DEPARTMENT OF NURSING MODULE 2 | HIGHER TIER EXAM END OF
TERM FINAL SPRING
HESI REGISTERED NURSING (RN) -MED SURG SUPPLEMENTARY
EXAMINATION- 2026
QUESTIONS AND CORRECT DETAILLED ANSWERS| {2025\2026}
UPDATE
PASS GUARANTEED | GRADED A+
The nurse is planning care for a client with diabetes mellitus who has gangrene of the toes to
the midfoot. Which goal should be included in this client's plan of care?
A.
Restore skin integrity.
B.
Prevent infection.
C.
Promote healing.
D.
Improve nutrition.
B
Rationale:The prevention of infection is a priority goal for this client. Gangrene is the result of
necrosis (tissue death). If infection develops, there is insufficient circulation to fight the infection
and the infection can result in osteomyelitis or sepsis. Because tissue death has already
occurred, options A and C are unattainable goals. Option D is important but of less priority than
option B.
, The clinic nurse is teaching a client newly diagnosed with Raynaud's Syndrome. What
instructions will the nurse include in the client's teaching plan? (Select all that apply.)
A.
Place your hands in 130°F/54.4°C water until warmed through.
B.
Wear warm clothing and socks when you are cold.
C.
Use finger guards when using a knife to avoid cutting your hands.
D.
Take your medication only when you feel the tingling in your fingers.
E.
Avoid stressful situations at work and in your home life.
B, C, E
Rationale:Water at 130°F/54.4°C can cause burns at 30 second exposure. Because of the
numbness and tingling the client may not be able to sense burning. Vasodilators are often
prescribed for these clients, especially during the cold months. The therapy needs to be
continuous for the maximum effect. The remaining instructions will benefit the client with
Raynaud's.
During assessment of a client in the intensive care unit, the nurse notes that the client's breath
sounds are clear on auscultation, but jugular vein distention and muffled heart sounds are
present. Which action should the nurse take first?
A.
Prepare the client for a pericardial tap.
B.
Administer intravenous furosemide.
TERM FINAL SPRING
HESI REGISTERED NURSING (RN) -MED SURG SUPPLEMENTARY
EXAMINATION- 2026
QUESTIONS AND CORRECT DETAILLED ANSWERS| {2025\2026}
UPDATE
PASS GUARANTEED | GRADED A+
The nurse is planning care for a client with diabetes mellitus who has gangrene of the toes to
the midfoot. Which goal should be included in this client's plan of care?
A.
Restore skin integrity.
B.
Prevent infection.
C.
Promote healing.
D.
Improve nutrition.
B
Rationale:The prevention of infection is a priority goal for this client. Gangrene is the result of
necrosis (tissue death). If infection develops, there is insufficient circulation to fight the infection
and the infection can result in osteomyelitis or sepsis. Because tissue death has already
occurred, options A and C are unattainable goals. Option D is important but of less priority than
option B.
, The clinic nurse is teaching a client newly diagnosed with Raynaud's Syndrome. What
instructions will the nurse include in the client's teaching plan? (Select all that apply.)
A.
Place your hands in 130°F/54.4°C water until warmed through.
B.
Wear warm clothing and socks when you are cold.
C.
Use finger guards when using a knife to avoid cutting your hands.
D.
Take your medication only when you feel the tingling in your fingers.
E.
Avoid stressful situations at work and in your home life.
B, C, E
Rationale:Water at 130°F/54.4°C can cause burns at 30 second exposure. Because of the
numbness and tingling the client may not be able to sense burning. Vasodilators are often
prescribed for these clients, especially during the cold months. The therapy needs to be
continuous for the maximum effect. The remaining instructions will benefit the client with
Raynaud's.
During assessment of a client in the intensive care unit, the nurse notes that the client's breath
sounds are clear on auscultation, but jugular vein distention and muffled heart sounds are
present. Which action should the nurse take first?
A.
Prepare the client for a pericardial tap.
B.
Administer intravenous furosemide.
