2025 Med Surg Hesi Actual Exam with Questions and Answers Graded A

● Raynaud's syndrome: avoid factors that initiate vasoconstriction such as cold, stress, and caffeine intake ○ A female client who works as a data entry clerk is concerned as to how her recent diagnosis of Raynaud's syndrome is going to affect her job performance. Which instruction should the nurse provide this client? A. Use a space heater to keep the workplace warm B. Obtain a keyboard designed to limit wrist flexion C. Keep both hands elevated during work breaks D. Take a multivitamin that contains vitamin D daily ● Burning with urination, frequency, urgency = symptoms of cystitis: may be related to hypertension: BP will be less than 140/80 ● Diverticulosis frequently asymptomatic until the diverticula becomes inflamed ● Hyperparathyroidism with acute flank pain: strain all urine (could be kidney stones) ● Unstable angina to reduce cardiac overload > Place commode at bedside for toileting ● Leukopenia: Precautions should be taken to protect the client because of weaken immune system ● In severe acute adrenal insufficiency > monitor pulse/ blood pressure ● Tuberculosis test: erythema without induration between 48-72 hours is is considered negative ● Lupas teaching: Emphasize the importance of taking prescribed corticosteroids accurately ● Pre Op assessment checklist: most immediate problem is clients low potassium ● Herpes zoster (shingles) educate patient about protecting family members ● Cataract post op care: stool softener ● Aplastic anemia: Monitor signs of bleeding & blood products should be administered as prescribed ● Renal calculus: Pain should be first assessment ● Meningitis: Lumbar puncture ● Normal finding in AV fistula: Enlarged vein ● Diabetes & blurred vision: The clients A1C will be less than 7.0% ● Heart failure assessment: Respiratory, cardiac, and renal function ● GERD & painful swallowing: Typically present in severe cases of GERD (Determine if client is taking medication) ● Type II diabetes: Blood pressure, current serum glucose, and respiratory status should be assessed ● Influenza: Oxygen saturation (First intervention) due to client exhibiting shortness of breath ● Asthma meds: Albuterol lOMoAR cPSD| Questions that were on the HESI: A client with eczema is using an OTC topical product with urea 10% OTC (Aqua Care Cream) to the affected skin areas. Which finding reflects the expected therapeutic response. A. Hydration of affected dry skin areas B. Healing with a return to normal skin appearance C. Reduced pain in eczematous areas D. Decreased weeping of ulcerations in affected area A male client who reports feeling chronically fatigued has a hemoglobin of 11.0 grams/dl (110 mmol/L or SI), hematocrit of 34% and microcytic and hypochromic red blood cells. Based on the findings, which dinner selection should the nurse suggest for the patient? A. Beef steak with steam broccoli and orange slices B. Cheese pasta and a lettuce and tomato salad C. Broil white fish with a baked sweet potato D. Grill shrimp and seasoned rice with asparagus salad. The nurse learns in changes of shift report that x-ray report for newly admitted client indicates consolidation in the left lower lung. What action should the nurse take? A. Administer a PRN dose of a bronchodilator. B. Complete an assessment of respiratory status C. Demonstrate use of incentive spirometer. D. Prepare a client for chest tube insertion Two hours before a client's scheduled surgery, the nurse is completing the preoperative checklist. Which information requires the most immediate action by the nurse? A. Surgical consent form is not signed B. Preoperative serum potassium level is 2.8 mEq/L (2.8mmol/L) C.Preoperative chest x-ray report is not available D. Client's pulse oximeter reading is 96% The nurse is assessing a client's arteriovenous (AV) fistula. Which finding provides evidence of its normal function? A. Ecchymotic area B. Enlarged vein C. Pulselessness D. Redness lOMoAR cPSD| A young adult male client has a diagnosis of epididymitis and a positive culture for Escherichia coli. Which information should the nurse include in the teaching plan? A. Avoid penile contact with the rectal area B. Epididymitis is a pre-cancerous condition C. Obtain an annual prostate digital exam D. Surgical intervention is often indicated While planning care for a client with carpal tunnel syndrome, the nurse identifies a collaborative problem of pain. What is the etiology