Prepare for the HESI Med-Surg exam with these practice test questions and answers. This guide covers medical-surgical nursing, patient care, and clinical procedures.
Q: What instruction should the nurse include in the discharge teaching plan of a client who had a cataract extraction today?a. sexual activities may be resumed upon return homeb. light housekeeping is permitted but avoid heavy liftingc. use a metal eye shield on operative eye during the dayd. administer eye ointment before applying eye drops
Answer: b. light housekeeping is permitted but avoid heavy lifting
Q: A male adult comes to the urgent care clinic 5 days after being diagnosed with influenza. He is short of breath, febrile, and coughing green colored sputum. Which intervention should the nurse implement first?a. Obtain a sputum sample for cultureb. Check his oxygen saturation levelc. Administer an oral antipyreticd. Auscultate bilateral lung sound
Answer: a. obtain a sputum sample for culture
Q: An elder male client tells the nurse that he is loosing sleep because he has to get up several times at night to go to the bathroom that he has trouble starting his urinary stream and that he does not feel like his bladder is ever completely empty. Which intervention should the nurse implement?a. collect a urine specimen for culture analysisb. obtain a fingerstick blood glucose levelc. palpate the bladder above the symphysis pubisd. review the client fluid intake
Answer: c. palpate the bladder above the symphysis pubis
Q: 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 7.30b. glucose of 350 mg /dlc. white blood cell count of 15000mmd. potassium of 2.5 meq/l
Answer: d. potassium of 2.5 meq/l
Q: A client with sickle cell anemia develops a fever during the last hour of administration of a unit of packed red blood cell. When notifying the healthcare provider what information should the nurse provide first using the SBAR communication process?a. explain specific reason for urgent notificationb. preface the report by stating the clients name and admitting diagnosisc. communicate the pre-transfusion temperaturesd. optain prn prescription for acetaminophen for fever 101f
Answer: a. explain specific reason for urgent notification
Q: An adult male client is admitted for pneumocystis carinil pneumonia (PCP) secondary to aids. While hospitalized he receives IV pentamidine isethionate therapy. In preparing this client for discharge what important aspect regarding his medication therapy should the nurse explain?a. AZT therapy must be stopped when IV aerosol pentamine is being used.b. IV pentamine will be given until oral pentamine can be toleratedc. It will be necessary to continue prophylactic doses of IV or aerosol pentamine every monthd. IV pentamine may offer protection to others aids related conditions such as kaposis sarcoma
Answer: c. it will be necessary to continue prophylactic doses of IV or aerosol pentamine every month
Q: A client subjective data includes dysuria, urgency, and urinary frequency. What action should the nurse implement next?a. collect a clean catch specimenb. palpate the suprapubic regionc. instruct to wipe from front to backd. inquire about recent sexual activity
Answer: a. collect a clean catch specimen
Q: A client tells the nurse that her biopsy results indicate that the cancer cells are well differentiated How should the nurse respond?a. offer the client reassurance that this information indicates that the clients cancer cells are benignb. explain that these tissue cells often respond more effectively to radiation than to chemotherapyc. ask the client if the healthcare provider has given her any information about the classification of her cancerd. help the client make plans to begin immediate treatment since her cancer is likely to spread quickly
Answer: c. ask the client if the healthcare provider has given her any information about the classification of her cancer
Q: A client with a chronic kidney disease is treated on hemodialysis. During the 1 treatment clients blood pressure drops from 150/90 to 80/30 Which action should the nurse take first?a. monitor bp q45 minutesb. lower the head of the chair and elevate feetc. stop dialysis treatmentd. administer 5% albumin IV
Answer: c. stop dialysis treatment
Q: A client with deep vain thrombosis (DVT) is receiving a continues infusion of heparin sodium 25,000 unit in 5% dextrose injection 250ml. The prescription indicates the dosage should be increase 900 units/hr. The nurse should program the infusion pump to deliver how many ml/hr?
