HESI MED-SURG practice exam with
verified solutions
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. - correct answer -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 off 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
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. - correct answer -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
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. - correct answer -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
Which physical assessment finding should the nurse anticipate in a client with long-term
gastroesophagealreflux disease (GERD)?
Hoarseness.
Dry mouth.
Mouth ulcers.
Weight loss. - correct answer -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.
,A client presents with chronic venous insufficiency. Which assessment finding should the nurse
anticipate?
Bilateral lower leg stasis dermatitis.
Clubbing of fingers and toes.
Intermittent claudication.
Peripheral cyanosis. - correct answer -Bilateral lower leg stasis dermatitis.
Clients who suffer from chroninc venous insufficiency 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.
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. - correct answer -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.
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. - correct answer -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 caffeinated 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.
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. - correct answer -Do not leave the diaphragm in place
longer than 8 hours after intercourse.
Replace the old diaphragm every 3 months.
The diaphragm needs to remain against the cervix for 6 to 8 hours to prevent pregnancy but should
not remain for longer than 8 hours to avoid the risk of toxic shock syndrome. The diaphragm should
be replaced every 3 months to maintain integrity.
A male client who smokes two packs of cigarettes a day states he understands that smoking cigarettes
is contributing to the difficulty that he and his wife are having in getting pregnant and wants to know
if other factors could be contributing to their difficulty. What information is best for the nurse to
provide? (Select all that apply.)
Marijuana cigarettes do not affect sperm count.
Alcohol consumption can cause erectile dysfunction.
Low testosterone levels affect sperm production.
verified solutions
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. - correct answer -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 off 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
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. - correct answer -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
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. - correct answer -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
Which physical assessment finding should the nurse anticipate in a client with long-term
gastroesophagealreflux disease (GERD)?
Hoarseness.
Dry mouth.
Mouth ulcers.
Weight loss. - correct answer -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.
,A client presents with chronic venous insufficiency. Which assessment finding should the nurse
anticipate?
Bilateral lower leg stasis dermatitis.
Clubbing of fingers and toes.
Intermittent claudication.
Peripheral cyanosis. - correct answer -Bilateral lower leg stasis dermatitis.
Clients who suffer from chroninc venous insufficiency 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.
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. - correct answer -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.
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. - correct answer -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 caffeinated 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.
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. - correct answer -Do not leave the diaphragm in place
longer than 8 hours after intercourse.
Replace the old diaphragm every 3 months.
The diaphragm needs to remain against the cervix for 6 to 8 hours to prevent pregnancy but should
not remain for longer than 8 hours to avoid the risk of toxic shock syndrome. The diaphragm should
be replaced every 3 months to maintain integrity.
A male client who smokes two packs of cigarettes a day states he understands that smoking cigarettes
is contributing to the difficulty that he and his wife are having in getting pregnant and wants to know
if other factors could be contributing to their difficulty. What information is best for the nurse to
provide? (Select all that apply.)
Marijuana cigarettes do not affect sperm count.
Alcohol consumption can cause erectile dysfunction.
Low testosterone levels affect sperm production.
