriate for a client immediately after thyroidectomy?
A. Flat, supine
B. Semi-Fowler's with head supported
C. Trendelenburg
D. Prone
Answer: B
Rationale: Semi-Fowler's reduces edema and tension on the suture line; head support
prevents strain on the neck.
Fluid, Electrolyte & Acid-Base
11. A client has a potassium level of 6.2 mEq/L. Which action should the nurse take first?
A. Administer potassium chloride
B. Place the client on a cardiac monitor
C. Encourage bananas and oranges
D. Prepare for dialysis
, Answer: B
Rationale: Hyperkalemia can cause lethal dysrhythmias; cardiac monitoring is the
immediate priority.
12. Which client is at highest risk for hypokalemia?
A. Client on furosemide
B. Client on spironolactone
C. Client with renal failure
D. Client taking NSAIDs
Answer: A
Rationale: Loop diuretics such as furosemide cause potassium loss. Spironolactone and
renal failure cause hyperkalemia.
13. A client with a sodium level of 118 mEq/L is confused. Which intervention is most
important?
A. Restrict fluids
B. Administer hypertonic saline as prescribed
C. Encourage water intake
D. Administer a diuretic
Answer: B
Rationale: Severe hyponatremia with neurologic symptoms requires careful correction with
hypertonic saline.
14. (SATA) Which findings indicate fluid volume deficit? Select all that apply.
A. Tachycardia
B. Bounding pulses
C. Decreased urine output
D. Dry mucous membranes
E. Weight gain
F. Poor skin turgor
Answer: A, C, D, F
Rationale: Fluid deficit causes tachycardia, oliguria, dry mucous membranes, and poor
turgor. Bounding pulses and weight gain indicate excess.
15. A client's arterial blood gas shows pH 7.30, PaCO₂ 50 mm Hg, HCO₃ 24 mEq/L. Which
condition does this indicate?
A. Respiratory acidosis
B. Respiratory alkalosis
Answers LATEST VERIFIED VERSION
1. A client is scheduled for surgery in 2 hours. Which finding should the nurse report to the
surgeon immediately?
A. Hemoglobin 13.2 g/dL
B. Temperature 101.8°F (38.8°C)
C. Blood pressure 118/76 mm Hg
D. NPO status since midnight
Answer: B
Rationale: An elevated temperature suggests infection, which may necessitate postponing
surgery. The other values are within normal limits or expected.
2. Which instruction is most important for the nurse to give a client scheduled for outpatient
surgery?
A. "Eat a light breakfast the morning of surgery."
B. "Arrange for a responsible adult to drive you home."
C. "Take your aspirin with a sip of water."
D. "You may drive yourself if you feel alert."
Answer: B
Rationale: Sedation/anesthesia impairs driving; a responsible adult escort is required.
Aspirin increases bleeding risk; NPO is typically required.
3. (SATA) Which findings indicate the client is ready for discharge from the PACU? Select all that
apply.
A. Alert and oriented
B. Oxygen saturation 94% on room air
C. Uncontrolled shivering
D. Stable vital signs for 30 minutes
E. Pain rating 8/10
F. Protective airway reflexes present
Answer: A, B, D, F
Rationale: Discharge criteria include alertness, adequate oxygenation, stable vitals, and
intact airway reflexes. Uncontrolled shivering and severe pain require intervention first.
,4. A postoperative client reports sudden shortness of breath and chest pain. Which action
should the nurse take first?
A. Administer the prescribed analgesic
B. Raise the head of the bed and apply oxygen
C. Assist the client to ambulate
D. Document the findings
Answer: B
Rationale: These signs suggest pulmonary embolism; immediate oxygenation and
positioning are priorities. Ambulation would be dangerous.
5. Which client is at greatest risk for malignant hyperthermia during surgery?
A. Client with a history of asthma
B. Client with a family history of malignant hyperthermia
C. Client with type 2 diabetes
D. Client with hypertension
Answer: B
Rationale: Malignant hyperthermia is an autosomal dominant genetic disorder triggered by
inhaled anesthetics and succinylcholine.
6. The nurse is teaching a client about using an incentive spirometer. Which statement indicates
correct understanding?
A. "I will use it once a day."
B. "I will take slow, deep breaths and hold them."
C. "I will exhale forcefully into the device."
D. "I will use it only when I feel short of breath."
Answer: B
Rationale: The spirometer encourages sustained maximal inspiration to prevent atelectasis;
it should be used 10 times per hour while awake.
7. Which finding at a surgical incision should the nurse report?
A. Slight redness at the edges
B. Serosanguineous drainage on day 1
C. Dehiscence with evisceration
D. Mild tenderness
Answer: C
Rationale: Evisceration is a surgical emergency requiring immediate intervention. The
others are expected findings.
,8. A client is 24 hours postoperative and has not voided. Which action should the nurse
take first?
A. Insert a Foley catheter
B. Palpate the bladder and assist the client to the bathroom
C. Restrict fluids
D. Administer a diuretic
Answer: B
Rationale: Noninvasive measures are attempted first; bladder distention should be assessed
and the client assisted to void.
9. (SATA) Which are risk factors for postoperative complications? Select all that apply.
A. Obesity
B. Smoking
C. Age 30
D. Diabetes mellitus
E. Malnutrition
F. Regular exercise
Answer: A, B, D, E
Rationale: Obesity, smoking, diabetes, and malnutrition impair healing and increase risk.
Age 30 and regular exercise are not risk factors.
10. Which position is most appropriate for a client immediately after thyroidectomy?
A. Flat, supine
B. Semi-Fowler's with head supported
C. Trendelenburg
D. Prone
Answer: B
Rationale: Semi-Fowler's reduces edema and tension on the suture line; head support
prevents strain on the neck.
Fluid, Electrolyte & Acid-Base
11. A client has a potassium level of 6.2 mEq/L. Which action should the nurse take first?
A. Administer potassium chloride
B. Place the client on a cardiac monitor
C. Encourage bananas and oranges
D. Prepare for dialysis
, Answer: B
Rationale: Hyperkalemia can cause lethal dysrhythmias; cardiac monitoring is the
immediate priority.
12. Which client is at highest risk for hypokalemia?
A. Client on furosemide
B. Client on spironolactone
C. Client with renal failure
D. Client taking NSAIDs
Answer: A
Rationale: Loop diuretics such as furosemide cause potassium loss. Spironolactone and
renal failure cause hyperkalemia.
13. A client with a sodium level of 118 mEq/L is confused. Which intervention is most
important?
A. Restrict fluids
B. Administer hypertonic saline as prescribed
C. Encourage water intake
D. Administer a diuretic
Answer: B
Rationale: Severe hyponatremia with neurologic symptoms requires careful correction with
hypertonic saline.
14. (SATA) Which findings indicate fluid volume deficit? Select all that apply.
A. Tachycardia
B. Bounding pulses
C. Decreased urine output
D. Dry mucous membranes
E. Weight gain
F. Poor skin turgor
Answer: A, C, D, F
Rationale: Fluid deficit causes tachycardia, oliguria, dry mucous membranes, and poor
turgor. Bounding pulses and weight gain indicate excess.
15. A client's arterial blood gas shows pH 7.30, PaCO₂ 50 mm Hg, HCO₃ 24 mEq/L. Which
condition does this indicate?
A. Respiratory acidosis
B. Respiratory alkalosis
