HESI Medical Surgical Nursing Practice Exam With Answers (375 Solved Questions)

Name: HESI Medical Surgical Nursing Practice Exam With Answers (375 Solved Questions)
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Familiarize yourself with different question types using HESI Medical Surgical Nursing Practice Exam With Answers, featuring past exams.

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MED SURG 1 & 2 HESI EXAM WITH SATISFIED SOLUTIONS
Hyperglycemia s/s - Polydipsia, poly iris, polyphagia, blurred vision, weakness, weight loss,
syncope
Encourage water, check BG, assess for ketoacidosis, insulin asdir
Hypoglycemia s/s - Headache, nausea, sweating, tremors, lethargy, hunger, confusion,
slurred speech, tingling around mouth, anxiety
Occurs rapidly, treat with complex carbs ( glucose gel, fruit juice, 10-16 jelly beans, gum
drops, life savers
Check BG, <40 May seize
Hypoglycemia s/s -
SMBG - Record results for provider,
Prediabetes - Fasting BG 100-125 or HBA1C 5.7-6.4
surgical risk factors - age; nutrition status; fluid/electrolyte status; general health (cardiac
conditions, coagulation probs => hemorrhage, URTI => surgery delayed, COPD exacerbation
possible r/t anesthesia, renal probs impair electrolyte stuff, uncontrolled DM => poor
healing and infection, meds including OTC (anticoagulants, tranquilizers - hypotension, heroin
- dec CNS response, antibiotics - incompatible w anesthetics, diuretics - electrolyte
imbalance, steroids, OTC herbs, vitamin E
Preop - time from decision to have surgery until taken to OR; Nurse gets hx, teaching,
checklist
preop history - age, allergies (iodine), current meds, hx of med/surg probs, prev. surgeries,
prev. experience w/ anesthesia, tobacco, drug abuse, understanding of procedure, coping
resources, cultural and ethical factors affecting surgery

preop teaching - regulations about valuables, food and fluid restrictions (NPO after
midnight), invasive procedures (foley, IV, NG, enema, douche), preop meds, OR,
transportation, skin prep, post-anesthesia, post op (res. care, activity - ROM, ambulation,
turning, pain control such as PCA, diet restrictions, PACU
preop checklist - informed consent; site marked by surgeon, all team members confirm; hx
and physical noted in chart; chest radiograph, ECG, and urinalysis if prescribed; hgb, hct,
electrolytes, glucose, type/crossmatch of blood; chart on hand; ID band on PT w/ allergies
noted; contacts, dentures, and all that jazz are removed; PT has voided or catheterized; PT
has gown; VS taken; premeds (antibiotics) given; skin prep performed (cleaned, hair
removed if needed, then cleaned again); nurse's signature completes
intraop care - keep quiet; SAFETY (client ID, procedure, site; sponge, needle, and instrument
counts accurate, position to prev injury, grounding device if electrocautery used; asepsis,
suction, correct labeling and handling of all specimens); monitor physical status (blood loss
- see effect on client, report VS changes to surgeon, positioning critical); psychological
(emotional support, provide info to the fam if it takes too long)
Postop care - Admission to PACU to recovery; on arrival, VS assessed along with LOC, skin
color and condition, dressing, fluids, tubes, and O2; once stabilized, PT taken back to the
floor
Postop care includes: monitor for signs of shock and hemorrhage (hypotension, narrow
pulse pressure, rapid weak pulse, cold moist skin, inc capillary refill time); position on side
to prev aspiration, side rails up; heated blanket for warmth; manage n/v w drugs; pain w IV
analgesics; check and assess drains
acute respiratory distress syndrome (ARDS) - low O2 and high CO2; hypoxemia that persists
even with 100% O2 on; dec. pulmonary compliance; dyspnea; non-cardiac pulmonary edema;
dense pulmonary infiltrates on radiography; unexpected, catastrophic; high mortality; no
abnormal sounds b/c edema happens in interstitial spaces;
causes of ARDS - COPD exacerbation; pneumonia; TB; contusion; aspiration; inhaled toxins;
emboli; OD; fluid overload; DIC; shock

