2024 HESI Medical Surgical Nursing Practice Exam With Answers (233 Solved Questions)

Name: 2024 HESI Medical Surgical Nursing Practice Exam With Answers (233 Solved Questions)
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MED SURGE HESI EXAM 2 WITH NGN (LATEST UPDATED 2024)
1. The nurse is providing teaching to a client with Type 2 diabetes mellitus and peripheral
neuropathy. Which information should the nurse provide?
a. Family members can help with regular foot exams
b. Heating pads are useful if on the low setting
c. Aching feet may be soaked in lukewarm water for one hour or more
d. Shoes should be worn outside the house, but it is fine to be barefoot inside - a. Family
members can help with regular foot exams
2. A client in the operating room received succinylcholine. The client is experiencing muscle
rigidity and has an extremely high temperature. What action should the nurse implement?
a. Hold a prescription for dantrolene until fever is reduced
b. Prepare ice packs for placement in the clients axillary area
c. Call the PACU nurse to prepare for prolonged ventilator support
d. Determine if prescribed antibiotics were administered preoperatively - b. Prepare ice
packs for placement in the clients axillary area
3. The nurse is developing a plan of care for a client who reports blurred vision and who is
newly diagnosed with cardiovascular disease. Which outcome should the nurse include in the
plan of care for this client?
a. The nurse will encourage the client to walk thirty minutes every day
b. The clients family will state signs and symptoms about the disease
c. The clients daily blood pressure will be less than 140/80 this month
d. The client blood pressure readings will be less than 160/90 - c. The clients daily blood
pressure will be less than 140/80 this month

4. The family suspects that acquired immune deficiency syndrome (AIDS) dementia is
occuring in their son who is human immunodeficiency virus (HIV) positive. Which symptoms
confirm their suspicions?
a. He has begun to sleep 18 out of 24 hours
b. A change has recently occurred in his handwriting
c. He refuses to see any of his friends or to return their phone calls
d. He exhibits angry outburst when the subject of dying is approached - b. A change has
recently occurred in his handwriting
5. A hospitalized client with peripheral arterial disease (PAD) is instructed regarding leg and
foot care. Which statement by the client indicates to the nurse that learning has occurred?
a. "Whenever I am sitting in a chair I will keep my legs up to reduce swelling"
b. "I can use a mirror to check the bottoms of my feet for any signs of breakdown"
c. "I will try to keep moving if leg pain occurs to help promote good circulation"
d. "I will use my swimming pool early in the day while the water is still very cool" - b. "I can
use a mirror to check the bottoms of my feet for any signs of breakdown"
6. While completing a health assessment for a client with migraine headaches, the nurse
assesses bilateral weakness in the client's hand grips. The client reports joint pain and
trouble twisting a door knob due to weakness. Which action should the nurse take in
response to these findings?
a. Explain that relief of the migraine pain will reduce related symptoms
b. Gather additional assessment data about the pain and weakness
c. Implement fall precautions to reduce the client's risk for injury
d. Consult with the occupational therapist for a functional assessment - d. Consult with the
occupational therapist for a functional assessment
7. A client with Cushing's syndrome is recovering from an elective laparoscopic procedure.
Which assessment finding warrant's immediate intervention by the nurse?

a. Purple marks on skin of the abdomen
b. Irregular apical pulse
c. Quarter size blood spot on dressing
d. Pitting ankle edema - b. Irregular apical pulse
8. A client with lung cancer who wears a subcutaneous morphine sulfate patch for pain is
short of breath and is difficult to arouse. When performing a head to toe assessment, the
nurse discovers four analgesic patches on the clients body. Which intervention should the
nurse implement first?
a. Remove all of the morphine patches
b. Administer a narcotic antagonist
c. Apply oxygen per face mask
d. Measure the client's blood pressure - b. Administer a narcotic antagonist
9. A client receives prescriptions for a multidrug regimen for the treatment of tuberculosis.
Which information should the nurse prioritize?
a. Adherence to the regimen is imperative
b. Medications should be taken with food
c. Serum liver panels are collected regularly
d. Enhanced sun protection measures will be needed - a. Adherence to the regimen is
imperative
10. The nurse is preparing a client for surgery who was admitted to the emergency center
following a motor vehicle collision. The client has an open fracture of the femur and is
bleeding moderately from the bone protrusion site. During the prescriptive assessment, the
nurse determines that the client currently receives heparin sodium 5,000 units
subcutaneously daily. What is the priority nursing action?
a. Notify the healthcare provider of the client's medication history
b. Observe the heparin injections sites for signs of bruising
c. Have the client sign the surgical and transfusion permits

