MED SURG PRACTICE HESI EXAM
WITH 100% CORRECT ANSWERS
2025/2026
The nurse is assessing a client's lab values following admin of
chemo. Which lab value leads the nurse to suspect that the client
is experiencing tumor lysis syndrome (TLS)? correct answers
>> Serum Ca+ of 5mg/dL
TLS results in hyperkalemia, hypocalcemia, hyperuricemia, and
hyperphosphatemia. A serum Ca+ level of 5 is low, is an indicator
or possible tumor lyss syndrome.
A client is admitted to the hospital w/ a dx of severe acute
diverticulitis. Which assessment finding should the nurse expect
this client to exhibit? correct answers >> Lower Left
quadrant pain and a low grade fever
LLQ pain occurs w/ diverticulitis because the sigmoid colon is the
most common area for diverticula, and the inflammation of
diverticula causes a low grad fever
During CPR, when attempting to ventilate a client's lungs, the
nurse notes that the chest is not moving. What action should the
nurse take 1st? correct answers >> Reposition the head to
validate that the head is in the proper position to open the airway
,The most frequent cause of inadequate aeration of the client's
lungs during CPR is improper positioning of the head resulting in
occlusion of the airway
A client is admitted to the hospital w/ a med dx of pneumococcal
pneumonia. The nurse knows that the prognosis for gram-neg
pneumonias (like E.coli, Klebsiella, Pseudomonas, and Proteus) is
very poor because correct answers >> The gram-neg
organisms are more resistant to abx therapy
The gram-neg organisms are resistant to drug therapy
A client is placed on a mechanical vent following a cerebral
hemorrhage, and vecuronium bromide (Norcuron) 0.04mg/kg q
12h IV is prescribed. What is the priority nsg dx for this client?
correct answers >> Impaired communication r/t paralysis of
skeletal muscles
To increase the client's tolerance of endotracheal intubation and /
or mechanical ventilation, a skeletal-muscle relaxant, such as
vecuronium, is usually prescribed. Impaired communication is a
serious outcome because the client cannot communicate their
needs due to intubation and diaphragmatic paralysis caused by
the drug.
When preparing a client who has had a total laryngectomy for DC,
what instruction is most important for the nurse to include in the
DC teaching? correct answers >> Tell the client to carry a
med alert card stating that he is a total neck breather
,It is imperative that total neck breathers carry a med alert notice
so that if they have a cardiac arrest, mouth to neck breathing can
be done. Mouth to mouth resuscitation measures will not help
them
The nurse would be correct in w/holding a dose of Digoxin in a
client w/ CHF w/out specific instruction for the HCP if the client's
correct answers >> serum K+ is 3
Hypokalemia can precipitate digitalis toxicity in persons receiving
Digoxin which will increase the chance of dangerous
dysrhythmias. Normal K+ is 3.5-5mgEq/L. The therapeutic range
for Digoxin is 0.8 - 2 ng/mL
After the 4th dose of gentamicin sulfate (Garamycin) IV, the nurse
plans to draw blood samples to determine peak and trough levels.
When are the best times to draw these samples? correct
answers >> 5 minutes b/f and 30 minutes after the next dose
Peak drug serum levels are achieved 30 minutes after IV admin of
aminoglycosides. The best time to draw a trough is the closest
time to the next administration
A client has undergone insertion of a permanent PM. When dvp'g
a DC teaching plan, the nurse writes a goal of "The client will
verbalize sx of PM failure". Which sx are the most important to
teach the client? correct answers >> Feelings of dizziness
Feelings of dizziness may occur as the result of a decreased HR,
leading to decreased CO
, The client w/ heart disease is on a continuous tele monitor and
has dvp'd sinus bradycardia. In determining the possible causes
of the bradycardia, the nurse assesses the client's med record.
Which mid is most likely the cause of the bradycardia? correct
answers >> Propanolol (Inderal)
Inderal (Propanolol) is a beta adrenergic blocking agent, which
causes decreased HR and decreased contractility.
In preparing a DC plan for a 22 yr old male client dx'd w/ Bueger's
disease (thromboangitis obliterans), which referral is most
important? correct answers >> Smoking cessation program
Buerger's disease is strongly r/t smoking. The most effective
means of controlling sx and disease progression is trough
smoking cessation. the cause is unknown
Which sx's should the nurse expect a client to exhibit who is dx'd
w/ a pheochromocytoma? correct answers >> HA,
diaphoresis, and palpitations
Pheochromocytoma is a catecholamine secreting tumor of the
adrenal medulla, and these sx are the typical triad of sx
depending upon the relative proportions of epi and norep
secretion
In assessing a client dx w/ primary hyperaldosteronism, the nurse
expects the lab test results to indicate a decreased serum level of
correct answers >> K+
WITH 100% CORRECT ANSWERS
2025/2026
The nurse is assessing a client's lab values following admin of
chemo. Which lab value leads the nurse to suspect that the client
is experiencing tumor lysis syndrome (TLS)? correct answers
>> Serum Ca+ of 5mg/dL
TLS results in hyperkalemia, hypocalcemia, hyperuricemia, and
hyperphosphatemia. A serum Ca+ level of 5 is low, is an indicator
or possible tumor lyss syndrome.