Answer: 9 mL/hour
Q: The nurse is obtaining the admission history for a client with suspected peptic ulcer disease (PUD). Which subjective data reported by the client supports this diagnosis?a. upper mid abdominal gnawing and burning painb. severe abdominal cramps and diarrhea after eating spicy foodsc. marked loss of weight and appetite over the last few monthsd. use of chewable and liquid antacids for indigestion
Answer: a. upper mid abdominal gnawing and burning pain
Q: The nurse is providing preoperative education for a jewish client schedule to receive a xenograft graft to promote burn healing. Which information should the nurse provide this client?a. the xenograft is taken from nonhuman sourcesb. grafting increases the risk for bacterial infectionc. as the burn heals the graft permanently attachesd. grafts are later removed by debriding procedure
Answer: a. the xenograft is taken from nonhuman sources
Q: A client who took a camping vacation two weeks ago in a country with a tropical climate comes to the clinic describing vague symptoms and diarrhea for the past week. Which finding is most important for the nurse to report?a. jaundice sclerab. intestinal crampingc. weakness and fatigued. weight loss
Answer: a. jaundice sclera
Q: During a home visit the nurse assesses the skin of a client with eczema who reports that an exacerbation of symptoms has occurred during the last week. Which information is most useful in determining the possible cause of the symptoms?a. an old friend with eczema came for visitb. recently received an influenza immunizationc. corticosteroid cream was applied to eczemad. a grandson and his new dog recently visited
Answer: d. a grandson and his new dog recently visited
Q: When explaining dietary guidelines to a client with acute glomerulonephritis (AGN) which instruction should the nurse include in the dietary teaching?a. select a protein rich food dailyb. restrict sodium intakec. eat high potassium foodsd. Avoid foods high in carbohydrate
Answer: b. restrict sodium intake
Q: A male client who is 24hr post operative for an exploratory laparoctomy complains that he is starving because he has had no real food since before surgery. Prior to advancing his diet which intervention should the nurse implememt?a. discontinue intravenous therapyb. Assess for abdominal distension and tendernessc. Obtain a prescription for a diet changed. Auscultate bowel sound in all four quadrants
Answer: d. auscultate bowel sounds in all four quadrants
Q: A client diagnosed with stable angina secondary to ischemic heart disease has a prescription for sublingual (SL) nitroglycerin (NTG). The nurse should tell the client to follow which instructions if chest pain is not relieved after taking 3 NTG tablets 5 min apart?a. drive to the nearest emergency departmentb. take another NTG SL tablet and lie down until angina subsidesc. call primary healthcare providerd. call 911 if pain is unrelieved and chew a tablet of aspirin 325mg
Answer: d. call 911 if pain is unrelieved and chew a tablet of aspirin 325 mg
Q: After taking orlistat (Xenical) for one week a female client tells the home health nurse that she is experiencing increasingly frequent oily stools and flatus. What action should the nurse take?a. obtain stool specimen to evaluate for occult blood and fat contentb. instruct the client to increase her intake of saturated fats over the next weekc. ask the client to describe her dietary intake history for the last several daysd. advice the client to stop taking the drug and contact the healthcare provider
Answer: c. ask the client to describe her dietary intake history for the last several days
Q: Two days after an abscess of the chin was drained the client returns to the clinic with fever chills and a maculopapular rash with pruritis. The client has taken an oral antibiotic and cleansed the wound today with provide iodine (Betadine) solution. Which intervention should the nurse implement first?a. determine if the client has a history of diabetesb. assess airway patency and oxygen saturationc. review recent medication history and allergiesd. obtain samples for complete blood count and cultures
Answer: b. assess airway patency and oxygen saturation
Q: A client experiences an ABO incompatibility reaction after multiple blood transfusions. Which finding should the nurse report immediately to the health care provider?a. low back pain and hypotensionb. rhinitis and nasal stuffinessc. delayed painful rash with urticariald. arthritic joint changes and chronic pain
Answer: a. low back pain and hypotension