d. Ensure that the potential for bleeding is explained to the client - a. Notify the healthcare
provider of the client's medication history
11. A client with orthopnea expresses concern about the ability to "get enough air" during a
scheduled thoracentesis. On which information should the nurse's response be based?
a. A thoracentesis is a brief process that has minimal discomfort
b. Orthopnea is frequently caused by a client's uncontrolled anxiety
c. The procedure is performed with the client in an upright position
d. Extra pillows can be used if needed to elevate the client's head - c. The procedure is
performed with the client in an upright position
12. What information should the nurse include in the teaching plan of a client diagnosed with
gastroesophageal reflux disease (GERD)?
a. Sleep without pillows at night to maintain neck alignment
b. Adjust food intake to three full meals per day and no snacks
c. Minimize symptoms by wearing loose, comfortable clothing
d. Avoid participation in any aerobic exercise programs - c. Minimize symptoms by wearing
loose, comfortable clothing
13. The nurse is caring for a client in the post anesthesia care unit (PACU) who underwent a
thoracotomy two hours ago. The nurse observes the following vital signs: heart rate 140
bpm, respirations 26 breaths/minute and blood pressure 140/90. Which intervention is
most important for the nurse to implement?
a. Medicate for pain and monitor vital signs according to protocol
b. Adminsted intravenous fluid bolus as prescribed by the HCP
c. Apply oxygen at 10 L via non-rebreather mask and monitor pulse oximeter.
d. Encourage the client to splint the incision with a pillow to cough and deep breathe - a.
Medicate for pain and monitor vital signs

14. An adult is diagnosed with restless leg syndrome and is referred to the sleep clinic. The
HCP prescribed ferrous sulfate 325 PO daily. Which laboratory values should the nurse
monitor ?
a. Platelet count and hematocrit
b. Serum electrolytes
c. Serum iron and ferritin
d. Neutrophils and eosinophils - c. Serum iron and ferritin
15. While caring for a client with a full thickness burn covering 40% of the body, the nurse
observes purulent drainage at the wound. Before reporting this finding to the HCP , the
nurse should review which of the client's laboratory values?
a. White blood cell count
b. Platelet count
c. Blood pH level
d. Hematocrit - a. White blood cell count
16. A client with a history of type 1 diabetes mellitus (DM) and asthma is readmitted to the
unit for the third time in two months with a current fasting blood sugar of 325 mg/dl. The
client describes to the nurse of not understanding why the blood glucose level continues to
be out of control. Which interventions should the nurse implement? Select all that apply.
a. Have the client describe a typical day at work, home, and social activities
b. Determine if the client is using a new insulin needle each administration
c. Evaluate the clients asthma medications that can elevate the blood glucose
d. Ask the client if they want a different manufactures glucose monitoring device
e. Have the client demonstrate techniques used to monitor blood glucose levels - a. Have the
client describe a typical day at work, home, and social activities
e. Have the client demonstrate techniques used to monitor blood glucose levels
17. The nurse assesses a client with cirrhosis and finds 4+ pitting edema of the feet and legs,
and massive ascites. Which mechanism contributes to edema and ascites in clients with
cirrhosis?

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a. Hyperaldosteronism causing an increased sodium reabsorption in renal tubules
b. Decreased portcaval pressure with greater collateral circulation
c. Decreased renin-angiotensin response related to an increase in renal blood flow
d. Hypoalbuminemia that results in a decreased colloid oncotic pressure - d.
Hypoalbuminemia that results in a decreased colloid oncotic pressure
18. An older client with long term type 2 diabetes mellitus (DM) is seen in the clinic for a
routine health assessment. Which assessments would the nurse complete if a patient with
type 2 diabetes mellitus (DM) is experiencing long term complications? Select all that apply.
a. Signs of respiratory tract infection
b. Sensation in feet and legs
c. Skin condition of lower extremities
d. Serum creatinine and BUN
e. Visual acuity - b. Sensation in feet and legs
c. Skin condition of lower extremities
e. Visual acuity
19. The nurse is caring for a client who is receiving teletherapy radiation for a malignant
tumor. Which instructions regarding skin of the portal site should the nurse provide?
a. Protect the skin of the radiation portal site from sunlight exposure
b. Apply moisture lotions daily to the radiation portal site
c. Avoid washing the skin inside the radiation portal site
d. Remove the ink marks of the portal after each radiation treatment - a. Protect the skin of
the radiation portal site from sunlight exposure
20. When conducting discharge teaching for a client diagnosed with diverticulitis, which diet
instruction should the nurse include?
a. Have a small frequent meals and sit up for at least two hours after meals
b. Eat a bland diet and avoid spicy foods
c. Eat a high-fiber diet and increase fluid intake