A client is admitted to the hospital w/ a dx of severe acute
diverticulitis. Which assessment finding should the nurse expect
this client to exhibit? correct answers >> Lower Left
quadrant pain and a low grade fever
LLQ pain occurs w/ diverticulitis because the sigmoid colon is the
most common area for diverticula, and the inflammation of
diverticula causes a low grad fever
During CPR, when attempting to ventilate a client's lungs, the
nurse notes that the chest is not moving. What action should the
nurse take 1st? correct answers >> Reposition the head to
validate that the head is in the proper position to open the airway
,The most frequent cause of inadequate aeration of the client's
lungs during CPR is improper positioning of the head resulting in
occlusion of the airway
A client is admitted to the hospital w/ a med dx of pneumococcal
pneumonia. The nurse knows that the prognosis for gram-neg
pneumonias (like E.coli, Klebsiella, Pseudomonas, and Proteus) is
very poor because correct answers >> The gram-neg
organisms are more resistant to abx therapy
The gram-neg organisms are resistant to drug therapy
A client is placed on a mechanical vent following a cerebral
hemorrhage, and vecuronium bromide (Norcuron) 0.04mg/kg q
12h IV is prescribed. What is the priority nsg dx for this client?
correct answers >> Impaired communication r/t paralysis of
skeletal muscles
To increase the client's tolerance of endotracheal intubation and /
or mechanical ventilation, a skeletal-muscle relaxant, such as
vecuronium, is usually prescribed. Impaired communication is a
serious outcome because the client cannot communicate their
needs due to intubation and diaphragmatic paralysis caused by
the drug.
When preparing a client who has had a total laryngectomy for DC,
what instruction is most important for the nurse to include in the
DC teaching? correct answers >> Tell the client to carry a
med alert card stating that he is a total neck breather
,It is imperative that total neck breathers carry a med alert notice
so that if they have a cardiac arrest, mouth to neck breathing can
be done. Mouth to mouth resuscitation measures will not help
them
The nurse would be correct in w/holding a dose of Digoxin in a
client w/ CHF w/out specific instruction for the HCP if the client's
correct answers >> serum K+ is 3
Hypokalemia can precipitate digitalis toxicity in persons receiving
Digoxin which will increase the chance of dangerous
dysrhythmias. Normal K+ is 3.5-5mgEq/L. The therapeutic range
for Digoxin is 0.8 - 2 ng/mL
After the 4th dose of gentamicin sulfate (Garamycin) IV, the nurse
plans to draw blood samples to determine peak and trough levels.
When are the best times to draw these samples? correct
answers >> 5 minutes b/f and 30 minutes after the next dose
Peak drug serum levels are achieved 30 minutes after IV admin of
aminoglycosides. The best time to draw a trough is the closest
time to the next administration
A client has undergone insertion of a permanent PM. When dvp'g
a DC teaching plan, the nurse writes a goal of "The client will
verbalize sx of PM failure". Which sx are the most important to
teach the client? correct answers >> Feelings of dizziness
Feelings of dizziness may occur as the result of a decreased HR,
leading to decreased CO
, The client w/ heart disease is on a continuous tele monitor and
has dvp'd sinus bradycardia. In determining the possible causes
of the bradycardia, the nurse assesses the client's med record.
Which mid is most likely the cause of the bradycardia? correct
answers >> Propanolol (Inderal)
Inderal (Propanolol) is a beta adrenergic blocking agent, which
causes decreased HR and decreased contractility.
In preparing a DC plan for a 22 yr old male client dx'd w/ Bueger's
disease (thromboangitis obliterans), which referral is most
important? correct answers >> Smoking cessation program
Buerger's disease is strongly r/t smoking. The most effective
means of controlling sx and disease progression is trough
smoking cessation. the cause is unknown
Which sx's should the nurse expect a client to exhibit who is dx'd
w/ a pheochromocytoma? correct answers >> HA,
diaphoresis, and palpitations
Pheochromocytoma is a catecholamine secreting tumor of the
adrenal medulla, and these sx are the typical triad of sx
depending upon the relative proportions of epi and norep
secretion
In assessing a client dx w/ primary hyperaldosteronism, the nurse
expects the lab test results to indicate a decreased serum level of
correct answers >> K+