of this problem? A. Diminished blood flow B. Compression of a nerve C. Irritation of nerve endings D. Ischemic tissue changes Following a transurethral resection of the prostate (TURP), a client is discharged from the hospital with an indwelling urinary catheter. Which instruction is important for the nurse to include in the discharge teaching plan? A. Avoid driving a car for 2 weeks B. Drink 3 liters of water each day C. Eliminate all spicy foods from your diet D. Clamp the catheter when taking a shower A client with chronic cirrhosis has esophageal varies. It is most important for the nurse to monitor the client for the onset of which problem? A. Brown, foamy urine B. Anorexia C. Clay-colored stool D. Hematemesis A client's laboratory findings indicate elevations in thyroxine and triiodothyronine hormones. The nurse suspects that the client may have hyperthyroidism. Which assessment finding is most often associated with hyperthyroidism? A. Increased pulse rate B. Diarrhea stools C. Atrophied thyroid gland D. Periorbital edema lOMoAR cPSD| A client is diagnosed with diverticulosis following a colonoscopy. The client denies any symptoms, and asks the nurse what to expect. Which is the best response by the nurse? A. Episodes of burning pain are commonly experienced B. Appetite loss, with resultant feelings of weakness, are common problems C. Symptoms may not occur unless sacs become inflamed D. As the sacs enlarge pain may be experienced in the lower abdomen A client with Cushing's syndrome is recovering from an elective laparoscopic procedure. Which assessment finding warrants immediate intervention by the nurse? A. Irregular apical pulse B. Pitting ankle edema C. Quarter size blood spot on dressing D. Purple marks on skin of the abdomen A female client who recently married returns to the clinic with recurrent cystitis and urethritis. The client presents with pain on urinating, urinary frequency, and urgency. Which additional information should the nurse obtain? A. Review a recent urinalysis for calcium oxalate B. Examine a client's history for any genetic renal disease C. Ask if she has recently has a streptococcus infection D. Inquire about hygiene practices after sexual intercourse A client has an absolute neutrophil count (ANC) of 500/mm^3 after completing chemotherapy. Which intervention is most important for the nurse to implement? A. Implement bleeding precautions B. Place the client in protective isolation C. Assess vital signs every 4 hours D. Review need for pneumococcal vaccine A client is receiving chemotherapy for treatment of metastatic carcinoma. When monitoring the client for systemic side effects, which assessment finding warrants intervention by the nurse? A. Leukopenia B. Polycythemia C. Ascites D. Nystagmus lOMoAR cPSD| A client with hyperparathyroidism reports a sudden onset of severe flank pain. Which intervention should the nurse include in the client's plan of care? A. Begin straining all urine B. Implement seizure precautions C. Administer a PRN dose of a laxative D. Initiate cardiac telemetry The nurse is caring for a client on a rehabilitation unit who has right cerebrovascular accident and is struggling with independent self-care. The nurse places a large mirror in the client's room. Which instruction should the nurse provide the client? A. Mirrors reflect light to brighten the room so you can see better B. A hoe-like environment helps you relax and feel more confident C. Check your appearance before leaving the room D. Use the mirror to watch yourself while dressing An older client who us agitated, dyspneic, orthopneic, and using accessory muscles to breathe is admitted for further treatment. Initial assessment includes a heart rate 128 beats/minute and irregular respirations 38 breaths/minute, blood pressure 168/100 mmHg, wheezes and crackles in all lung fields. An hour after the administration of furosemide 60 mg IV, which assessments should the nurse obtain to determine the client's response to the treatment? (Select all that apply) A. Oxygen saturation B. Skin elasticity C. Pain scale D. Lung Sounds E. Urinary output During the admission assessment, the nurse identifies multiple bruises at various stages of healing on a male client recently diagnosed with aplastic anemia. The nurse reviews his stat serum laboratory values which reveal platelets 50,000/mm^3, white blood cells 3,000/mm^3, and red blood cells 2.5 million/mm^3. Which actions should the nurse