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d. Eat a soft diet with increased intake of milk and milk products - c. Eat a high-fiber diet and
increase fluid intake
21. An adult who was recently diagnosed with glaucoma tells the nurse, "it feels like I am
driving through a tunnel". The client expresses great concern about going blind. Which
nursing instruction is most important for the nurse to provide this client?
a. Maintain prescribed eye drop regimen
b. Avoid frequent eye pressure measurements
c. Wear a prescription glasses
d. Eat a diet high in carotene - a. Maintain prescribed eye drop regimen
22. Which client has the highest risk for developing skin cancer?
a. A 70-year-old fair-skinned client who works as a secretary
b. A 65-year-old fair-skinned lenient who is a construction worker
c. A 16-year-old dark skinned client who tans in tanning beds once a week
d. A 25-year-old dark skinned client whose mother had skin cancer - b. A 65-year-old fair-
skinned lenient who is a construction worker
23. During spring break, a young adult presents to the urgent care clinic reports a stiff neck,
a fever for the past 6 hours, and a headache. Which intervention is most important for the
nurse to implement first?
a. Initiate isolation precautions
b. Administer an antipyretic
c. Draw blood cultures
d. Prepare for a lumbar puncture - a. Initiate isolation precautions
24. The nurse assesses a client with petechiae and ecchymosis scattered across the arms
and legs. Which laboratory results should the nurse review?
a. Red blood cell count
b. Platelet count

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c. Hemoglobin levels
d. White blood cell count - b. Platelet count
25. An older adult client with a long history of chronic obstructive pulmonary disease (COPD)
is admitted with progressive shortness of breath and a persistent cough. The client is
anxious and is complaining of a dry mouth. Which intervention should the nurse implement?
a. Assist client to an upright position
b. Administer a prescribed sedative
c. Apply a high-flow venturi mask
d. Encourage client to drink water - a. Assist client to an upright position
26. The nurse is providing discharge instructions to a client who is receiving prednisone 5
mg PO daily for a rash due to contact with poison ivy. Which symptoms should the nurse tell
the client to report to the HCP?
a. Rapid weight gain
b. Abdominal striae
c. Moon faces
d. Gastric irritation - a. Rapid weight gain
27. A client with cholithiasis is admitted with jaundice due to obstruction of the common bile
duct. Which finding is most important for the nurse to report to the HCP?
a. Distended, hard, and rigid abdomen
b. Clay-colored stool
c. Radiating, sharp pain in right shoulder
d. Bile-stained emesis - a. Distended, hard, and rigid abdomen
28. A client with chronic kidney disease is started on hemodialysis. During the first dialysis
treatment, the client's blood pressure drops from 150/90 to 80/30. Which action should the
nurse take first?
a. Stop the dialysis treatment

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b. Adminster 5% albumin IV
c. Monitor blood pressure Q45M
d. Lower the head of the chair and elevate feet - a. Stop the dialysis treatment
29. The nurse is collecting information from a client with chronic pancreatitis who reports
persistent gnawing abdominal pain. To help the client manage the pain, which assessment
data is most important for the nurse to obtain?
a. Presence and activity of bowel sounds
b. Color and consistency of feces
c. Eating patterns and dietary intake
d. Level and amount of physical activity - c. Eating patterns and dietary intake
30 A client who had a C-5 spinal cord injury 2 years ago is admitted to the emergency
department with the diagnosis of autonomic dysreflexia secondary to full bladder. Which
assessment finding should the nurse expect this client to exhibit?
a. Complaints of chest pain and shortness of breath
b. Hypotension and venous pooling in the extremities
c. Profuse diaphoresis and severe, pounding headache
d. Pain and a burning sensation upon urination and hematuria - d. Pain and a burning
sensation upon urination and hematuria
31. The nurse is obtaining a health history from a new client who has a history of kidney
stones. Which statement by the client indicates an increased risk for renal calculi?
a. Eats a vegetarian diet with cheese 2 to 3 times a day
b. Experiences additional stress since adopting a child
c. Jogs more frequently than usual daily routine
d. Drinks several bottles of carbonate water daily - a. Eats a vegetarian diet with cheese 2 to
3 times a day

