BSN 266 HESI
Med Surg Exam
(NGN-Style Presentation & Case Scenarios)
Actual Qs & Verified Ans to Pass the Exam
This Hesi test contains:
Next Gen-style presentation of the questions with expert rationales for a BSN-level
Med-Surg exam.
Each question includes Answer Choices, the Correct Answer, and a detailed Expert
Rationale explaining the reasoning process, suitable for the 2025 HESI Med-Surg
exam standard.
, 1. . A client is admitted with a traumatic brain injury after violently striking his head against a
brick wall during a gang fight. Which finding is most important for further assessment?
A. Serosanguinous nasal drainage
B. Mild headache
C. Dizziness
D. Fatigue
Correct Answer: A. Serosanguinous nasal drainage
Rationale: Serosanguinous nasal drainage may indicate a cerebrospinal fluid (CSF) leak, which is a serious
sign of basal skull fracture. Such drainage suggests a breach in the dura mater and increases risk for
infection (meningitis). Immediate and further assessment is critical to prevent complications. Mild
headache, dizziness, and fatigue are common but less acute compared to CSF leak signs.
2. A female oncology client with hyperesthesia is using a TENS unit for chronic pain. Which
nursing activity should the RN implement rather than delegate to a practical nurse (PN)?
A. Apply electrodes to the client’s skin
B. Monitor for skin irritation
C. Evaluate the client’s ability to adjust the voltage to control pain
D. Teach basic TENS unit functions
Correct Answer: C. Evaluate the client’s ability to adjust the voltage to control pain
Rationale: Evaluation and assessment of client safety and understanding require RN clinical judgment and
cannot be delegated. While applying electrodes or teaching device use can be delegated, evaluating
effective and safe adjustment of voltage for pain control requires ongoing professional assessment.
3. The nurse is preparing a teaching plan for a client newly diagnosed with glaucoma and has
allergic rhinitis. Which information about OTC allergy medications is most important?
,A. Allergy medications containing pseudoephedrine or phenylephrine should be avoided
B. Antihistamines are safe and recommended
C. OTC allergy medications do not affect glaucoma
D. Use decongestants liberally for symptom relief
Correct Answer: A. Allergy medications containing pseudoephedrine or phenylephrine should be avoided
Rationale: Pseudoephedrine and phenylephrine are sympathomimetic decongestants that increase
intraocular pressure and can worsen glaucoma. Clients with glaucoma must avoid these substances to
prevent exacerbation of their condition. Antihistamines may be safer alternatives but require consultation.
4. A client with multiple trauma and known secondary syphilis is admitted. What precaution should
the nurse implement?
A. Standard precautions; gloves during any contact with skin lesions
B. Contact precautions for airborne transmission
C. No special precautions required
D. Droplet precautions
Correct Answer: A. Standard precautions; gloves during any contact with skin lesions
Rationale: Secondary syphilis can be transmitted via contact with skin or mucous membrane lesions.
Standard precautions must be carefully implemented, including wearing gloves during skin contacts, to
prevent transmission. Airborne and droplet precautions are not indicated.
---
5. The nurse is caring for a client with HIV infection who develops Mycobacterium avium complex
(MAC) infection. What is the most significant desired outcome?
A. Return to pre-illness weight
B. Complete eradication of MAC
, C. No fever for 24 hours
D. Ability to ambulate independently
Correct Answer: A. Return to pre-illness weight
Rationale: MAC infections in HIV patients often cause wasting syndrome. Nutritional status and weight
restoration are critical to improving immune response and overall prognosis. Complete eradication is
difficult; thus, symptom control and functional status improvement are priority goals.
---
6. A young adult female reports lack of appetite, hypersomnia, stress incontinence, and heart
palpitations. Which symptom is characteristic of premenstrual syndrome (PMS)?
A. Heart palpitations
B. Stress incontinence
C. Hypersomnia
D. Lack of appetite
Correct Answer: A. Heart palpitations
Rationale: Heart palpitations can be part of the autonomic symptoms associated with PMS due to hormonal
fluctuations. Stress incontinence and hypersomnia are less typical for PMS and may require other
evaluation.
