HESI MEDSURG EXAM PACK 4 VERSIONS ALL INCLUSIVE TEST BANK ACCURATELY UPDATED 2025 | VERIFIED QUESTIONS AND ANSWERS | GUARANTEED PASS | HIGHEST LEVEL

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
C C C C C C C C C C C C C C C




community hemodialysis facility. Before his scheduled dialysis treatment, which electrolyte
C C C C C C C C C C




imbalance should the nurse anticipate?
C C C C C




A) Hypophosphatemia.
B) Hypocalcemia.
C) Hyponatremia.
D) Hypokalemia
B.
C




Hypocalcemia develops in CKD because of chronic hyperphosphatemia. Increased phosphate
C C C C C C C C C




levels cause the peripheral deposition of calcium and resistance to vitamin D absorption needed for
C C C C C C C C C C C C C C C




calcium absorption. Prior to dialysis, the nurse would expect to find the client hypernatremic and
C C C C C C C C C C C C C C C




hyperkalemic, not with C or D.
C C C C C C




The home health nurse is assessing a male client being treated for Parkinson's disease with Sinemet.
C C C C C C C C C C C C C C C




The nurse observes that he does not demonstrate any apparent emotion when speaking and rarely
C C C C C C C C C C C C C C C




blinks. Which intervention should the nurse implement?
C C C C C C C




A) Perform a complete cranial nerve assessment. C C C C C




B) Instruct the client that he may be experiencing medication toxicity.
C C C C C C C C C




C) Document the presence of these assessment findings. C C C C C C




D) Advise the client to seek immediate medical evaluation. C.
C C C C C C C C




A masklike expression and infrequent blinking are common clinical features of parkinsonism. The
C C C C C C C C C C C C




nurse should document these expected findings. Signs of toxicity of Sinemet include dyskinesia,
C C C C C C C C C C C C C




hallucinations, and psychosis.
C C C




A client with CHF and Afib develops ventricular ectopy with a pattern of 8 ectopic beats/min.
C C C C C C C C C C C C C C C




Which action should the nurse take based on this observation?
C C C C C C C C C C




A) Assess for bilateral jugular vein distention.
C C C C C




B) Increase oxygen flow via nasal cannula. C C C C C




C) Administer PRN Lasix. C C




D) Auscultate for a pleural friction rub. C C C C C

,B.
The client should have the oxygen flow immediately increased to promote oxygenation of the
C C C C C C C C C C C C C

,myocardium. Ventricular ectopy, characterized by multiple PVCs, is often caused by myocardial
C C C C C C C C C C C




ischemia exacerbated by hypokalemia.
C C C C




During the change of shift report, the charge nurse reviews the infusions being received by clients on
C C C C C C C C C C C C C C C C




the oncology unit. The client receiving which infusion should be assessed first?
C C C C C C C C C C C C




A) Continuous IV infusion of magnesium. C C C C




B) One-time infusion of albumin. C C C




C) Continuous epidural infusion of morphine. C C C C




D) Intermittent infusion of IV vancomycin. C C C C




C.
C




All four of these clients have a potential to have significant complications. The client with the
C C C C C C C C C C C C C C C




morphine epidural infusion is at highest risk for respiratory depression and should be assessed
C C C C C C C C C C C C C C




first.
C




A 25-year-old client was admitted yesterday after a motor vehicle collision. Neurodiagnostic
C C C C C C C C C C C




studies have shown a basal skull fracture in the middle fossa. Assessment on admission revealed
C C C C C C C C C C C C C C C




both halo and battle signs. Which new symtom indicates that the client is likely to be experiencing a
C C C C C C C C C C C C C C C C C C




common life-threatening complication associated with a basal skull fracture?
C C C C C C C C C




A) Bilateral jugular vein distension. C C C




B) Oral temp of 102. C C C




C) Intermittent focal motor seizures. C C C




D) Intractable pain in the cervical region. C C C C C




B.
C




Clients with basilar skull fractures are at high risk for infection of the brain, as indicated by an
C C C C C C C C C C C C C C C C C




increased oral temp because the fracture leaves the meninges open to bacterial invasion.
C C C C C C C C C C C C C