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32. A client tells the clinic nurse about expericing burning on uriantion, and assssment
reveals that the client had sexual intercourse four days ago with a person who was casually
met. Which action should the nurse implement?
a. Observe the perineal area for a chancroid-like lesion
b. Obtain specimen of urethral drainage for culture
c. Assess for perineal itching, erythema, and excoriation
d. Identify all sexual paterns in the last four days - b. Obtain specimen of urethral drainage
for culture
33. An adult client is admitted with flank pain and is diagnosed with acute pyelonephritis.
What is the priority nursing action?
a. Monitor hemoglobin and hematocrit
b. Encourage turning and deep breathing
c. Administer IV antibiotics as prescribed
d. Auscultate for presence of bowel sounds - c. Administer IV antibiotics as prescribed
34. Which food is most important for the nurse to encourage a client with osteomalacia to
include in a daily diet?
a. Fortified milk and cereals
b. Citrus fruits and juices
c. Green leafy vegetables
d. Red meats and eggs - a. Fortified milk and cereals
35. A client with Herpes zoster (shingles) on the thorax tells the nurse of having difficulty
sleeping. Which is the probable etiology of this problem?
a. Frequent cough
b. Pain
c. Nocturia
d. Dyspnea - b. Pain

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36. A client with cholelithiasis has a gallstone lodged in the common bile duct and is unable
to eat or drink without becoming nauseated and vomiting. Which finding should the nurse
report to the healthcare provider
a. Belching
b. Amber urine
c. Yellow sclera
d. Flatulence - c. Yellow sclera
37. While caring for a client with Amyotrophic Lateral Sclerosis (ALS), the nurse performs a
neurological assessment every four hours. Which assessment finding warrants immediate
intervention by the nurse
a. Inappropriate laughter
b. Increasing anxiety
c. Weakened cough effort
d. Asymmetrical weakness - c. Weakened cough effort
38. The nurse is caring for a client who is postoperative for a femoral head fracture repair.
Which intervention(s) should the nurse plan to administer for deep vein thrombosis
prophylaxis? Select all that apply.
a. Pneumatic compression devices
b. Incentive spirometry
c. Assisted ambulation
d. Patient-controlled analgesic
e. Calf-pump exercises
f. Prescribed anticoagulant therapy - a. Pneumatic compression devices
e. Calf-pump exercises
f. Prescribed anticoagulant therapy
39. A client with gouty arthritis reports tenderness and swelling of the right right ankle and
great toe. The nurse observes the area of inflammation extends above the ankle area. The

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client receives prescriptions for colchicine and indomethacin. Which instruction should the
nurse include in the discharge teaching?
a. Eat a high protein foods to achieve ideal body weight
b. Drink a least 8 cups (1920) mL of water per day
c. Use electric heating pad when pain is at its worse
d. Encourage active range of motion to limit stiffness - b. Drink a least 8 cups (1920) mL of
water per day
40. A client with a history of peptic ulcer disease (PUD) is admitted after vomiting bright red
blood several times over the course of 2 hours. In reviewing the laboratory results, the
nurse finds the clients hemoglobin is 12 g/dL and the hematocrit is 35%. Which action
should the nurse prepare to take?
a. Continue to monitor for blood loss
b. Administer 1,000 mL normal saline
c. Transfuse 2 units of platelets
d. Prepare for client for emergency surgery - b. Administer 1,000 mL normal saline
41. An obese client with emphysema who smokes at least a pack of cigarettes daily is
admitted after experiencing a sudden increase in dyspnea and activity intolerance. Oxygen
therapy is initiated and it is determined that the client will be discharged with oxygen. Which
information is most important for the nurse to emphasize in the discharge teaching plan?
a. Methods for weight loss
b. Guidelines for oxygen use
c. Approaches to conserve energy
d. Strategies for smoking cessation - b. Guidelines for oxygen use
42. A client arrives at the medical-surgical unit 4 hours after a transurethral resection of
the prostate. A triple-lumen catheter for a continuous bladder irrigation with normal saline
is infused and the nurse observes dark, pink tinged outflow with blood clots in the tubing and
collection bag. Which action should the nurse take?