---
7. PET scan is commonly used with oncology clients to provide which diagnostic information?
A. Identification of metastatic sites of cancer
B. Tumor size measurement only
C. Bone density analysis
D. Assessment of tumor histology
Med Surg Exam
(NGN-Style Presentation & Case Scenarios)
Actual Qs & Verified Ans to Pass the Exam
This Hesi test contains:
Next Gen-style presentation of the questions with expert rationales for a BSN-level
Med-Surg exam.
Each question includes Answer Choices, the Correct Answer, and a detailed Expert
Rationale explaining the reasoning process, suitable for the 2025 HESI Med-Surg
exam standard.
, 1. . A client is admitted with a traumatic brain injury after violently striking his head against a
brick wall during a gang fight. Which finding is most important for further assessment?
A. Serosanguinous nasal drainage
B. Mild headache
C. Dizziness
D. Fatigue
Correct Answer: A. Serosanguinous nasal drainage
Rationale: Serosanguinous nasal drainage may indicate a cerebrospinal fluid (CSF) leak, which is a serious
sign of basal skull fracture. Such drainage suggests a breach in the dura mater and increases risk for
infection (meningitis). Immediate and further assessment is critical to prevent complications. Mild
headache, dizziness, and fatigue are common but less acute compared to CSF leak signs.
2. A female oncology client with hyperesthesia is using a TENS unit for chronic pain. Which
nursing activity should the RN implement rather than delegate to a practical nurse (PN)?
A. Apply electrodes to the client’s skin
B. Monitor for skin irritation
C. Evaluate the client’s ability to adjust the voltage to control pain
D. Teach basic TENS unit functions
Correct Answer: C. Evaluate the client’s ability to adjust the voltage to control pain
Rationale: Evaluation and assessment of client safety and understanding require RN clinical judgment and
cannot be delegated. While applying electrodes or teaching device use can be delegated, evaluating
effective and safe adjustment of voltage for pain control requires ongoing professional assessment.
3. The nurse is preparing a teaching plan for a client newly diagnosed with glaucoma and has
allergic rhinitis. Which information about OTC allergy medications is most important?
,A. Allergy medications containing pseudoephedrine or phenylephrine should be avoided
B. Antihistamines are safe and recommended
C. OTC allergy medications do not affect glaucoma
D. Use decongestants liberally for symptom relief
Correct Answer: A. Allergy medications containing pseudoephedrine or phenylephrine should be avoided
Rationale: Pseudoephedrine and phenylephrine are sympathomimetic decongestants that increase
intraocular pressure and can worsen glaucoma. Clients with glaucoma must avoid these substances to
prevent exacerbation of their condition. Antihistamines may be safer alternatives but require consultation.
4. A client with multiple trauma and known secondary syphilis is admitted. What precaution should
the nurse implement?
A. Standard precautions; gloves during any contact with skin lesions
B. Contact precautions for airborne transmission
C. No special precautions required
D. Droplet precautions
Correct Answer: A. Standard precautions; gloves during any contact with skin lesions
Rationale: Secondary syphilis can be transmitted via contact with skin or mucous membrane lesions.
Standard precautions must be carefully implemented, including wearing gloves during skin contacts, to
prevent transmission. Airborne and droplet precautions are not indicated.
---
5. The nurse is caring for a client with HIV infection who develops Mycobacterium avium complex
(MAC) infection. What is the most significant desired outcome?
A. Return to pre-illness weight
B. Complete eradication of MAC
, C. No fever for 24 hours
D. Ability to ambulate independently
Correct Answer: A. Return to pre-illness weight
Rationale: MAC infections in HIV patients often cause wasting syndrome. Nutritional status and weight
restoration are critical to improving immune response and overall prognosis. Complete eradication is
difficult; thus, symptom control and functional status improvement are priority goals.
---
6. A young adult female reports lack of appetite, hypersomnia, stress incontinence, and heart
palpitations. Which symptom is characteristic of premenstrual syndrome (PMS)?
A. Heart palpitations
B. Stress incontinence
C. Hypersomnia
D. Lack of appetite
Correct Answer: A. Heart palpitations
Rationale: Heart palpitations can be part of the autonomic symptoms associated with PMS due to hormonal
fluctuations. Stress incontinence and hypersomnia are less typical for PMS and may require other
evaluation.
---
7. PET scan is commonly used with oncology clients to provide which diagnostic information?
A. Identification of metastatic sites of cancer
B. Tumor size measurement only
C. Bone density analysis
D. Assessment of tumor histology