assessment of ARDS - dyspnea, hyperpnea, crackles; intercostal retractions; cyanosis,
pallor; hyposemia (PaO2 < 50); anxiety, restlessness
ARDS interventions - position for max lung expansion; s/s hypoxemia; breath sounds;
emotional support; VS and cardiac monitor; monitor ABGs; vital organ status (LOC, renal
system output, apical pulse); fluids and lytes; metabolic status
ABGS - pH - 7.35-7.45
PCO2 - 35-45
HCO3 - 21-28
PO2 - 80-100
O2 Sat - 95-100
Base excess - 0+- 2
*perform allen test before taking blood from radial
Metformin - biguanide; careful w/ contrast dye (renal failyre and lactic acidosis)
rapid acting insulin - lispro (humalog) - 10-15 min *all peak w/in 30-60 mins
aspart (novolog) - 5-15 min
glulisine (apidra) - 5-15 min
short acting - regular (humalog r, novolin r, iletin II regular) 1-1.5h; peak in 2h; only insulin
that can be given IV
-often mixed w/ intermediate, never with long acting
intermediate acting - NPH (humulin n, iletin II lente, iletin II NPH, novolin N) 2-4h; peak in 4-
12h;
very long acting - glargine (lantus) CANNOT MIX THIS.
detemis (levemir) *onset iin 1h w/ no peak
Hypothyroidism - dec thyroid hormone; primary or secondary;
s/s: weakness, fatigue, cold intolerance, weight gain, constipation, goiter, slow speech, dry
cool skin, puffy face, dry coarse hair, thick brittle nails

Cushings - adrenal hypofunction; high adrenocortical hormones; weight gain, muscle
weakness, buffalo hump, thinning extremities w/ muscle wasting, thin fragile skin, moon
face, ruddy complexion, hirsutism, truncal obesity, broad purple striae, bruising,
hyperglycemia, hyper atresia, hypokalemia, impaired wound healing; treated w/ surgery,
HTN, radiation, or drug therapy
Teach to take steroids w meals to prev GI distress, don't skip doses; avoid infection; low
sodium diet;
Hypocalcemia s/s -
HHNS - occurs w/ type 2 most of the time, esp older PTs; characterized by hyperosmolarity
of blood and hyperglycemia; caused by stress; slower onset than DKA; normal pH; osmolality
> 350 ( BG usually 600-1200); BUN and creatinine elevated; higher mortality that DKA;
mental status changes, severe dehydration, postural hypotension
DKA - Results fro insulin deficiency; features are hyperglycemia, dehydration/electrolyte
loss (diuresis), and acidosis; fat breakdown forms free fatty acids and glycerol; rapid onset;
osmolality 300-350; BUN and creatinine elevated
causes of DKA - Missed insulin dose, illness/infection, undiagnosed diabetes
DKA clinical manifestations - Polyuria, polydipsia, fatigue; ketonuria; pH < 7.3; n/v,
dehydration, abdominal pain, kussmaul respirations; acetone odor
DKA PT prevention education - Take insulin as usual, BG and urine ketones q4h, fluids (lyte
replacement), report n/v/d to provider
DKA treatment - rehydration - isotonic (NS), electrolyte replacement (esp K), reversing
acidosis (insulin drip w/ regular insulin, not too fast bc cerebral edema)
DM nursing assessment findings - Skin infections, non healing. Wounds, periodontal disease,
cataracts, retinopathy, angina, dyspnea, HTN, hair loss in extremities, coolness, shiny thin
skin, weak peripheral pulses, pallor, thick nails wth ridges, edema, UTI, signs of renal failure

( edema, anorexia, nausea, fatigue, difficulty concentrating), neuropathy (numbness, tingling,
pain, burning), diarrhea at night, impotence, dry vag, period probs, depression
Somogyi phenomenon - dec in BG around 2-3am to hypoglycemic levels; should dec evening
insulin dose
dawn phenomenon - normal BG until like 3am; should change time of evening injection from
dinnertime to bedtime
insulin waning - progressive rise in BG from bed til morning; should inc evening dose
Pheocromocytoma - tumor of adrenal medulla; triad: headache, diaphoresis, and palpitations
in the PT w/ HTN; fatal if undetected; patient is anxious and weak; bed rest w/ HOB elevated;
alpha adrenergic blocker, maybe w/ a beta blocker; adrenalectomy
diabetic retinopathy - capillary basement membrane thickening; asymptomatic at first;
destruction of retinal vessels; abnormal new growth of vessels rupture and form scar tissue
which causes retina to detach; prevention key; huge cause of blindness
Addisons - Emergency; vascular collapse (IV fluids), hypoglycemia (IV glucose), aldosterone
replacement; Autoimmune; may be caused by sudden withdrawal from steroids or stress;
lack of cortisol, androgens, and aldosterone; secondary is caused by lack of ACTH from
pituitary;
S/s: fatigue, weakness, weight loss, anorexia, n/v, postural hypotension, hypoglycemia,
hyponatremia, hyperkalmia, hyper pigmentation, shock, loss of body hair, hypovolemia
DM - Hyperglycemia; affects metabolism of protein, carbs, and fat; 4 ways to dx: FPG > 126;
BHA1C > 6.5; random BG of 200; OGTT > 200
Type 1: B cell destruction; autoimmune
Type 2: insulin deficit or dec uptake; obesity major risk factor
Any stressful event inc BG, so illness causes hyperglycemia
In doubt of whether it's hyper or hypo, treat for hypo
FOOT CARE

