HESI MEDSURG EXAM PACK 4 VERSIONS ALL
INCLUSIVE TEST BANK ACCURATELY UPDATED
2025 | VERIFIED QUESTIONS AND ANSWERS |
GUARANTEED PASS | HIGHEST LEVEL
A client diagnosed with chronic kidney disease (CKD) 2 years ago is regularly treated at a
community hemodialysis facility. Before his scheduled dialysis treatment, which electrolyte
imbalance should the nurse anticipate?
A) Hypophosphatemia.
B) Hypocalcemia.
C) Hyponatremia.
D) Hypokalemia
B.
Hypocalcemia develops in CKD because of chronic hyperphosphatemia. Increased phosphate
levels cause the peripheral deposition of calcium and resistance to vitamin D absorption needed
for calcium absorption. Prior to dialysis, the nurse would expect to find the client hypernatremic
and hyperkalemic, not with C or D.
The home health nurse is assessing a male client being treated for Parkinson's disease with
Sinemet. The nurse observes that he does not demonstrate any apparent emotion when speaking
and rarely blinks. Which intervention should the nurse implement?
A) Perform a complete cranial nerve assessment.
B) Instruct the client that he may be experiencing medication toxicity.
C) Document the presence of these assessment findings.
D) Advise the client to seek immediate medical evaluation.
C.
A masklike expression and infrequent blinking are common clinical features of parkinsonism.
The nurse should document these expected findings. Signs of toxicity of Sinemet include
dyskinesia, hallucinations, and psychosis.
A client with CHF and Afib develops ventricular ectopy with a pattern of 8 ectopic beats/min.
Which action should the nurse take based on this observation?
A) Assess for bilateral jugular vein distention.
B) Increase oxygen flow via nasal cannula.
C) Administer PRN Lasix.
D) Auscultate for a pleural friction rub.
,B.
The client should have the oxygen flow immediately increased to promote oxygenation of the
,myocardium. Ventricular ectopy, characterized by multiple PVCs, is often caused by myocardial
ischemia exacerbated by hypokalemia.
During the change of shift report, the charge nurse reviews the infusions being received by
clients on the oncology unit. The client receiving which infusion should be assessed first?
A) Continuous IV infusion of magnesium.
B) One-time infusion of albumin.
C) Continuous epidural infusion of morphine.
D) Intermittent infusion of IV vancomycin.
C.
All four of these clients have a potential to have significant complications. The client with the
morphine epidural infusion is at highest risk for respiratory depression and should be assessed
first.
A 25-year-old client was admitted yesterday after a motor vehicle collision. Neurodiagnostic
studies have shown a basal skull fracture in the middle fossa. Assessment on admission revealed
both halo and battle signs. Which new symtom indicates that the client is likely to be
experiencing a common life-threatening complication associated with a basal skull fracture?
A) Bilateral jugular vein distension.
B) Oral temp of 102.
C) Intermittent focal motor seizures.
D) Intractable pain in the cervical region.
B.
Clients with basilar skull fractures are at high risk for infection of the brain, as indicated by an
increased oral temp because the fracture leaves the meninges open to bacterial invasion.
An older client is admitted with a diagnosis of bacterial pneumonia. Which symptom should the
nurse report to the HCP after assessing the client?
A) Leukocytosis and febrile.
B) Polycythemia and crackles.
C) Pharyngitis and sputum production.
D) Confusion and tachycardia.
D.
The onset of Pneumonia in the older client may be signaled by general deterioration, confusion,
increased HR, and/or increased respirations. A, B, and C are often absent in the older client with
bacterial pneumonia.
The nurse is reviewing routine medications taken by a client with chronic angle closure
glaucoma. Which medication prescription should the nurse question?
, A) Antianginal with a therapeutic effect of vasodilation.
B) Anticholinergic with a side effect of pupillary dilation.
C) Antihistamine with a side effect of sedation.
D) Corticosteroid with a side effect of hyperglycemia.
B.
Clients with angle-closure glaucoma should not take medications that dilate the pupil because
they can precipitate acute and severely increased IOP. A, C, and D do not cause increased IOP,
which is the primary concern with angle-closure glaucoma.
The nurse is caring for a critically ill client with cirrhosis of the liver who has a NG tube draining
bright red blood. The nurse notes that the client's serum hemoglobin and hematocrit levels are
decreased. Which additional change in laboratory data should the nurse expect?
A) Increased serum albumin level.
B) Decreased serum creatinine.
C) Decreased serum ammonia level.
D) Increased liver function test results.
C.
The breakdown of glutamine in the intestine and the increased activity of colonic bacteria from
the digestion of proteins increase ammonia levels in clients with advanced liver disease, so
removal of blood, a protein source, from the intestine results in a reduced level of ammonia. A,
B, and D will not be significantly affected by the removal of blood.
A resident in a long-term care facility is diagnosed with Hep B. Which intervention should the
nurse implement with the staff caring for this client?
A) Determine if all employees have had the Hep B vaccine series.
B) Explain that this type of hepatitis can be transmitted when feeding the client.
C) Assure the employees that they cannot contract Hep B when providing direct care.
D) Tell the employees that wearing gloves and a gown are required when providing care.
A.
Hep B vaccine should be administered to all health care providers. Hep A (not Hep B) can be
transmitted by fecal-oral contamination. There is a chance that staff could contract Hep B if
exposed to the client's blood and/or body fluids, therefore C is incorrect. There is no need to
wear gloves and gowns except with blood or body fluid contact.
A client with HTN has been receiving ramipril (altace), 5mg, PO, daily for 2 weeks and is
scheduled to receive a dose at 0900. At 0830, the client's blood pressure is 120/70. Which action
should the nurse take?
A) Administer the prescribed dose at the scheduled time.