implement? (Select all that apply) A. Initiate sepsis protocol B. Provide a soft-bristle toothbrush C. Monitor for signs of bleeding D. Implement contact precautions E. Infuse blood products as prescribed lOMoAR cPSD| The nurse is developing plan of care for a client who reports blurred vision and who is newly diagnosed with type 2 diabetes. Which outcome should the nurse include in the plan of care for this client? A. The nurse will encourage the client to walk 30 minutes every day B. The client's blood pressure readings will be less than 160/90 mmHg C. The client's hemoglobin A1c will be less than 7.0% in 3 months D. The nurse will demonstrate the procedure for accurate eye care The nurse is developing a plan of care for an adult client with cardiovascular disease who reports blurred-vision. Which outcome should the nurse include in the plan of care for this client? A. The client's daily blood pressure will be less than 140/80 mmHg this month B. The nurse will encourage the client to walk 30 minutes every day C. The client's blood pressure readings will be less than 160/90. mmHg D. The client will take up to 4 nitroglycerine tablets sublingually for chest pain A client who fractured the right femur from a fall at home is placed in a skeletal traction while awaiting surgery. When the client tells the nurse the need to urinate, which intervention should the nurse implement? A. Insert an indwelling catheter preoperatively B. Release the traction so the client can use a bedpan C. Log roll the client and place adult disposable briefs beneath the client D. Maintain traction while the client uses a female urinal When teaching a client with Parkinson's disease, which rationale for the prescription of carbidopa-levodopa should the nurse include? A. Reduces the inflammatory process improving nerve transmission and function B Increases the amount of dopamine available for muscles to function correctly C. Slows the scarring in the myelin sheath improving muscle tone and strength D. Acts as an antiseizure medication reducing the tremors caused by the disease A male client with acquired immune deficiency syndrome (AIDS) and Pneumocystis carinii pneumonia has a CD4+ T cell count of 200 cells/microliter. The client asks the nurse why he keeps getting these massive infections. Which pathophysiologic mechanism should the nurse describe in response to the client's question? A. Bone marrow suppression of white blood cells causes insufficient cells to phagocytize organisms B. Exposure to multiple environmental infectious agents overburdens the immune system until it fails C. The humoral immune response lacks B cells that form antibodies and opportunistic lOMoAR cPSD| infections result D. Inadequate numbers of T lymphocytes are available to initiate cellular immunity and macrophages The nurse is assessing a client who has herpes zoster. Which question will allow the nurse to gather further information about this condition? A. Has everyone at home already had varicella? B. Have the anti fungal creams been effective? C. Do your family members share combs and brushes? D. Do you have any dry patches on your feet and hands? A client with renal calculus is complaining of severe right flank pain, nausea, and vomiting. Which nursing problem has the highest priority? A. Risk for aspiration related to vomiting B. Nutritional deficit related to nausea C. Impaired renal function related to pain D. Acute pain related to real calculus The nurse prepares a teaching plan for an adult client with metabolic syndrome. Which findings should the nurse address to help the client reduce the risk for diabetes mellitus and vascular disease? (Select all that apply) A. Hypothyroidism B. Increased triglyceride levels C. Hyperglycemia D. Blood pressure of 150/96 E. Elevated high density lipoproteins F. Abdominal obesity The nurse reviews the laboratory results of a client during an annual physical examination and identifies a positive guaiac test of stool. Which additional serum laboratory test result should the nurse review? A. Whit blood cell count B. Glucose C. Platelet count D. Amylase lOMoAR cPSD| The home health nurse is evaluating a male client who manages his asthma and measures his peak expiratory flow rate (PEFR). Today he is experiencing an acute exacerbation and tells the nurse his PEFR is 60% of his personal-best reading. He is experiencing expiratory and inspiratory wheezes and has a RR of 24 breaths/minute, and oxygen