HESI MED-SURG EXAM PREP 2025/2026 –
VERIFIED PRACTICE QUESTIONS,
DETAILED RATIONALES & PROVEN
STRATEGIES FOR GUARANTEED
SUCCESS
The nurse is assisting a client out of bed for the first time after surgery. What
action should the nurse do first? - -- ANSWER IS----Allow the client to sit with the
bed in a high Fowler's position.
Rationale
The first step is to raise the head of the bed to a high Fowler's position, which
allow venous return to compensate from lying flat and the vasodilation effects of
perioperative drugs. This helps prevent the client from becoming light-headed
and decreases the chance of a client fall.
After the fourth dose of gentamicin sulfate (Garamycin) IV, the nurse plans to
draw blood samples to determine peak and trough levels. When are the best
times to draw these samples? - -- ANSWER IS----5 minutes before and 30 minutes
after the next dose.
Rationale
,Peak drug serum levels are achieved 30 minutes after the completion of the IV
infusion of gentamicin sulfate. The best time to draw a trough is the closest time
to the next administration.
In assessing a client diagnosed with primary hyperaldosteronism, the nurse
expects the laboratory test results to indicate an increased serum level of which
substance? - -- ANSWER IS----Sodium.
Rationale
Clients with primary aldosteronism exhibit an increase in serum sodium levels
(hypernatremia) and have profound decline in the serum levels of potassium
(hypokalemia)--hypertension is the most prominent and universal sign.
Antidiuretic hormone is decreased with diabetes insipidus. Glucose is not affected
by primary aldosteronism.
Which milestone indicates to the nurse successful achievement of young
adulthood? - -- ANSWER IS----Completes education and becomes self-supporting.
Rationale
Transitioning through young adulthood is characterized by establishing
independence as an adult, and includes developmental tasks such as completing
education, beginning a career, and becoming self-supporting (B). (A and C) are
characteristic of adolescence. Although strong bonds with parents are an
expected finding for this age group, the need for support and approval (D)
indicates dependency, which is a developmental delay.
,The nurse is assessing a client who smokes cigarettes and has been diagnosed
with emphysema. Which finding would the nurse expect this client to exhibit? - --
ANSWER IS----Normal skin coloring.
Rationale
The differentiation between the "pink puffer" and the "blue bloater" is a well-
known method of differentiating clients exhibiting symptoms of emphysema
(normal color but puffing respirations) from those exhibiting symptoms of chronic
bronchitis (edematous, cyanotic, shallow respirations).
A male client who smokes two packs of cigarettes a day states he understands
that smoking cigarettes is contributing to the difficulty that he and his wife are
having in getting pregnant and wants to know if other factors could be
contributing to their difficulty. What information is best for the nurse to provide?
(Select all that apply.) - -- ANSWER IS----Alcohol consumption can cause erectile
dysfunction.
Low testosterone levels affect sperm production.
Cessation of smoking improves general health and fertility.
Rationale
Use of tobacco, alcohol, and marijuana may affect sperm counts. Sperm count is
also negatively affected by low testerone levels and obesity.
The nurse working on a telemetry unit finds a client unconscious and in pulseless
ventricular tachycardia (VT). The client has an implanted automatic defibrillator.
What action should the nurse implement? - -- ANSWER IS----Shock the client with
200 joules per hospital policy.
, Rationale
The client must be externally shocked 200 joules per hospital policy to restore an
effective cardiac rhythm. The automatic defibrillator is obviously malfunctioning.
What is the correct procedure for performing an opthalmoscopic examination on
a client's right retina? - -- ANSWER IS----From a distance of 12 to 15 inches and
slightly to the side, shine the light into the client's pupil.
Rationale
The client should focus on a distant object behind the examiner who should stand
at 12-15 inches away and to the side of his/her line of vision. The examiner should
hold the ophthalmoscope firmly against his/her face and then direct it at the
client's pupil.
During lung assessment, the nurse places a stethoscope on a client's chest and
instructs him/her to say "99" each time the chest is touched with the
stethoscope. What would be the correct interpretation if the nurse hears the
spoken words "99" very clearly through the stethoscope? - -- ANSWER IS----May
indicate pneumonia.
Rationale
This test (whispered pectoriloquy) demonstrates hyperresonance and helps
determine the clarity with which spoken words are heard upon auscultation.
Normally, the spoken word is not well transmitted through lung tissue, and is
heard as a muffled or unclear transmission of the spoken word. Increased clarity
of a spoken word is indicative of some sort of consolidation process (e. g., tumor,
pneumonia), and is not a normal finding.
