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HESI RN MEDICAL SURGICAL EXAM
QUESTIONS AND ANSWERS UPDATED
(2024/2025) (VERIFIED ANSWERS)
A physical therapist (PT) places a gait belt on a client and is assisting them
with ambulation from the bed to the chair. As they get up out of the bed,
they report being dizzy and begin to fall. The PT carefully allows them to
fall back to the bed and notifies the primary nurse. Which written
documentation should the nurse put in the client's record?
A) Client experienced orthostatic hypotension when getting out of bed.
B) PT reported client complained of dizziness when getting out of bed, and
gait belt was used to allow client to fall back onto the bed.
C) PT notified the primary nurse that the client could not ambulate at this
time because of dizziness.
D) Client had difficulty ambulating from the bed to the chair when
accompanied by the PT, variance report completed. - ANS ✓B) PT reported
client complained of dizziness when getting out of bed, and gait belt was used to
allow client to fall back onto the bed.
Rationale: This documentation provides the factual data of the events that
occurred. A)The nurse is making an assumption that the dizziness was
caused by orthostatic hypotension. C) Not all the pertinent facts are
included in this documentation.
D) A variance report should never be documented in the client's record.
A new nurse graduate is caring for a postoperative client with the following
arterial blood gases (ABGs): pH, 7.30; PCO2, 60 mm Hg; PO2, 80 mm Hg;
bicarbonate, 24 mEq/L; and O2 saturation, 96%. Which of these actions by
the new graduate is indicated?
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A) Encourage the client to use the incentive spirometer and to cough.
B) Administer oxygen by nasal cannula.
C) Request a prescription for sodium bicarbonate from the health care
provider.
D) Inform the charge nurse that no changes in therapy are needed. - ANS
✓A) Encourage the client to use the incentive spirometer and to cough.
Rationale: Respiratory acidosis is caused by CO2 retention and impaired
chest expansion secondary to anesthesia. The nurse takes steps to promote
CO2 elimination, including maintaining a patent airway and expanding the
lungs through breathing techniques. O2 is not indicated because Po2 and
oxygen saturation are within the normal range. Sodium bicarbonate is not
indicated because the bicarbonate level is in the normal range; promoting
excretion of respiratory acids is the priority in respiratory acidosis. Post
anesthesia, the client will need interventions as described in A above or
may progress to a state of somnolence and unresponsiveness.
The nurse is providing dietary instructions to a 68-year-old client who is at
high risk for development of coronary heart disease (CHD). Which
information should the nurse include?
A) Limit dietary selection of cholesterol to 300 mg per day
B) Increase intake of soluble fiber to 10 to 25 grams per day.
C) Decrease plant stanols and sterols to less than 2 grams/day.
D) Ensure saturated fat is less than 30% of total caloric intake. - ANS ✓B)
Increase intake of soluble fiber to 10 to 25 grams per day.
Rationale: To reduce risk factors associated with coronary heart disease,
the daily intake of soluble fiber (B) should be increased to between 10 and
25 gm. Cholesterol intake (A) should be limited to 180 mg/day or less.
Intake of plant stanols and sterols is recommended at 2 g/day (C).
Saturated fat (D) intake should be limited to 7% of total daily calories.
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A splint is prescribed for nighttime use by a client with rheumatoid
arthritis. Which statement by the nurse provides the most accurate
explanation for use of the splints?
A) Prevention of deformities.
B) Avoidance of joint trauma.
C) Relief of joint inflammation.
D) Improvement in joint strength. - ANS ✓A) Prevention of deformities.
Rationale: Splints may be used at night by clients with rheumatoid arthritis
to prevent deformities (A) caused by muscle spasms and contractures.
Splints are not used for (B). (C) is usually treated with medications,
particularly those classified as non-steroidal antiinflammatory drugs
(NSAIDs). For (D), a prescribed exercise program is indicated.
A 32-year-old female client complains of severe abdominal pain each
month before her menstrual period, painful intercourse, and painful
defecation. Which additional history should the nurse obtain that is
consistent with the client's complaints?
A) Frequent urinary tract infections.
B) Inability to get pregnant.
C) Premenstrual syndrome.
D) Chronic use of laxatives. - ANS ✓B) Inability to get pregnant.
Rationale: Dysmenorrhea, dyspareunia, and difficulty or painful defecation
are common symptoms of endometriosis, which is the abnormal
displacement of endometrial tissue in the dependent areas of the pelvic
peritoneum. A history of infertility (B) is another common finding
associated with endometriosis. Although (A, C, and D) are common,
nonspecific gynecological complaints, the most common complaints of the
client with endometriosis are pain and infertility.
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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?
A) Dyspnea.
B) Nocturia.
C) Confusion.
D) Stomatitis. - ANS ✓B) Nocturia.
Rationale: As the glomerular filtration rate decreases in early renal
insufficiency, metabolic waste products, including urea, creatinine, and
other substances, such phenols, hormones, electrolytes, accumulate in the
blood. In the early stage of renal insufficiency, polyuria results from the
inability of the kidneys to concentrate urine and contribute to nocturia (B).
(A, C, and D) are more common in the later stages of renal failure.
A client with heart disease is on a continuous telemetry monitor and has
developed sinus bradycardia. In determining the possible cause of the
bradycardia, the nurse assesses the client's medication record. Which
medication is most likely the cause of the bradycardia?
A) Propanolol (Inderal).
B) Captopril (Capoten).
C) Furosemide (Lasix).
D) Dobutamine (Dobutrex). - ANS ✓A) Propanolol (Inderal).
Rationale: Inderal (A) is a beta adrenergic blocking agent, which causes
decreased heart rate and decreased contractility. Neither (B), an ACE
inhibitor, nor (C), a loop diuretic, causes bradycardia. (D) is a
sympathomimetic, direct acting cardiac stimulant, which would increase
the heart rate.
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