Q: A young adult male who has had type 2 diabetes mellitus (DM) is admitted to the intensive care unit with hyperglycemic nonketotic syndrome (HHNS). A sliding scale protocol for an isotonic IV solution with regular insulin is prescribed based on the results of a continuous blood glucose monitoring device that is attached to the client’s central venous catheter. When the client’s respirations become labored and his lungs sound indicate crackles what action should the nurse take?a. collect a specimen for a white blood cell count and culturesb. determine the clients glycosylated hemoglobin (A1C)c. administer insulin IV push until the clients fluid volume is adjustedd. decrease infusion rate to address fluid overload
Answer: d. decrease infusion rate to address fluid overload
Q: When preparing to apply a fentanyl (Duragesic) transdermal patch the nurse notes that the previously applied patch is intact on the client’s upper back and the client denies pain. What action should the nurse take?a. Remove the patch and consult with the healthcare provider about the client pain resolutionb. Place the patch on the clients shoulder and leave both patches in place for 12 hoursc. Administer an oral analgesic and evaluate its effectiveness before applying a new patchd. Apply a new patch in a different location after removing the original patch
Answer: d. apply a new patch in a different location after removing the original patch
Q: A client who had a myocardial infarction is admitted to the coronary critical care unit (CCU) with a nitroglycerin drip infusing. The clients last blood pressure measurements was 78/36. What action should the nurse implement?a. obtain blood pressure q5 minutes using duranap machineb. change the dilution of the nitroglycerin infusionc. reduce the rate of the nitroglycerin infusiond. begin dopamine infusion at 5mcg/kg per minute
Answer: c. reduce the rate of the nitroglycerin infusion
Q: An adolescent is admitted to the hospital because of a suicide attempt with an overdose of acetaminophen (Tylenol). Which blood values are most important for the nurse to monitor during the first 72 hours following ingestion of this overdose?a. BUN creatinine specific gravityb. White blood count, hemoglobin hematocritc. PH,PCO2, HC03d. LDH OR LD, SGOT OR ALT, SGPT OR AST
Answer: d. LDH or LD, SGOT or ALT, SGPT or ASTacetaminophen is processed by the liver
Q: An elderly post-operative female client is receiving morphine sulfate via a PCA pump. Which assessment finding should prompt a nurse to administer the prescribed PRN medication naloxone?a. her respiratory rate is 7 breath/minuteb. she indicates that she feels as if she cannot get enough air to breathc. she has intercostal retractions and bilateral wheezing is auscultatedd. her pulse oximeter is 89% on room air
Answer: a. her respiratory rate is 7 breaths/minute
Q: Which assessment finding indicates to the nurse that the muscarinic agent bethanechol (Urecholine) is effective for a client diagnosed with urinary retention?a. urinary output equal to intakeb. no terminal urinary dribblingc. denies stress incontinenced. absence of xerostomia
Answer: a. urinary output equal to intake
Q: Following involvement in a motor vehicle collision, a middle aged adult client is admitted to the hospital with multiple facial fractures. The client’s blood alcohol level is high on admission. Which PRN prescription should be administer if the clients begins to exhibit signs and symptoms of delirium tremens (DT s)?a. Lorazepam (Ativan) 2mg IMb. Chlorpromazine (thorazine) 50 mg IMc. Prochlorperazine (Compazine) 5 mg IMd. Hydromorphone (Dilaudid) 2 mg IM
Answer: a. lorazepam (Ativan) 2mg IM
Q: Which instructions should the nurse include in the teaching plan of a client who is taking the diuretic spironolactone (Aldactone)?a. call the healthcare provider if you develop gynecomastiab. Take the medication in the morningc. Avoid caffeine and smokingd. Increase your consumption of bananas and oranges
Answer: b. take the medication in the morning(You would want to decrease your consumption of potassium)
Q: A glucagon emergency kit is prescribed for a client with type 1 diabetes mellitus. When should the nurse instruct the client to take the glucagon?a. after meals to increase endogenous insulin secretionb. after insulin administration to prevent hypoglycemiac. when recognized signs of severe hypoglycemia occurd. when unable to eat during sick days
Answer: c. when recognized signs of severe hypoglycemia occur
Q: A client with hyperthyroidism is being treated with radioactive iodine (I-131). Which explanation should be included in preparing this client for this treatment?a. describe radioactive iodine as a tasteless, colorless medication administered by the healthcare providerb. explain the need for using lead shields for 2 to 3 weeks after the treatmentc. describe the signs of goiter because this is a common side effects of radioactive iodined. explain that relief of the signs/ symptoms of hyperthyroidism will occur immediately
Answer: a. describe radioactive iodine as a tasteless, colorless medication administered by the healthcare provider
Q: A female client is being treated for tuberculosis with rifampin (rifadin) which statement indicates that further teaching is needed?
