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
q q q q q q q q q q q q q q q q
hemodialysisfacility.Beforehisscheduleddialysistreatment,whichelectrolyte imbalance should the
q q q q q q q q q q q q
nurse anticipate?
q q
A) Hypophosphatemia.
B) Hypocalcemia.
C) Hyponatremia.
D) Hypokalemia
B.
Hypocalcemia develops in CKD because of chronic hyperphosphatemia. Increased phosphate levels q q q q q q q q q q
cause the peripheraldeposition of calcium and resistance to vitamin Dabsorption needed forcalcium
q q q q q q q q q q q q q q q
absorption.Priortodialysis,thenurse wouldexpecttofindtheclienthypernatremic and hyperkalemic,
q q q q q q q q q q q q q q q
not with C or D.
q q q q q
The home health nurse is assessing a male client being treated for Parkinson's disease with Sinemet.
q q q q q q q q q q q q q q q
Thenurseobserves thathedoesnotdemonstrateanyapparent emotion whenspeaking and rarely blinks.
q q q q q q q q q q q q q q q q
Which intervention should the nurse implement?
q q q q q q
A) Perform a complete cranial nerveassessment. q q q q q
B) Instructtheclient that he maybe experiencingmedication toxicity.
q q q q q q q q q
C) Documentthe presenceof these assessment findings. q q q q q q
D) Advise theclient to seek immediate medical evaluation. q q q q q q q
C.
Amasklikeexpressionandinfrequentblinkingarecommonclinicalfeaturesofparkinsonism. The
q q q q q q q q q q q q
nurse should document these expected findings. Signs of toxicity of Sinemet include dyskinesia,
q q q q q q q q q q q q q
hallucinations, and psychosis.
q q q
AclientwithCHFandAfib developsventricularectopywith apatternof8 ectopicbeats/min. Which
q q q q q q q q q q q q q q q q
action should the nurse take based on this observation?
q q q q q q q q q
A) Assess for bilateral jugular vein distention. q q q q q
B) Increaseoxygenflowvia nasal cannula. q q q q q
C) AdministerPRN Lasix. q q
D) Auscultate for a pleural friction rub. q q q q q
,B.
Theclient should havethe oxygen flow immediatelyincreased to promote oxygenation of the
q q q q q q q q q q q q q
,myocardium.Ventricularectopy,characterizedbymultiplePVCs,isoftencausedbymyocardial q q q q q q q q q q q
ischemia exacerbated by hypokalemia.
q q q q
Duringthechangeofshift report,thechargenurse reviews theinfusions beingreceivedby clients on the
q q q q q q q q q q q q q q q q q
oncologyunit. The client receiving which infusion should be assessed first?
q q q q q q q q q q q
A) Continuous IVinfusion of magnesium. q q q q
B) One-timeinfusion ofalbumin. q q q
C) Continuous epidural infusion of morphine. q q q q
D) Intermittent infusion of IV vancomycin. q q q q
C.
All four of these clients have a potential to have significant complications. The client with the
q q q q q q q q q q q q q q q
morphineepiduralinfusion isat highest risk for respiratorydepression and shouldbeassessed first.
q q q q q q q q q q q q q q q
A 25-year-old client was admitted yesterday after a motor vehicle collision. Neurodiagnostic studies
q q q q q q q q q q q q
haveshownabasalskullfractureinthemiddlefossa.Assessment onadmissionrevealed both halo and
q q q q q q q q q q q q q q q q q
battle signs. Which new symtom indicates that the client is likely to be experiencing a common life-
q q q q q q q q q q q q q q q q q
threatening complication associated with a basal skull fracture? q q q q q q q
A) Bilateraljugularvein distension. q q q
B) Oral temp of 102. q q q
C) Intermittent focal motorseizures. q q q
D) Intractablepain inthe cervical region. q q q q q
B.
