PN Medical Surgical HESI Exam 2025/2026__ Prep
Test Bank With 200 Real Exam Practice Questions
and Correct Answers with Rationales/ PN Hesi Med
Surg Exam 2025—2026/ Evolve Med Surg (PN)
When educating a client after a total laryngectomy, which instruction would be most
important for the nurse to include in the discharge teaching?
A. Recommend that the client carry suction equipment at all times.
B. Instruct the client to have writing materials with him at all times.
C. Tell the client to carry a medical alert card that explains his condition.
D. Caution the client not to travel outside the United States alone.
C
Rationale: Neck breathers carry a medical alert card that notifies health care personnel
of the need to use mouth to stoma breathing in the event of a cardiac arrest in this
client. Mouth to mouth resuscitation will not establish a patent airway. Options A and
D are not necessary. There are many alternative means of communication for clients
who have had a laryngectomy; dependence on writing messages is probably the least
effective.
The nurse receives the client's next scheduled bag of TPN labeled with the additive
NPH insulin. Which action should the nurse implement?
A. Hang the solution at the current rate.
B. Refrigerate the solution until needed.
1
,C.Prepare the solution with new tubing.
D.Return the solution to the pharmacy.
D
Rationale: Only regular insulin is administered by the IV route, so the TPN solution
containing NPH insulin should be returned to the pharmacy. Options A, B, and C are
not indicated because the solution should not be administered.
We have an expert-written solution to this problem!
A postoperative client receives a Schedule II opioid analgesic for pain. Which
assessment finding requires the most immediate intervention by the nurse?
A. Hypoactive bowel sounds with abdominal distention
B. Client reports continued pain of 8 on a 10-point scale
C. Respiratory rate of 12 breaths/min, with O2 saturation of 85%
D. Client reports nausea after receiving the medication
C
Rationale: Administration of a Schedule II opioid analgesic can result in respiratory
depression, which requires immediate intervention by the nurse to prevent respiratory
arrest. Options A, B, and D require action by the nurse but are of less priority than
option C.
2
,A client is placed on a mechanical ventilator following a cerebral hemorrhage, and
vecuronium bromide, 0.04 mg/kg every 12 hours IV, is prescribed. What is the priority
nursing diagnosis for this client?
A. Impaired communication related to paralysis of skeletal muscles
B. High risk for infection related to increased intracranial pressure
C. Potential for injury related to impaired lung expansion
D. Social isolation related to inability to communicate
A
Rationale:To increase the client's tolerance of endotracheal intubation and/or
mechanical ventilation, a skeletal muscle relaxant such as vecuronium is usually
prescribed. Option A is a serious outcome because the client cannot communicate his
or her needs. Although this client might also experience option D, it is not a priority
when compared with option A. Infection is not related to increased intracranial
pressure. The respirator will ensure that the lungs are expanded, so option C is
incorrect.
A family member was taught to suction a client's tracheostomy prior to the client's
discharge from the hospital. Which observation by the nurse indicates that the family
member is capable of correctly performing the suctioning technique?
A. Turns on the continuous wall suction to 190 mm Hg.
B. Inserts the catheter until resistance or coughing occurs.
C. Withdraws the catheter while maintaining suctioning.
D. Reclears the tracheostomy after suctioning the mouth.
B
3
, Rationale:Option B indicates correct technique for performing suctioning. Suction
pressure should be between 80 and 120 mm Hg, not 190 mm Hg. The catheter should
be withdrawn 1 to 2 cm at a time with intermittent, not continuous, suction. Option D
introduces pathogens unnecessarily into the tracheobronchial tree.
A client is diagnosed with an acute small bowel obstruction. Which assessment
finding requires the most immediate intervention by the nurse?
A. Fever of 102° F
B. Blood pressure of 150/90 mm Hg
C. Abdominal cramping
D. Dry mucous membranes
A
Rationale:A sudden increase in temperature is an indicator of peritonitis. The nurse
should notify the health care provider immediately. Options B, C, and D are also
findings that require intervention by the nurse but are of less priority than option A.
Option B may indicate a hypertensive condition but is not as acute a condition as
peritonitis. Option C is an expected finding in clients with small bowel obstruction
and may require medication. Option D indicates probable fluid volume deficit, which
requires fluid volume replacement.
In assessing a client diagnosed with primary aldosteronism, the nurse expects the
laboratory test results to indicate a decreased serum level of which substance?