Answer: I will take my usual contraceptive for birth control
Q: A client is discharged with a prescription for warfarin (Coumadin). What discharge instructions should the nurse emphasize to the client?a. take a multi vitamin supplement dailyb. use an astringent for superficial bleedingc. avoid going barefoot especially outsided. include large amounts of spinach in the diet
Answer: c. avoid going barefoot, especially outside
Q: In caring for a client with diabetes insipidus who is receiving an antidiuretic hormone intranasal which serum lab test is most important for the nurse to monitor?a. osmolalityb. calciumc. plateletsd. glucose
Answer: a. osmolality
Q: After administering dihydroergotamine (Migranal) 1 mg subcutaneously to a client with a severe migraine headache the nurse should explain that relief can be expected within what time frame?a. 2 hoursb. 5 minutesc. 1 hourd. 15 minutes
Answer: d. 15 minutes
Q: A client with hypertension who has been taking labetalol for two weeks, reports a five pound (2.2 kg) weight gain. Which follow up assessment is most important for the nurse to obtain?a. capillary refillb. body temperaturec. muscle strengthd. breath sounds
Answer: d. breath sounds
Q: A male client is receiving pilocarpine hydrochloride (Isopto Carpine) ophthalmic drops for glaucoma. He calls the clinic and ask the nurse why he has difficulty seeing at night. What explanation should the nurse provide?a. The eye drops slow pupil response to accommodate for darknessb. The drops increase the fluid in the eyes and cloud the visual field ( possible answer)c. The drug can cause lens to become more opaqued. The medication causes pupils to dilate which reduces night vision
Answer: a. the eye drops slow pupil response to accommodate for darkness
Q: A client who is taking and oral dose of tetracycline complains of gastrointestinal upset. What snack should the nurse instruct the client to take with the tetracycline?a. toasted wheat bread and jellyb. cheese and crackersc. cold cereal with skim milkd. fruit flavored yogurt
Answer: a.toasted wheat bread and jelly
Q: The therapeutic effect of insulin in treating type 1 diabetes mellitus is based on which physiologic action?a. Facilitates transport of glucose into the cellb. Increases intracellular receptor site sensitivityc. Stimulates function of beta cells in the pancreasd. Delays carbohydrates digestion and absorption
Answer: a. facilitates transport of glucose into the cell
Q: The health care provider prescribe a medication for an older adult client who is complaining of insomnia. And instructs the client to return in 2 weeks. The nurse should question which prescription?a. Eszoplicone (Lunesta)10 mg orally at bed timeb. Zolpidem 10 mg orally at bed timec. Temazepan orally at bed timed. Ramelteon orally at bedtime
Answer: a. eszoplicone (Lunesta) 10mg PO at bedtime
Q: A male client reports to the nurse that he is experiencing GI distress from high dose of a corticosteroid and is planning to stop taking the medication. In response to the client’s statement what nursing action is most important for the nurse to take?a. Encourage the client to take medication with food to decrease GI distressb. Advice the client that the medication should be stopped gradually rather than abruptly.c. Review the clients dosing schedule to ensure he is taking the prescribed amountd. Assess the client for other indication of adverse effects of corticosteroid
Answer: b. advise the client that the medication should be stopped gradually rather than abruptly
Q: Fifteen minutes after receiving sulfa athenozole. A male client report a burning sensation over his abdomen chest and groin. Which intervention is most important for the nurse to implement?a. Auscultate lung sounds for wheezingb. Review the clients list if drugs allergiesc. Add sulfamethinozole to clients allergiesd. Check neurological vital signs
Answer: b. review the clients list of drug allergies
Q: Antibiotic resistant organism are a major infection control problems. To help minimize the emergence of resistant bacteria what instruction should the nurse provide to the clients?a. stop taking prescribed antibiotics when symptoms decreaseb. avoid using antibiotics when suffering from colds or the fluc. ask the healthcare provider to prescribe the newest antibiotic when neededd. request a prescription for first time vancomysin for a sore throat
Answer: b. avoid using antibiotics when suffering from colds or the flu
Q: A client with symptoms of influenza that started the previous day ask the clinic nurse about taking oseltamivir (Tamiflu) to treat the infection. Which response should the nurse provide?a. Advise the client once symptoms occur is too late to receive an influenza vaccinationb. Refer the client to the healthcare provider at the clinic to obtain a medication prescriptionc. Explain to the client that antibiotics are not useful in treating viral infections such as influenzad. Instruct the client that over the counter medications are sufficient to manage influenza symptoms
Answer: b. refer the client to the healthcare provider at the clinic to obtain a medication prescription
Q: Twenty minutes after the nurse starts a secondary IV infusion of cafepime (maxipime) 2 grams using an infusion pump to deliver the dose in one hour, the client reports feeling nauseated. What action should the nurse implement?a. stop medication infusion and notify the healthcare provider of the adverse effectb. increase the rate of the infusion to complete the dose of the medication more rapidlyc. continue the infusion and administer a prn antiemetic prescriptiond. reassure the client that the nausea is not related to the iv infusion
Answer: c. continue the infusion and administer a PRN antiemetic prescription
Q: The nurse administer donepezil hydrochloride (Aricept) to a client with Alzheimer’s disease as an intervention for which client problem?a. fluid volume excessb. disturbed thought processesc. chronic paind. altered breathing patterns
Answer: b. disturbed thought processes
Q: To prevent deep vein thrombosis following knee replacement surgery, an adult male client is receiving enoxaparin (Lovenox) subcutaneously daily. Which laboratory finding requires immediate action by the nurse?a. blood urea nitrogen (BUN) 20mg/dl or 7.1 mmol/L (SI)b. Hematocrit 45%c. Serum creatinine 1.0 mg/dl or 88.4 mol/L (SI)d. Platelet count of 100,000/mm3 or 100×10??/ L (SI)
Answer: d