Clients with basilar skull fractures are at high risk for infection of the brain, as indicated by an
q q q q q q q q q q q q q q q q q
increased oral temp because the fracture leaves the meninges open to bacterial invasion.
q q q q q q q q q q q q q
An older client is admitted with a diagnosis of bacterial pneumonia. Which symptom should the nurse
q q q q q q q q q q q q q q q
report to the HCP after assessing the client?
q q q q q q q q
A) Leukocytosisand febrile. q q
B) Polycythemia andcrackles. q q
C) Pharyngitisand sputum production. q q q
D) Confusion and tachycardia. q q
D.
The onset of Pneumonia in the older client may be signaled by general deterioration, confusion,
q q q q q q q q q q q q q q
increased HR, and/or increased respirations. A, B, and C are often absent in the older client with
q q q q q q q q q q q q q q q q q
bacterial pneumonia.
q q
Thenurseisreviewingroutinemedicationstaken bya clientwithchronicangle closure glaucoma.
q q q q q q q q q q q q q q
Which medication prescription should the nurse question?
q q q q q q q
, A) Antianginal with atherapeutic effect of vasodilation. q q q q q q
B) Anticholinergic with aside effect of pupillarydilation. q q q q q q q
C) Antihistamine with a side effect ofsedation. q q q q q q
D) Corticosteroid with a side effect of hyperglycemia. q q q q q q
B.
Clients with angle-closure glaucoma should not take medications that dilate the pupil because theycan
q q q q q q q q q q q q q q
precipitateacuteandseverelyincreased IOP.A,C,andDdonotcauseincreased IOP, which is the
q q q q q q q q q q q q q q q q q q
primary concern with angle-closure glaucoma.
q q q q q
Thenurseis caringfora criticallyillclient with cirrhosis oftheliverwho hasaNGtubedraining bright red
q q q q q q q q q q q q q q q q q q q q q
blood. The nurse notes that the client's serum hemoglobin and hematocrit levels are decreased. Which
q q q q q q q q q q q q q q q
additional change in laboratory data should the nurse expect?
q q q q q q q q q
A) Increasedserumalbumin level. q q q
B) Decreasedserum creatinine. q q
C) Decreasedserum ammonia level. q q q
D) Increasedliverfunction test results. q q q q
C.
Thebreakdownof glutamineintheintestineand theincreased activityofcolonicbacteriafrom the
q q q q q q q q q q q q q q q
digestion of proteins increase ammonia levels in clients with advanced liver disease, so removalof
q q q q q q q q q q q q q q q
blood,aproteinsource,fromtheintestineresults inareducedlevelofammonia.A, B, and D will not be
q q q q q q q q q q q q q q q q q q q q q
significantly affected by the removal of blood.
q q q q q q q
Aresidentinalong-term carefacilityisdiagnosed withHepB.Whichinterventionshouldthe nurse
q q q q q q q q q q q q q q q q
implement with the staff caring for this client?
q q q q q q q q
A) Determineif all employees have had theHep B vaccine series. q q q q q q q q q q
B) Explainthatthis typeof hepatitis can betransmitted when feedingthe client. q q q q q q q q q q q q
C) Assurethe employees that theycannot contract Hep B when providingdirect care.
q q q q q q q q q q q q
D) Tellthe employees that wearing gloves anda gown arerequired when providingcare.
q q q q q q q q q q q q q
A.
HepBvaccineshouldbe administeredtoallhealthcareproviders.HepA(not HepB)canbe transmitted
q q q q q q q q q q q q q q q q q q
by fecal-oral contamination. There is a chance that staff could contract Hep B if exposed to the client's
q q q q q q q q q q q q q q q q q q
blood and/or bodyfluids, therefore C is incorrect. There is no need to wear gloves and gowns except
q q q q q q q q q q q q q q q q q q
with blood or body fluid contact.
q q q q q q
A client with HTN has been receiving ramipril (altace), 5mg, PO, daily for 2 weeks and is scheduledto
q q q q q q q q q q q q q q q q q q
receiveadoseat0900.At 0830,theclient's blood pressureis120/70.Whichaction should the nurse take?
q q q q q q q q q q q q q q q q q q q
A) Administerthe prescribed dose at the scheduled time. q q q q q q q
B) Hold the dose and contact the HCP. q q q q q q
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
q q q q q q q q q q q q q q q q
hemodialysisfacility.Beforehisscheduleddialysistreatment,whichelectrolyte imbalance should the
q q q q q q q q q q q q
nurse anticipate?
q q
A) Hypophosphatemia.