A. Sodium
B. Phosphate
4
Test Bank With 200 Real Exam Practice Questions
and Correct Answers with Rationales/ PN Hesi Med
Surg Exam 2025—2026/ Evolve Med Surg (PN)
When educating a client after a total laryngectomy, which instruction would be most
important for the nurse to include in the discharge teaching?
A. Recommend that the client carry suction equipment at all times.
B. Instruct the client to have writing materials with him at all times.
C. Tell the client to carry a medical alert card that explains his condition.
D. Caution the client not to travel outside the United States alone.
C
Rationale: Neck breathers carry a medical alert card that notifies health care personnel
of the need to use mouth to stoma breathing in the event of a cardiac arrest in this
client. Mouth to mouth resuscitation will not establish a patent airway. Options A and
D are not necessary. There are many alternative means of communication for clients
who have had a laryngectomy; dependence on writing messages is probably the least
effective.
The nurse receives the client's next scheduled bag of TPN labeled with the additive
NPH insulin. Which action should the nurse implement?
A. Hang the solution at the current rate.
B. Refrigerate the solution until needed.
1
,C.Prepare the solution with new tubing.
D.Return the solution to the pharmacy.
D
Rationale: Only regular insulin is administered by the IV route, so the TPN solution
containing NPH insulin should be returned to the pharmacy. Options A, B, and C are
not indicated because the solution should not be administered.
We have an expert-written solution to this problem!
A postoperative client receives a Schedule II opioid analgesic for pain. Which
assessment finding requires the most immediate intervention by the nurse?
A. Hypoactive bowel sounds with abdominal distention
B. Client reports continued pain of 8 on a 10-point scale
C. Respiratory rate of 12 breaths/min, with O2 saturation of 85%
D. Client reports nausea after receiving the medication
C
Rationale: Administration of a Schedule II opioid analgesic can result in respiratory
depression, which requires immediate intervention by the nurse to prevent respiratory
arrest. Options A, B, and D require action by the nurse but are of less priority than
option C.
2
,A client is placed on a mechanical ventilator following a cerebral hemorrhage, and
vecuronium bromide, 0.04 mg/kg every 12 hours IV, is prescribed. What is the priority
nursing diagnosis for this client?
A. Impaired communication related to paralysis of skeletal muscles
B. High risk for infection related to increased intracranial pressure
C. Potential for injury related to impaired lung expansion
D. Social isolation related to inability to communicate
A
Rationale:To increase the client's tolerance of endotracheal intubation and/or
mechanical ventilation, a skeletal muscle relaxant such as vecuronium is usually
prescribed. Option A is a serious outcome because the client cannot communicate his
or her needs. Although this client might also experience option D, it is not a priority
when compared with option A. Infection is not related to increased intracranial
pressure. The respirator will ensure that the lungs are expanded, so option C is
incorrect.
A family member was taught to suction a client's tracheostomy prior to the client's
discharge from the hospital. Which observation by the nurse indicates that the family
member is capable of correctly performing the suctioning technique?
A. Turns on the continuous wall suction to 190 mm Hg.
B. Inserts the catheter until resistance or coughing occurs.
C. Withdraws the catheter while maintaining suctioning.
D. Reclears the tracheostomy after suctioning the mouth.
B
3
, Rationale:Option B indicates correct technique for performing suctioning. Suction
pressure should be between 80 and 120 mm Hg, not 190 mm Hg. The catheter should
be withdrawn 1 to 2 cm at a time with intermittent, not continuous, suction. Option D
introduces pathogens unnecessarily into the tracheobronchial tree.
A client is diagnosed with an acute small bowel obstruction. Which assessment
finding requires the most immediate intervention by the nurse?
A. Fever of 102° F
B. Blood pressure of 150/90 mm Hg
C. Abdominal cramping
D. Dry mucous membranes
A
Rationale:A sudden increase in temperature is an indicator of peritonitis. The nurse
should notify the health care provider immediately. Options B, C, and D are also
findings that require intervention by the nurse but are of less priority than option A.
Option B may indicate a hypertensive condition but is not as acute a condition as
peritonitis. Option C is an expected finding in clients with small bowel obstruction
and may require medication. Option D indicates probable fluid volume deficit, which
requires fluid volume replacement.
In assessing a client diagnosed with primary aldosteronism, the nurse expects the
laboratory test results to indicate a decreased serum level of which substance?
A. Sodium
B. Phosphate
4