saturation rate of 94% on room air. Which PRN medication should the nurse instruct the client to use? A. Albuterol 2.5 to 5 mg per nebulization B. Epinephrine auto-injector 0.15 mg C. Salmeterol 2 puffs per measured-dose inhaled D. Oxygen at 6 liter/minute by nasal cannula A client who had colon surgery 3 days ago is anxious and requesting assistance to reposition. While the nurse is turning the client, the wound dehiscences and eviscerates. The nurse moistens an available sterile dressing and places it over the wound. Which intervention should the nurse implement next? A. Prepare the client to return to the operating room B. Obtain a sample of the drainage to send to the lab C. Auscultate the abdomen for bowel sound activity D. Bring additional sterile dressing supplies to the room After several days of coughing and taking acetaminophen to treat temperature of 101 F, a client with diabetes mellitus (DM) is admitted to the hospital with an upper respiratory infection. Several hours after admission, the client reports having a severe headache and feeling dizzy. Which intervention should the nurse implement first? A. Reassess vital signs B. Administer an antipyretic C. Obtain a sputum for culture D. Obtain a fingerstick glucose While assisting a client to the toilet, the client begins to have a seizure and the nurse eases the client to the floor. The nurse calls for help and monitors the client until the seizing stops. Which intervention should the nurse implement first? A. Observe for lacerations to the tongue B. Document details of the seizure activity C. Observe for prolonged periods of apnea D. Evaluate for evidence of incontinence An adult client comes to urgent care clinic 5 days after being diagnosed with influenza. The client is short of breath, febrile, and coughing green-colored sputum. Which intervention should the nurse implement first? A. Obtain a sputum sample for culture B. Check his oxygen saturation level C. Auscultate bilateral lung sounds D. Administer an oral antipyretic lOMoAR cPSD| An older adult recently diagnosed with type 2 diabetes mellitus (DM) suddenly becomes confused and weak, with cool, clammy skin. The client is unable to remember what to do for such symptoms and is taken to a near-by urgent care facility by a neighbor. Which nursing interventions should the nurse implement? (select all that apply) A. Prepare to administer regular insulin B. Palpate for bladder for pain or distention C. Check a blood sample for glucose level D. Report any changes in blood pressure E. Observe respiratory rate and pattern An adult client who received partial-thickness and full-thickness burns over 40% of the body in a house fire is admitted to the inpatient burn unit. Which fluid should the nurse prepare to administer during the acute phase of the client's burn recovery? A. 5% dextrose in water B. total parenteral nutrition C. 5% dextrose in 0.25 normal saline D. Lactate Ringers A client with eczema is applying 10% urea cream onto the affected skin areas. Which finding reflects the expected therapeutic response? A. Reduced pain in eczematous areas B. Decreased weeping of ulcerations in affected areas C. Healing with a return to normal skin appearance D. Hydration of affected dry skin areas When planning care for a client with rheumatoid arthritis, which intervention is most important for the nurse to include? A. Schedule rest periods between activities to minimize fatigue B. Teach coping skill for living with a chronic illness C. Provide assistive devices to empower client independence D. Implement measures to manage chronic pain An adult client is admitted with diabetic ketoacidosis (DKA) and a urinary tract infection (UTI) Prescriptions for intravenous antibiotics and insulin infusion are initiated. Which serum laboratory value warrants the most immediate intervention by the nurse? A. blood ph of 7.30 B. glucose of 350 mg /dl C. white blood cell count of 15000mm D. potassium of 2.5 meq/l A healthcare worker with no known exposure to tuberculosis has received a Mantoux tuberculosis skin test. The nurse's assessment of the test after 72 hours indicates 5mm of erythema without induration. What is the best initial nursing action? lOMoAR cPSD| A. Review client's history for possible exposure to TB B. Instruct the client to return for a repeat test in 1 week C. Refer client to a healthcare provider for isoniazid (INH) therapy D. Document negative results in the client's medical record