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shock - widespread reduction of tissue perfusion; those at risk are post MI, very old and
very young, PT w/ severe dysrhythmias, adrenocorticoid dysfunction, recent hemorrhage,
burns, massive infection
*early signs are agitation and restlessness resulting from cerebral hypoxia
*all types can lead to systemic inflammatory respiratory syndrome (SIRS) and myltiple
organ dysfunction syndrome (MODS)
hypovolemic shock - internal or external blood or fluid loss; most common
stage 1 (initial): apprehension and restlessness, inc HR, cool pale skin, fatigue
stage 2 (compensatory): flattened neck veins; delayed venous filling; inc pulse and rr; pallor;
diaphoresis; cool skin; dec urinary output; sunken, soft eyeballs; confusion
stage 3 (progressive): edema; inc blood viscosity; excessively low bp; dysrhythmia; ischemia,
MI; weak thready or absent peripheral pulses
stage 4 (irreversible): profound hypotension; unresponsive to vasopressors; severs
hypxemia; unresponsive to O2; anuria; renal shutdown; HR slows, BP falls; cardiac and
respiratory arrest; death inevitable
cardiogenic shock - related to ischemia or impairment in tissue perfusion resulting from MI,
serious arrhythmia, or HF; all of these dec. CO
position client in high fowlers if pulmonary edema w/ legs dependent
anaphylactic shock - related to allergens; aute and life threatening w/ respiratory distress
r/t bronchial constriction leading to airway obstruction; vascular collapse may follow
neurogenic shock - r/t injury to descending sympathetic pathways in spinal cord; results
from loss of vasomotor tone and sympathetic innervation to heart
septic shock - r/t endotoxins released by bacteria; cause vascular pooling, diminished
venous return, and dec. CO
obstructive shock - physical obstruction r/t tamponade, emboli, compartment syndrome
that impedes filling or outflow of blood resulting in dec. CO

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medical treatment of shock - oxygenation and ventilation; fluid resuscitation w/ fluid
(isotonic), whole blood, not done w/ cardiogenic b/c pulmonary edema results; drug therapy
w/ drugs that increase (blood products, cryastalloids) or decrease preload (morphine,
nitrates, diuretics), drugs that inc. afterload (vasopressors, dopamine) or dec. afterload
(ACE, ARB), drugs that dec contractility (beta blockers, calcium channel blockers) or inc
contractility (digoxin)
assessment findings of PT in shock - VS: tachycardia, tachypnea, BP dec
mental status: in early shock they are restless and hyperalert, in late shock they have dec
alertness, lethargy, coma
skin changes: cool and clammy, diaphoresis, paleness
fluid status: urine dec, urins specific gravity > 1.020
interventions for PT in shock - monitor VS q15min; I/O to mantain at least 30mL out per hr;
call provider if output falls below 30mL/hr; fluids asdir; position appropriately; meds given
IV b/c of dec perfusion IM and SQ; keep PT warm; side rails up; get blood for labs; monitor
medication effects esp w/ vasopressor and vasodilator drugs
DIC - first phase has abnormal clotting in microcirculation that uses up clotting factors and
then hemorrhage occurs; suspected w/ acute hypotension and septicemia w/ blood oozing
from more than one place; dx with prolonged PT, PTT; dec fibrinogen and platelets; and inc
FDP
DIC Assessment - petichiae, purpuraa, hematomas; oozing from IV sites, drains, gums, and
wounds; GI & GU bleeding; hemoptysis; mental status change, hypotension/tachycardia; pain
DIC interventions - monitor for bleeding; monitor VS & PT/INR; prevent injury and bleeding
(gentle oral care, minimal needle sticks, turn frequently, minimize BP measurements, gentle
suction if needed, pressure to oozing site
if discovered in clotting phase, heparin can stop the micro-clots; if PT gets past that point,
clotting factors are given along w/ palliative care for symptoms
angina - cardiac O2 demand exceeds supply;
caused by: atherosclerosis, HTN, coronary artery spasm, hypertrophic cardiomyopathy,
activities that inc heart's O2 demand (physical exertion, cold temperatures)