An older client is admitted with a diagnosis of bacterial pneumonia. Which symptom should the
C C C C C C C C C C C C C C




nurse report to the HCP after assessing the client?
C C C C C C C C C




A) Leukocytosis and febrile. C C




B) Polycythemia and crackles. C C




C) Pharyngitis and sputum production. C C C




D) Confusion and tachycardia. C C




D.
C




The onset of Pneumonia in the older client may be signaled by general deterioration, confusion,
C C C C C C C C C C C C C C




increased HR, and/or increased respirations. A, B, and C are often absent in the older client with
C C C C C C C C C C C C C C C C C




bacterial pneumonia.
C C




The nurse is reviewing routine medications taken by a client with chronic angle closure
C C C C C C C C C C C C C




glaucoma. Which medication prescription should the nurse question?
C C C C C C C C

, A) Antianginal with a therapeutic effect of vasodilation. C C C C C C




B) Anticholinergic with a side effect of pupillary dilation. C C C C C C C




C) Antihistamine with a side effect of sedation. C C C C C C




D) Corticosteroid with a side effect of hyperglycemia. C C C C C C




B.
C




Clients with angle-closure glaucoma should not take medications that dilate the pupil because they
C C C C C C C C C C C C C




can precipitate acute and severely increased IOP. A, C, and D do not cause increased IOP, which is
C C C C C C C C C C C C C C C C C C




the primary concern with angle-closure glaucoma.
C C C C C C




The nurse is caring for a critically ill client with cirrhosis of the liver who has a NG tube draining
C C C C C C C C C C C C C C C C C C C




bright red blood. The nurse notes that the client's serum hemoglobin and hematocrit levels are
C C C C C C C C C C C C C C C




decreased. Which additional change in laboratory data should the nurse expect?
C C C C C C C C C C C




A) Increased serum albumin level. C C C




B) Decreased serum creatinine. C C




C) Decreased serum ammonia level. C C C




D) Increased liver function test results. C C C C




C.
C




The breakdown of glutamine in the intestine and the increased activity of colonic bacteria from the
C C C C C C C C C C C C C C C




digestion of proteins increase ammonia levels in clients with advanced liver disease, so removal of
C C C C C C C C C C C C C C C




blood, a protein source, from the intestine results in a reduced level of ammonia. A, B, and D will
C C C C C C C C C C C C C C C C C C C




not be significantly affected by the removal of blood.
C C C C C C C C C




A resident in a long-term care facility is diagnosed with Hep B. Which intervention should the nurse
C C C C C C C C C C C C C C C C




implement with the staff caring for this client?
C C C C C C C C




A) Determine if all employees have had the Hep B vaccine series. C C C C C C C C C C




B) Explain that this type of hepatitis can be transmitted when feeding the client.
C C C C C C C C C C C C




C) Assure the employees that they cannot contract Hep B when providing direct care.
C C C C C C C C C C C C




D) Tell the employees that wearing gloves and a gown are required when providing care. A.
C C C C C C C C C C C C C C




Hep B vaccine should be administered to all health care providers. Hep A (not Hep B) can be
C C C C C C C C C C C C C C C C C




transmitted by fecal-oral contamination. There is a chance that staff could contract Hep B if
C C C C C C C C C C C C C C C




exposed to the client's blood and/or body fluids, therefore C is incorrect. There is no need to wear
C C C C C C C C C C C C C C C C C C




gloves and gowns except with blood or body fluid contact.
C C C C C C C C C C




A client with HTN has been receiving ramipril (altace), 5mg, PO, daily for 2 weeks and is scheduled
C C C C C C C C C C C C C C C C C




to receive a dose at 0900. At 0830, the client's blood pressure is 120/70. Which action should the
C C C C C C C C C C C C C C C C C C




nurse take?
C C




A) Administer the prescribed dose at the scheduled time. C C C C C C C




B) Hold the dose and contact the HCP. C C C C C C