HESI (RN) -MEDICAL SURGICAL SUPPLEMENTARY EXAMINATION- 2026
FACULTY OF NURSING| HIGHER TIER EXAM MODULE 1 FINAL SPRING
EXAM
QUESTIONS AND CORRECT DETAILLED ANSWERS| 2025\2026 UPDATE
PASS GUARANTEED | GRADED A+ |JUST RELEASED
A central venous catheter has been inserted via a jugular vein, and a radiograph has confirmed
placement of the catheter. A prescription has been received for a medication STAT, but IV fluids
have not yet been started. Which action should the nurse take prior to administering the
prescribed medication?
A.
Assess for signs of jugular venous distention.
B.
Obtain the needed intravenous solution.
C.
Flush the line with heparinized solution.
D.
Flush the line with normal saline.
D
Rationale:Medication can be administered via a central line without additional IV fluids. The line
should first be flushed with a normal saline solution to ensure patency. Insufficient evidence
exists on the effectiveness of flushing catheters with heparin. Option A will not affect the
decision to administer the medication and is not a priority. Administration of the medication
STAT is of greater priority than option B.
, In assessing a client with an arteriovenous (AV) shunt who is scheduled for dialysis today, the
nurse notes the absence of a thrill or bruit at the shunt site. What action should the nurse take?
A.
Advise the client that the shunt is intact and ready for dialysis as scheduled.
B.
Encourage the client to keep the shunt site elevated above the level of the heart.
C.
Notify the health care provider of the findings immediately.
D.
Flush the site at least once with a heparinized saline solution.
C
Rationale:Absence of a thrill or bruit indicates that the shunt may be obstructed. The nurse
should notify the health care provider so that intervention can be initiated to restore function of
the shunt. Option A is incorrect. Option B will not resolve the obstruction. An AV shunt is
internal and cannot be flushed without access using special needles.
The nurse is providing care to a client after a percutaneous transluminal coronary angioplasty
(PTCA). What actions will the nurse include in the client's plan of care? (Select all that apply.)
A.
Frequent vital signs.
B.
Determine if the client is allergic to aspirin.
C.
Assist out of bed 2 hours after return from the procedure.
D.
Offer fluids of choice.
FACULTY OF NURSING| HIGHER TIER EXAM MODULE 1 FINAL SPRING
EXAM
QUESTIONS AND CORRECT DETAILLED ANSWERS| 2025\2026 UPDATE
PASS GUARANTEED | GRADED A+ |JUST RELEASED
A central venous catheter has been inserted via a jugular vein, and a radiograph has confirmed
placement of the catheter. A prescription has been received for a medication STAT, but IV fluids
have not yet been started. Which action should the nurse take prior to administering the
prescribed medication?
A.
Assess for signs of jugular venous distention.
B.
Obtain the needed intravenous solution.
C.
Flush the line with heparinized solution.
D.
Flush the line with normal saline.
D
Rationale:Medication can be administered via a central line without additional IV fluids. The line
should first be flushed with a normal saline solution to ensure patency. Insufficient evidence
exists on the effectiveness of flushing catheters with heparin. Option A will not affect the
decision to administer the medication and is not a priority. Administration of the medication
STAT is of greater priority than option B.
, In assessing a client with an arteriovenous (AV) shunt who is scheduled for dialysis today, the
nurse notes the absence of a thrill or bruit at the shunt site. What action should the nurse take?
A.
Advise the client that the shunt is intact and ready for dialysis as scheduled.
B.
Encourage the client to keep the shunt site elevated above the level of the heart.
C.
Notify the health care provider of the findings immediately.
D.
Flush the site at least once with a heparinized saline solution.
C
Rationale:Absence of a thrill or bruit indicates that the shunt may be obstructed. The nurse
should notify the health care provider so that intervention can be initiated to restore function of
the shunt. Option A is incorrect. Option B will not resolve the obstruction. An AV shunt is
internal and cannot be flushed without access using special needles.
The nurse is providing care to a client after a percutaneous transluminal coronary angioplasty
(PTCA). What actions will the nurse include in the client's plan of care? (Select all that apply.)
A.
Frequent vital signs.
B.
Determine if the client is allergic to aspirin.
C.
Assist out of bed 2 hours after return from the procedure.
D.
Offer fluids of choice.