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angina assessment - pain described as heavy, squeezing, pressure, burning, choking, aching,
feeling of apprehension
substernal, radiating to L arm and/or shoulder
transient or prolonged, with gradual or sudden onset, often short duration
dyspnea, tachycardia, palpitations
n/v, fatigue, diaphoresis, pallor, weakness, syncope, dysrhythmias,
ECG usually at baseline; ST depression in anginal attacks and T wave inversion (exercise
stress test shows same)
stress echocardiogram looks for changes in wall motion (indicated in women)
cardiac catheterization: detects arterial blockage
angina risk factors - nonmodifiable: heredity, gender (male > female until menopause),
ethnic background (african americans), age
modifiable: hyperlipidemia, serum cholesterol > 300, LDL elevated, HDL low, HTN, smoking,
obesity, physical inactivity, DM, stress
LDL - <100 desirable; bad cholesterol
HDL - >60 desirable; good cholesterol
angina interventions - monitor meds; determine what precipitates pain; teach risk factors;
During attack: immediate rest, VS, ECG, nitroglycerin tabs 5 min apart not to exceed tabs,
emergency treatment w/ no relief
teach to avoid isometric activity, start exercise program, teach that sex is ok when exercise
is tolerated, can take nitroglycerin before hand, provide nutrition info;
medical tx: PTCA
MI - disruption in or deficiency of coronary artery blood supply resulting in necrosis of
cardiac tissue
Caused by: thrombus or clotting; shock or hemorrhage
MI assessment - Pain: onset in lower sternal region; severity inc to unbearabe, radiates to
shoulder and down arm or to neck; women may have DOB or fatigue; differs from angina b/c

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sudden onset; not relieved by rest, may have n/v, anxiety, feeling of impending doom, not
relieved by nitroglycerin; those w/ diabetic neuropathy may not have pain... silent MI
rapid irregular feeble pulse, dec LOC, dysrhythmias, cardiogenic shock or fluid retention,
elevated cardiac markers, troponin best, HF - wet lung sounds, ECG changes as early as 2hr,
n/v gastric discomfort or indigestion, cool pale sweaty skin
women: dyspnea, unusual fatigue, sleep disturbances
MI interventions - MONA; VS, ECG, O2 AT 2-6L NC;
hyponatremia - cause: diuretics, GI fluid loss, hypotonic tube feeding, D5W or hypotonic IV
fluids, diaphoresis
s/s: anorexia, n/v, weakness, lethargy, confusion, muscle cramps and twitching, seizures;
Na < 135
tx: restrict fluids (safest); IV saline asdir if restricting fluids doesnt work
hypernatremia - cause: water deprivation, hypertonic tube feeding, diabetes insipidus,
heatsrtoke, hyperventiation, watery diarrhea, renal failure, cushings
s/s: thirst, hyperpyrexia, sticky mucous membranes, dry mouth, hallucinations, lethargy,
irritability, seizures; Na > 145
tx: restrict sodium, inc water
hypokalemia - cause: diuretics, diarrhea, vomiting, GI suction, steroids, hyperaldosteronism,
bulimia, cushings
s/s: fatigue, anorexia, n/v, muscle weakness, dec GI motility, dysrhythmias, parathesia, flat
T waves; K < 3.5
tx: supplements (don't give on empty stomach); NEVER GIVE IV BOLUS. WILL KILL YOUR BUTT
DEAD; high K diet (banana, orange, spinach, avocado, cantaloupe, potatoes); renal status
before giving
hyperkalemia - cause: oliguria, acidosis, renal failure, addisons, multiple blood transfusions
s/s: muscle weakness, bradycardia, dysrhythmias, flaccid paralysis, intestinal colic, tall t
waves; K > 5