B) Hypocalcemia.
C) Hyponatremia.
D) Hypokalemia
B.
Hypocalcemia develops in CKD because of chronic hyperphosphatemia. Increased phosphate levels q q q q q q q q q q
cause the peripheraldeposition of calcium and resistance to vitamin Dabsorption needed forcalcium
q q q q q q q q q q q q q q q
absorption.Priortodialysis,thenurse wouldexpecttofindtheclienthypernatremic and hyperkalemic,
q q q q q q q q q q q q q q q
not with C or D.
q q q q q
The home health nurse is assessing a male client being treated for Parkinson's disease with Sinemet.
q q q q q q q q q q q q q q q
Thenurseobserves thathedoesnotdemonstrateanyapparent emotion whenspeaking and rarely blinks.
q q q q q q q q q q q q q q q q
Which intervention should the nurse implement?
q q q q q q
A) Perform a complete cranial nerveassessment. q q q q q
B) Instructtheclient that he maybe experiencingmedication toxicity.
q q q q q q q q q
C) Documentthe presenceof these assessment findings. q q q q q q
D) Advise theclient to seek immediate medical evaluation. q q q q q q q
C.
Amasklikeexpressionandinfrequentblinkingarecommonclinicalfeaturesofparkinsonism. The
q q q q q q q q q q q q
nurse should document these expected findings. Signs of toxicity of Sinemet include dyskinesia,
q q q q q q q q q q q q q
hallucinations, and psychosis.
q q q
AclientwithCHFandAfib developsventricularectopywith apatternof8 ectopicbeats/min. Which
q q q q q q q q q q q q q q q q
action should the nurse take based on this observation?
q q q q q q q q q
A) Assess for bilateral jugular vein distention. q q q q q
B) Increaseoxygenflowvia nasal cannula. q q q q q
C) AdministerPRN Lasix. q q
D) Auscultate for a pleural friction rub. q q q q q
,B.
Theclient should havethe oxygen flow immediatelyincreased to promote oxygenation of the
q q q q q q q q q q q q q
,myocardium.Ventricularectopy,characterizedbymultiplePVCs,isoftencausedbymyocardial q q q q q q q q q q q
ischemia exacerbated by hypokalemia.
q q q q
Duringthechangeofshift report,thechargenurse reviews theinfusions beingreceivedby clients on the
q q q q q q q q q q q q q q q q q
oncologyunit. The client receiving which infusion should be assessed first?
q q q q q q q q q q q
A) Continuous IVinfusion of magnesium. q q q q
B) One-timeinfusion ofalbumin. q q q
C) Continuous epidural infusion of morphine. q q q q
D) Intermittent infusion of IV vancomycin. q q q q
C.
All four of these clients have a potential to have significant complications. The client with the
q q q q q q q q q q q q q q q
morphineepiduralinfusion isat highest risk for respiratorydepression and shouldbeassessed first.
q q q q q q q q q q q q q q q
A 25-year-old client was admitted yesterday after a motor vehicle collision. Neurodiagnostic studies
q q q q q q q q q q q q
haveshownabasalskullfractureinthemiddlefossa.Assessment onadmissionrevealed both halo and
q q q q q q q q q q q q q q q q q
battle signs. Which new symtom indicates that the client is likely to be experiencing a common life-
q q q q q q q q q q q q q q q q q
threatening complication associated with a basal skull fracture? q q q q q q q
A) Bilateraljugularvein distension. q q q
B) Oral temp of 102. q q q
C) Intermittent focal motorseizures. q q q
D) Intractablepain inthe cervical region. q q q q q
B.