B) Hold the dose and contact the HCP.
INCLUSIVE TEST BANK ACCURATELY UPDATED
2025 | VERIFIED QUESTIONS AND ANSWERS |
GUARANTEED PASS | HIGHEST LEVEL
A client diagnosed with chronic kidney disease (CKD) 2 years ago is regularly treated at a
community hemodialysis facility. Before his scheduled dialysis treatment, which electrolyte
imbalance should the nurse anticipate?
A) Hypophosphatemia.
B) Hypocalcemia.
C) Hyponatremia.
D) Hypokalemia
B.
Hypocalcemia develops in CKD because of chronic hyperphosphatemia. Increased phosphate
levels cause the peripheral deposition of calcium and resistance to vitamin D absorption needed
for calcium absorption. Prior to dialysis, the nurse would expect to find the client hypernatremic
and hyperkalemic, not with C or D.
The home health nurse is assessing a male client being treated for Parkinson's disease with
Sinemet. The nurse observes that he does not demonstrate any apparent emotion when speaking
and rarely blinks. Which intervention should the nurse implement?
A) Perform a complete cranial nerve assessment.
B) Instruct the client that he may be experiencing medication toxicity.
C) Document the presence of these assessment findings.
D) Advise the client to seek immediate medical evaluation.
C.
A masklike expression and infrequent blinking are common clinical features of parkinsonism.
The nurse should document these expected findings. Signs of toxicity of Sinemet include
dyskinesia, hallucinations, and psychosis.
A client with CHF and Afib develops ventricular ectopy with a pattern of 8 ectopic beats/min.
Which action should the nurse take based on this observation?
A) Assess for bilateral jugular vein distention.
B) Increase oxygen flow via nasal cannula.
C) Administer PRN Lasix.
D) Auscultate for a pleural friction rub.
,B.
The client should have the oxygen flow immediately increased to promote oxygenation of the
,myocardium. Ventricular ectopy, characterized by multiple PVCs, is often caused by myocardial
ischemia exacerbated by hypokalemia.
During the change of shift report, the charge nurse reviews the infusions being received by
clients on the oncology unit. The client receiving which infusion should be assessed first?
A) Continuous IV infusion of magnesium.
B) One-time infusion of albumin.
C) Continuous epidural infusion of morphine.
D) Intermittent infusion of IV vancomycin.
C.
All four of these clients have a potential to have significant complications. The client with the
morphine epidural infusion is at highest risk for respiratory depression and should be assessed
first.
A 25-year-old client was admitted yesterday after a motor vehicle collision. Neurodiagnostic
studies have shown a basal skull fracture in the middle fossa. Assessment on admission revealed
both halo and battle signs. Which new symtom indicates that the client is likely to be
experiencing a common life-threatening complication associated with a basal skull fracture?
A) Bilateral jugular vein distension.
B) Oral temp of 102.
C) Intermittent focal motor seizures.
D) Intractable pain in the cervical region.
B.
Clients with basilar skull fractures are at high risk for infection of the brain, as indicated by an
increased oral temp because the fracture leaves the meninges open to bacterial invasion.
An older client is admitted with a diagnosis of bacterial pneumonia. Which symptom should the
nurse report to the HCP after assessing the client?
A) Leukocytosis and febrile.
B) Polycythemia and crackles.
C) Pharyngitis and sputum production.
D) Confusion and tachycardia.
D.
The onset of Pneumonia in the older client may be signaled by general deterioration, confusion,
increased HR, and/or increased respirations. A, B, and C are often absent in the older client with
bacterial pneumonia.
The nurse is reviewing routine medications taken by a client with chronic angle closure
glaucoma. Which medication prescription should the nurse question?
, A) Antianginal with a therapeutic effect of vasodilation.
B) Anticholinergic with a side effect of pupillary dilation.
C) Antihistamine with a side effect of sedation.
D) Corticosteroid with a side effect of hyperglycemia.
B.
Clients with angle-closure glaucoma should not take medications that dilate the pupil because
they can precipitate acute and severely increased IOP. A, C, and D do not cause increased IOP,
which is the primary concern with angle-closure glaucoma.
The nurse is caring for a critically ill client with cirrhosis of the liver who has a NG tube draining
bright red blood. The nurse notes that the client's serum hemoglobin and hematocrit levels are
decreased. Which additional change in laboratory data should the nurse expect?
A) Increased serum albumin level.
B) Decreased serum creatinine.
C) Decreased serum ammonia level.
D) Increased liver function test results.
C.
The breakdown of glutamine in the intestine and the increased activity of colonic bacteria from
the digestion of proteins increase ammonia levels in clients with advanced liver disease, so
removal of blood, a protein source, from the intestine results in a reduced level of ammonia. A,
B, and D will not be significantly affected by the removal of blood.
A resident in a long-term care facility is diagnosed with Hep B. Which intervention should the
nurse implement with the staff caring for this client?
A) Determine if all employees have had the Hep B vaccine series.
B) Explain that this type of hepatitis can be transmitted when feeding the client.
C) Assure the employees that they cannot contract Hep B when providing direct care.
D) Tell the employees that wearing gloves and a gown are required when providing care.
A.
Hep B vaccine should be administered to all health care providers. Hep A (not Hep B) can be
transmitted by fecal-oral contamination. There is a chance that staff could contract Hep B if
exposed to the client's blood and/or body fluids, therefore C is incorrect. There is no need to
wear gloves and gowns except with blood or body fluid contact.
A client with HTN has been receiving ramipril (altace), 5mg, PO, daily for 2 weeks and is
scheduled to receive a dose at 0900. At 0830, the client's blood pressure is 120/70. Which action
should the nurse take?
A) Administer the prescribed dose at the scheduled time.
B) Hold the dose and contact the HCP.