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tx:50% glucose w/ regular insulin; Kayexalate; ECG; calcium gluconate; loop diuretics;
dialysis
hypocalcemia - renal failure, hypoparathyroidism, malabsorption, pancreatitis, alkalosis
s/s: diarrhea, numbness, tingling, convulsions, positive trousseau or chvostek; Ca < 8.5
tx: supplements; slow IV infusion; inc intake (dairy, greens)
hypercalcemia - cause: hyperparathyroidism, malignant bone disease, prolonged
immobilization, excess supplementation
s/s: muscle weakness, constipation, anorexia, n/v, polyuria, polydipsia, neurosis,
dysrhythmias; Ca > 10.5
hypomagnesemia - cause: alcoholism, malabsorption, DKA, prolonged GI suction, diuretics;
s/s: anorexia, distention, neuromuscular irritability, depression, disorientation; Mg < 1.5
tx: MgSO4 IV; high Mg diet (meats, nuts, legumes, fish, veggies)
hypermagnesemia - cause: renal failure, adrenal insufficiency, excess replacement;
s/s: flushing, hypotension, drowsiness, lethargy, dec DTR; depressed respirations,
bradycardia; Mg > 2.5
tx: avoid Mg based antacids and laxatives, restrict diet, also calcium gluconate for toxicity
hypophosphatemia (dec pH) - cause: refeeding after starvation, alcohol withdrawal, DKA,
respiratory alkalosis
s/s: parethesias, muscle weakness, muscle pain, mental changes, cardiomyopathy,
respiratory failure; pH < 2
tx: treat cause; oral replacements w/ vit D
hyperphosphatemia (inc pH) - cause: renal failure, excess intake of phosphorus
s/s: short term: tetany symptoms; long term: phosphorus precipitation in nonosseous sites;
pH > 4.5
tx: aluinum hydroxide w/ meals to bind phosphorus; dialysis if renal failure is cause
isotonic IV solutions - osmolality close to EC
indicated for intravascular hydration

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NS; LR; D5W (almost hypotonic)
ex: dehydration caused by running, labor, fever
hypotonic IV solutions - osmolality lower than ECF
cause fluid to move from ECF to ICF
used for cellular dehydration
1/2NS (HNS); D2.5HNS
ex: dehydration caused by prolonged dehydration, also seen w/ PT on TPN for a long time
hypertonic IV solutions - osmolality higher than ECF
indicated for intravascular dehydration with interstitial or cerebral overhydration
used carefully
only used when serum osmolality is dangerously low
D5LR; D5HNS; D5NS; D10W
ex: dehydration from surgery.. blood loss causes intravascular dehydration but tissue cuts
inflame and pull fluid in to the area, causing interstitial overhydration; also seen with ascites
and third spacing
PRBCs - for acute blood loss, low danger of fluid overload
platelets - bleeding r/t thrombocytopenia; bad agitated periodically
albumin prep'd from plasma, 5% & 25% solutions - hypovolemic shock, hypoalbuminemia;
25g/100mL is osmotically equal to 500mL of plasma
cryoprecipitates - replacement of clotting factors; used for hemophilia
respiratory acidosis - dec pH; inc PCO2; normal C=HCO3
caused by hypoventilation
COPD, pulmonary disease, drugs, obesity, mechanical asphyxia, sleep apnea
respiratory alkalosis - inc pH; dec PCO2; normal HCO3
caused by hyperventilation

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overventilation on ventilator, response to acidosis, bacteremia, thyrotoxicosis, fever,
hepatic failure, response to hypoxia, hysteria
metabolic acidosis - dec pH; normal PCO2; dec HCO3
caused byaddition of large amounts of fixed acids to body fluids
lactic acidosis (circulatory failure), ketoacidosis, phosphates and sulfates (renal disease),
acid ingestion, secondary to respiratory alkalsis, adrenal insufficiency
metabolic alkalosis - inc pH; normal PCO2; inc HCO3
caused by retention of base or removal of acid from body
excessive gastric drainage, vomiting, potassium depletion (diuretic therapy), burns,
excessive NaHCO3 administration
HIV - retrovirus that attacks CD4 T cells; destroys them and reduces body's ability to fight
infection; initial symptoms within 3 wks of exposure, then become asymptomatic
HIV risk factors - homo/bisexual males; IV drug abusers; heterosexual partners of risk
group member; recipients of blood products before screening (1985); taking steroids or
other meds that cause immunosuppression; infants of infected moms; breastfeeding infants
of affected moms
HIV primary infection - CD4 > 800;
flu like symptoms, fever, malaise
mononucleosis like illness, lymphadenopathy, fever, malaise, rash
symptoms usually occur within 3 wks of initial exposure, then asymptomatic
HIV asymptomatic - CD4 > 500; CDC A
no clinical problems
continuous viral replication
can last for years (10+)
HIV symptomatic - CD4 betwee 200-499; CDC B
persistent generalized lymphadenopathy; persistent fever; weight loss, diarrhea, peripheral
neuropathy, herpes zoste, candidiasis, cervical dysplasia, hairy leukoplakia oral