VERIFIED PRACTICE QUESTIONS,
DETAILED RATIONALES & PROVEN
STRATEGIES FOR GUARANTEED
SUCCESS
The nurse is assisting a client out of bed for the first time after surgery. What
action should the nurse do first? - -- ANSWER IS----Allow the client to sit with the
bed in a high Fowler's position.
Rationale
The first step is to raise the head of the bed to a high Fowler's position, which
allow venous return to compensate from lying flat and the vasodilation effects of
perioperative drugs. This helps prevent the client from becoming light-headed
and decreases the chance of a client fall.
After the fourth dose of gentamicin sulfate (Garamycin) IV, the nurse plans to
draw blood samples to determine peak and trough levels. When are the best
times to draw these samples? - -- ANSWER IS----5 minutes before and 30 minutes
after the next dose.
Rationale
,Peak drug serum levels are achieved 30 minutes after the completion of the IV
infusion of gentamicin sulfate. The best time to draw a trough is the closest time
to the next administration.
In assessing a client diagnosed with primary hyperaldosteronism, the nurse
expects the laboratory test results to indicate an increased serum level of which
substance? - -- ANSWER IS----Sodium.
Rationale
Clients with primary aldosteronism exhibit an increase in serum sodium levels
(hypernatremia) and have profound decline in the serum levels of potassium
(hypokalemia)--hypertension is the most prominent and universal sign.
Antidiuretic hormone is decreased with diabetes insipidus. Glucose is not affected
by primary aldosteronism.
Which milestone indicates to the nurse successful achievement of young
adulthood? - -- ANSWER IS----Completes education and becomes self-supporting.
Rationale
Transitioning through young adulthood is characterized by establishing
independence as an adult, and includes developmental tasks such as completing
education, beginning a career, and becoming self-supporting (B). (A and C) are
characteristic of adolescence. Although strong bonds with parents are an
expected finding for this age group, the need for support and approval (D)
indicates dependency, which is a developmental delay.
,The nurse is assessing a client who smokes cigarettes and has been diagnosed
with emphysema. Which finding would the nurse expect this client to exhibit? - --
ANSWER IS----Normal skin coloring.
Rationale
The differentiation between the "pink puffer" and the "blue bloater" is a well-
known method of differentiating clients exhibiting symptoms of emphysema
(normal color but puffing respirations) from those exhibiting symptoms of chronic
bronchitis (edematous, cyanotic, shallow respirations).
A male client who smokes two packs of cigarettes a day states he understands
that smoking cigarettes is contributing to the difficulty that he and his wife are
having in getting pregnant and wants to know if other factors could be
contributing to their difficulty. What information is best for the nurse to provide?
(Select all that apply.) - -- ANSWER IS----Alcohol consumption can cause erectile
dysfunction.
Low testosterone levels affect sperm production.
Cessation of smoking improves general health and fertility.
Rationale
Use of tobacco, alcohol, and marijuana may affect sperm counts. Sperm count is
also negatively affected by low testerone levels and obesity.
The nurse working on a telemetry unit finds a client unconscious and in pulseless
ventricular tachycardia (VT). The client has an implanted automatic defibrillator.
What action should the nurse implement? - -- ANSWER IS----Shock the client with
200 joules per hospital policy.
, Rationale
The client must be externally shocked 200 joules per hospital policy to restore an
effective cardiac rhythm. The automatic defibrillator is obviously malfunctioning.
What is the correct procedure for performing an opthalmoscopic examination on
a client's right retina? - -- ANSWER IS----From a distance of 12 to 15 inches and
slightly to the side, shine the light into the client's pupil.
Rationale
The client should focus on a distant object behind the examiner who should stand
at 12-15 inches away and to the side of his/her line of vision. The examiner should
hold the ophthalmoscope firmly against his/her face and then direct it at the
client's pupil.
During lung assessment, the nurse places a stethoscope on a client's chest and
instructs him/her to say "99" each time the chest is touched with the
stethoscope. What would be the correct interpretation if the nurse hears the
spoken words "99" very clearly through the stethoscope? - -- ANSWER IS----May
indicate pneumonia.
Rationale
This test (whispered pectoriloquy) demonstrates hyperresonance and helps
determine the clarity with which spoken words are heard upon auscultation.
Normally, the spoken word is not well transmitted through lung tissue, and is
heard as a muffled or unclear transmission of the spoken word. Increased clarity
of a spoken word is indicative of some sort of consolidation process (e. g., tumor,
pneumonia), and is not a normal finding.