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a. Monitoring catheter drainage
b. Decreasing the flow rate
c. Irrigating the catheter manually
d. Discounting infusing solution - a. Monitoring catheter drainage
43. The nurse is planning care for an older adult client who experienced a cerebrovascular
accident several weeks ago. The client has expressive aphasia and often becomes frustrated
with the nursing staff. Which intervention should the nurse implement?
a. Teach the client use of basic sign language
b. Speak slowly to the client
c. Encourage clients use of picture charts
d. Ask the client simple questions - c. Encourage clients use of picture charts
44. After three days of persistent epigastric pain, a female client presents to the clinic. She
has been taking oral antacids without relief. Her visit signs are heart rate 122 beats/minute,
respirations 16 breaths/minute, oxygen saturation 96%, and blood pressure 116/70. The
nurse obtains a 12-lead electrocardiogram (ECG). Which assessment finding is most critical?
a. Irregular pulse rate
b. Bile colored emesis
c. ST elevation in three leads
d. Complaint of radiating jaw pain - c. ST elevation in three leads
45. A client with acute renal injury (AKI) weighs 50kg and has a potassium level of 6.7 is
admitted to the hospital. Which prescribed medication should the nurse administer first?
a. Calcium acetate one tablet by mouth
b. Sodium polystyrene sulfonate 15 grams by mouth
c. Epostein alfa, recombinant 2,500 units subcutaneously
d. Sevelamer one tablet by mouth - b. Sodium polystyrene sulfonate 15 grams by mouth

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46. The nurse observes an increased number of blood clots in the drainage tubing of a client
with continuous bladder irrigation following a trans-rethral resection of the prostate
(TURP). What is the best initial nursing action?
a. Provide additional oral fluid intake
b. Measure the client's intake and output
c. Increase the flow of the bladder irrigation
d. Administer a PRN dose of an antispasmodics agent - c. Increase the flow of the bladder
irrigation
47. A cardiac catheterization of a client with heart disease indicates the following blockages:
95% proximal left anterior descending (LAD), 99% proximal circumflex, and ? % proximal
right coronary artery (RCA). The client later asks the nurse "what does all this mean for
me?" What information should the nurse provide?
a. Blood supply to the heart is diminished by artherosclerotic lesions, which necessitate
lifestyle changes
b. Blood vessels supplying the pumping chamber have blockages indicating a past heart
attack
c. Three main arteries have major blockages, with only 1 to 5% of blood flow getting through
to the heart muscle
d. The heart is not receiving enough blood, so there is a risk of heart failure and fluid
retention - c. Three main arteries have major blockages, with only 1 to 5% of blood flow
getting through to the heart muscle
48. Four days following an abdominal aortic aneurysm repair, the client is exhibiting edema
of both lower extremities, and pedal pulses are not palpable. Which action should the nurse
implement first?
a. Elevate extremities on pillows
b. Evaluate edema for pitting
c. Assess pulses with a vascular doppler
d. Wrap the feet with warmed blankets - c. Assess pulses with a vascular doppler

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49. A client who was involved in a motor vehicle collision is admitted with a fractured left
femur which is immobilized using a fracture traction splint in preparation for an open
reduction internal fraction (ORIF). The nurse determines that the clients distal pulses are
diminished in the left foot. Which interventions should the nurse implement? Select all that
apply.
a. Verify pedal pulses using a doppler pulse pulse device
b. Evaluate the application of the splint to the left leg
c. Offer ice chips and oral clear liquids
d. Monitor left leg for pain, pallor, parenthesis, paralysis, pressure
e. Administer oral antispasmodics and narcotic analgesics - a. Verify pedal pulses using a
doppler pulse pulse device
b. Evaluate the application of the splint to the left leg
d. Monitor left leg for pain, pallor, parenthesis, paralysis, pressure
50. The nurse is caring for a client with a lower left lobe pulmonary abscess. Which position
should the nurse instruct the client to maintain?
a. Left lateral
b. Supine, knees flexed
c. Dorsal recumbent
d. Knee-chest - a. Left lateral
51. The healthcare provider prescribes diagnostic tests for a client whose chest x-ray
indicates pneumonia. Which diagnostic test should the nurse review for implementation in
the most therapeutic treatment of pneumonia?
a. Sputum culture and sensitivity
b. Blood cultures
c. Arterial blood gasses (ABG)
d. Computerized tomography (CT) of the chest - a. Sputum culture and sensitivity
52. A male client with heart failure (HF) calls the clinic and reports that he cannot put his
shoes on because they are too tight. Which additional information should the nurse obtain?

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2024 HESI Medical Surgical Nursing Practice Exam With Answers (233 Solved Questions)

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