Clients with basilar skull fractures are at high risk for infection of the brain, as indicated by an
q q q q q q q q q q q q q q q q q
increased oral temp because the fracture leaves the meninges open to bacterial invasion.
q q q q q q q q q q q q q
An older client is admitted with a diagnosis of bacterial pneumonia. Which symptom should the nurse
q q q q q q q q q q q q q q q
report to the HCP after assessing the client?
q q q q q q q q
A) Leukocytosisand febrile. q q
B) Polycythemia andcrackles. q q
C) Pharyngitisand sputum production. q q q
D) Confusion and tachycardia. q q
D.
The onset of Pneumonia in the older client may be signaled by general deterioration, confusion,
q q q q q q q q q q q q q q
increased HR, and/or increased respirations. A, B, and C are often absent in the older client with
q q q q q q q q q q q q q q q q q
bacterial pneumonia.
q q
Thenurseisreviewingroutinemedicationstaken bya clientwithchronicangle closure glaucoma.
q q q q q q q q q q q q q q
Which medication prescription should the nurse question?
q q q q q q q
, A) Antianginal with atherapeutic effect of vasodilation. q q q q q q
B) Anticholinergic with aside effect of pupillarydilation. q q q q q q q
C) Antihistamine with a side effect ofsedation. q q q q q q
D) Corticosteroid with a side effect of hyperglycemia. q q q q q q
B.
Clients with angle-closure glaucoma should not take medications that dilate the pupil because theycan
q q q q q q q q q q q q q q
precipitateacuteandseverelyincreased IOP.A,C,andDdonotcauseincreased IOP, which is the
q q q q q q q q q q q q q q q q q q
primary concern with angle-closure glaucoma.
q q q q q
Thenurseis caringfora criticallyillclient with cirrhosis oftheliverwho hasaNGtubedraining bright red
q q q q q q q q q q q q q q q q q q q q q
blood. The nurse notes that the client's serum hemoglobin and hematocrit levels are decreased. Which
q q q q q q q q q q q q q q q
additional change in laboratory data should the nurse expect?
q q q q q q q q q
A) Increasedserumalbumin level. q q q
B) Decreasedserum creatinine. q q
C) Decreasedserum ammonia level. q q q
D) Increasedliverfunction test results. q q q q
C.
Thebreakdownof glutamineintheintestineand theincreased activityofcolonicbacteriafrom the
q q q q q q q q q q q q q q q
digestion of proteins increase ammonia levels in clients with advanced liver disease, so removalof
q q q q q q q q q q q q q q q
blood,aproteinsource,fromtheintestineresults inareducedlevelofammonia.A, B, and D will not be
q q q q q q q q q q q q q q q q q q q q q
significantly affected by the removal of blood.
q q q q q q q
Aresidentinalong-term carefacilityisdiagnosed withHepB.Whichinterventionshouldthe nurse
q q q q q q q q q q q q q q q q
implement with the staff caring for this client?
q q q q q q q q
A) Determineif all employees have had theHep B vaccine series. q q q q q q q q q q
B) Explainthatthis typeof hepatitis can betransmitted when feedingthe client. q q q q q q q q q q q q
C) Assurethe employees that theycannot contract Hep B when providingdirect care.
q q q q q q q q q q q q
D) Tellthe employees that wearing gloves anda gown arerequired when providingcare.
q q q q q q q q q q q q q
A.
HepBvaccineshouldbe administeredtoallhealthcareproviders.HepA(not HepB)canbe transmitted
q q q q q q q q q q q q q q q q q q
by fecal-oral contamination. There is a chance that staff could contract Hep B if exposed to the client's
q q q q q q q q q q q q q q q q q q
blood and/or bodyfluids, therefore C is incorrect. There is no need to wear gloves and gowns except
q q q q q q q q q q q q q q q q q q
with blood or body fluid contact.
q q q q q q
A client with HTN has been receiving ramipril (altace), 5mg, PO, daily for 2 weeks and is scheduledto
q q q q q q q q q q q q q q q q q q
receiveadoseat0900.At 0830,theclient's blood pressureis120/70.Whichaction should the nurse take?
q q q q q q q q q q q q q q q q q q q
A) Administerthe prescribed dose at the scheduled time. q q q q q q q
B) Hold the dose and contact the HCP. q q q q q q
