MED SURG HESI V1 EXAMINATION TEST 2026
FULL SOLVED QUESTIONS AND SOLUTIONS
◉ A client with a 16-year history of diabetes mellitus is having renal
function tests because of recent fatigue, weakness, elevated blood
urea nitrogen, and serum creatinine levels. Which finding should the
nurse conclude as an early symptom of renal insufficiency?
Dyspnea
Nocturia
Confusion.
Stomatitis. Answer: Nocturia
As the glomerular filtration rate decreases in early renal
insufficiency, metabolic waste products, including urea, creatinine,
and other substances, such as phenols, hormones, and electrolytes,
accumulate in the blood. In the early stage of renal insufficiency,
polyuria results from the inability of the kidneys to concentrate
urine and contributes to nocturia.
◉ An elderly client is admitted with a diagnosis of bacterial
pneumonia. When observing the client for the first signs of
decreasing oxygenation, the nurse should assess for which clinical
cues?
,Abominal distention.
Undue fatigue.
Cyanosis of the lips.
Confusion and tachycardia. Answer: Confusion and tachycardia
The onset of pneumonia in the elderly may be signaled by general
deterioration, confusion, increased heart rate or increased
respiratory rate due to the decreased oxygen- carbon dioxide
exchange at the alveoli, known as the V-Q mismatch. Cyanosis is a
very late sign.
◉ During suctioning, a client with an uncuffed tracheostomy tube
begins to cough violently and dislodges the tracheostomy tube.
Which action should the nurse implement first?
Notify the healthcare provider for reinsertion.
Attempt to reinsert the tracheostomy tube.
Position the client in a lateral position with the neck extended.
Ventilate client's tracheostomy stoma with a manual bag-mask..
Answer: Attempt to reinsert the tracheostomy tube.
The nurse should attempt to reinsert the tracheostomy tube by
using a hemostat to open the tracheostomy or by grasping the
,retention sutures (if present) to spread the opening and insert a
replacement tube (with its obturator) into the stoma. Once in place,
the obturator should immediately be removed.
◉ During a health fair, a 72-year-old male client tells the nurse that
he is experiencing shortness of breath. Auscultation reveals crackles
and wheezing in both lungs. Suspecting that the client might have
chronic bronchitis, which classic symptom would the nurse expect
this client to have?
Racing pulse with exertion.
Clubbing of the fingers.
An increased chest diameter.
Productive cough with grayish-white sputum.. Answer: Productive
cough with grayish-white sputum.
Chronic bronchitis, one of the diseases comprising the diagnosis of
chronic obstructive pulmonary disease (COPD), is characterized by a
productive cough with grayish-white sputum.
◉ Despite several eye surgeries, a 78-year-old client who lives alone
has persistent vision problems. The visiting nurse is discussing
home safety hazards with the client. The nurse suggests that the
edges of the steps be painted which color?
, Black.
White.
Light green.
Medium yellow.. Answer: Medium yellow
The color yellow is the easiest for a person with failing vision to see.
◉ When providing discharge teaching for a client with osteoporosis,
the nurse should reinforce which home care activity?
A diet low in phosphates.
Skin inspection for bruising.
Exercise regimen, including swimming.
Elimination of hazards to home safety.. Answer: Elimination of
hazards to home safety.
Discussion about fall prevention strategies is imperative for the
discharged client with osteoporosis. Advice about safety measures in
the home should be provided such as the elimination of throw rugs
and proper lighting to minimize trip hazards and falls.
◉ A 58-year-old client, who has no health problems, asks the nurse
about the Pneumovax vaccine. The nurse's response to the client
should be based on which information?
FULL SOLVED QUESTIONS AND SOLUTIONS
◉ A client with a 16-year history of diabetes mellitus is having renal
function tests because of recent fatigue, weakness, elevated blood
urea nitrogen, and serum creatinine levels. Which finding should the
nurse conclude as an early symptom of renal insufficiency?
Dyspnea
Nocturia
Confusion.
Stomatitis. Answer: Nocturia
As the glomerular filtration rate decreases in early renal
insufficiency, metabolic waste products, including urea, creatinine,
and other substances, such as phenols, hormones, and electrolytes,
accumulate in the blood. In the early stage of renal insufficiency,
polyuria results from the inability of the kidneys to concentrate
urine and contributes to nocturia.
◉ An elderly client is admitted with a diagnosis of bacterial
pneumonia. When observing the client for the first signs of
decreasing oxygenation, the nurse should assess for which clinical
cues?
,Abominal distention.
Undue fatigue.
Cyanosis of the lips.
Confusion and tachycardia. Answer: Confusion and tachycardia
The onset of pneumonia in the elderly may be signaled by general
deterioration, confusion, increased heart rate or increased
respiratory rate due to the decreased oxygen- carbon dioxide
exchange at the alveoli, known as the V-Q mismatch. Cyanosis is a
very late sign.
◉ During suctioning, a client with an uncuffed tracheostomy tube
begins to cough violently and dislodges the tracheostomy tube.
Which action should the nurse implement first?
Notify the healthcare provider for reinsertion.
Attempt to reinsert the tracheostomy tube.
Position the client in a lateral position with the neck extended.
Ventilate client's tracheostomy stoma with a manual bag-mask..
Answer: Attempt to reinsert the tracheostomy tube.
The nurse should attempt to reinsert the tracheostomy tube by
using a hemostat to open the tracheostomy or by grasping the
,retention sutures (if present) to spread the opening and insert a
replacement tube (with its obturator) into the stoma. Once in place,
the obturator should immediately be removed.
◉ During a health fair, a 72-year-old male client tells the nurse that
he is experiencing shortness of breath. Auscultation reveals crackles
and wheezing in both lungs. Suspecting that the client might have
chronic bronchitis, which classic symptom would the nurse expect
this client to have?
Racing pulse with exertion.
Clubbing of the fingers.
An increased chest diameter.
Productive cough with grayish-white sputum.. Answer: Productive
cough with grayish-white sputum.
Chronic bronchitis, one of the diseases comprising the diagnosis of
chronic obstructive pulmonary disease (COPD), is characterized by a
productive cough with grayish-white sputum.
◉ Despite several eye surgeries, a 78-year-old client who lives alone
has persistent vision problems. The visiting nurse is discussing
home safety hazards with the client. The nurse suggests that the
edges of the steps be painted which color?
, Black.
White.
Light green.
Medium yellow.. Answer: Medium yellow
The color yellow is the easiest for a person with failing vision to see.
◉ When providing discharge teaching for a client with osteoporosis,
the nurse should reinforce which home care activity?
A diet low in phosphates.
Skin inspection for bruising.
Exercise regimen, including swimming.
Elimination of hazards to home safety.. Answer: Elimination of
hazards to home safety.
Discussion about fall prevention strategies is imperative for the
discharged client with osteoporosis. Advice about safety measures in
the home should be provided such as the elimination of throw rugs
and proper lighting to minimize trip hazards and falls.
◉ A 58-year-old client, who has no health problems, asks the nurse
about the Pneumovax vaccine. The nurse's response to the client
should be based on which information?