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AIDS - CD4 < 200 CDC C
variety of bacteria, parasites, or viruses overwhelm body's immune system
once classified ad category C, stays that way.. has implication for entitlements (health
benefits, housing, food stamps)
HIV assessment - positive ELISA, confirmed by western blot test (electrophoresis)
symptoms: extreme fatigue, appetite loss/weight loss (>10lb in 2mo); swollen glands; leg
weakness or pain; night sweats; unexplained diarrhea; cry cough; white spots in mouth and
throat; painful blisters, maybe shingles; painless purple-blue lesions on skin; confusion;
disorientation; in women, recurrent vaginal infections
HIV Interventions - assess respiratory status frequently; avoid known sources of infection;
strict asepsis for invasive procedures; frequent VS; plan for rest periods; elevate HOB; refer
to nutritionise; small, frequent meals; weigh daily; encourage PT to avoid fatty foods; monitor
for skin breakdown; safety precautions; emotional support for PT and family; IV fluids for
hydration; TPN asdir; meds and pain mgmt
opportunistic infections of HIV - pneumonia; kaposi sarcoma; cryptosporidiosis; candidiasis
of oral cavity and esophagus; cryptococcal meningitis; cytomegalovirus (CMS, preggo nurse
shouldn't have this PT) Retinitis; CMV colitis; disseminated CMV; perirectal mucutaneous
herpes simplex; lymphoma of CNS; TB; HIV encephalopathy
HIV dugs - NRTI's; Non-NRTI's; protease inhibitors; COMBINATION PRODUCTS; CCR5 inhibitor;
fusion inhibitor; antiprotozoals; antivirals; antifungals
pneumonia - inflammation of lower respiratory tract; caused by aspiration, inhalation, or
hematogenous spread; can be bacterial, viral, fungal (rare), or chemical; community or
nosocomial acquired
at risk for pneumonia - PT w/ lots of lung secretions; smokers; immobile;
immunosuppressed; depressed gag or cough reflex; sedated; neuromuscular disorders;
NG/OG intubation; hospitalized; altered LOC; anyone susceptible to aspiration; brain injury;
drug OD; stroke victim

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pneumonia assessment - tachypnea, shallow often w/ accessory muscles; abrupt onset of
fever w/ shaking and chills; productive cough w/ pleuritic pain; rapid, bounding pulse; pain
and dullness ofer affected lung area; bronchial breath sounds, crackles; CXR shows
infiltrates w/ consolidation or pleural effusion; elevated WBC; ABG indicates hypoxemia; drop
in O2 sat.. should be > 90% but 95% preferred; older adults: confusion, lethargy/malaise,
anorexia, rapid rr, tachycardia
*fever can cause dehydration and inc O2 demand
*irritibility and restlessness are early signs of cerebral hypoxia
pneumonia interventions - assess sputum (vol, color, consistency, clarity); deep breath q2h;
humidity to loosen secretions; fluids up to 3L qday; lung sounds before and after coughing;
rate, depth, and pattern of respirations; ABGs; O2 sat; skin color; mental status; O2 asdir; VS
regularly (temp)rest periods; teach to get immunizations
preventing pneuomonia - older adults: get flu shots and pneomovax, avoid sources of
infection and indoor pollutants, don't smoke
immunosuppressed: flu shots, pneumovax, avoid infection sources, sensible nutrition, fluid
intake, balance of rest and activity
comatose/immobile: elevation of HOB for 1hr after feeding, turn frequently
asplenia: flu and pneumovax
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

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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

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HESI Medical Surgical Nursing Practice Exam With Answers (375 Solved Questions)

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