HESI RN MEDICAL SURGICAL EXAM
PACK 2026 with verified QUESTION AND
ANSERS GRADED A+
The nurse is assessing a client with acute pancreatitis. Which finding
requires the most immediate intervention by the nurse?
A.
The client's amylase level is three times higher than the normal level.
B.
The client has a carpal spasm when taking a blood pressure.
C.
On a 1 to 10 scale, the client tells the nurse that her epigastric pain is at 7.
D.
The client states that she will continue to drink alcohol after going home. -
B
The nurse is assessing a client with acute pancreatitis. Which finding
requires the most immediate intervention by the nurse?
Rationale:A positive Trousseau sign indicates hypocalcemia and always
requires further assessment and intervention, regardless of the cause (40%
to 75% of those with acute pancreatitis experience hypocalcemia, which
can have serious, systemic effects). A key diagnostic finding of pancreatitis
is serum amylase and lipase levels that are two to five times higher than
the normal value. Severe boring pain is an expected symptom for this
diagnosis, but dealing with the hypocalcemia is a priority over administering
an analgesic. Long-term planning and teaching do not have the same
immediate importance as a positive Trousseau sign.
A 55-year-old male client has been admitted to the hospital with a medical
diagnosis of chronic obstructive pulmonary disease (COPD). Which risk
factor is the most significant in the development of this client's COPD?
A.
The client's father was diagnosed with COPD in his 50s.
B.
A close family member contracted tuberculosis last year.
, C.
The client smokes one to two packs of cigarettes per day.
D.
The client has been 40 pounds overweight for 15 years. - C
Rationale:Smoking, considered to be a modifiable risk factor, is the most
significant risk factor for the development of COPD. The exact mechanism
of genetic and hereditary implications for the development of COPD is still
under investigation, although exposure to similar predisposing factors (e.g.,
smoking or inhaling secondhand smoke) may increase the likelihood of
COPD incidence among family members. Options B and D do not exceed
the risks associated with cigarette smoking in the development of COPD.
In assessing a client diagnosed with primary aldosteronism, the nurse
expects the laboratory test results to indicate a decreased serum level of
which substance?
A.
Sodium
B.
Phosphate
C.
Potassium
D.
Glucose - C
Rationale:Clients with primary aldosteronism exhibit a profound decline in
serum levels of potassium; hypokalemia; hypertension is the most
prominent and universal sign. The serum sodium level is normal or
elevated, depending on the amount of water resorbed with the sodium.
Option B is influenced by parathyroid hormone (PTH). Option D is not
affected by primary aldosteronism.
The nurse is completing an admission interview for a client with Parkinson
disease. Which question will provide additional information about
manifestations that the client is likely to experience?
A.
"Have you ever experienced any paralysis of your arms or legs?"
B.
"Do you have frequent blackout spells?"
C.
"Have you ever been frozen in one spot, unable to move?"
D.
,"Do you have headaches, especially ones with throbbing pain?" - C
Rationale:Clients with Parkinson disease frequently experience difficulty in
initiating, maintaining, and performing motor activities. They may even
experience being rooted to the spot and unable to move. Parkinson
disease does not typically cause option A, B, or D.
Client census is often used to determine staffing needs. Which method of
obtaining census determination for a particular unit provides the best
formula for determining long-range staffing patterns?
A.
Midnight census
B.
Oncoming shift census
C.
Average daily census
D.
Hourly census - C
Rationale:An average daily census is determined by trend data and takes
into account seasonal and daily fluctuations, so it is the best method for
determining staffing needs. Options A and B provide data at a certain point
in time, and that data could change quickly. It is unrealistic to expect to
obtain an hourly census, and such data would only provide information
about a certain point in time.
A male client has just undergone a laryngectomy and has a cuffed
tracheostomy tube in place. When initiating bolus tube feedings
postoperatively, when should the nurse inflate the cuff?
A.
Immediately after feeding
B.
Just prior to tube feeding
C.
Continuous inflation is required
D.
Inflation is not required - B
Rationale:The cuff should be inflated before the feeding to block the
trachea and prevent food from entering if oral feedings are started while a
cuffed tracheostomy tube is in place. It should remain inflated throughout
the feeding to prevent aspiration of food into the respiratory system.
, Options A and D place the client at risk for aspiration. Option C places the
client at risk for tracheal wall necrosis.
A client with a nasogastric tube attached to low suction states that she is
nauseated. The nurse assesses that there has been no drainage through
the nasogastric tube in the last 2 hours. Which action should the nurse take
first?
A.
Irrigate the nasogastric tube with sterile normal saline.
B.
Reposition the client on her side.
C.
Advance the nasogastric tube 5 cm.
D.
Administer an intravenous antiemetic as prescribed. - B
Rationale:The immediate priority is to determine if the tube is functioning
correctly, which would then relieve the client's nausea. The least invasive
intervention, repositioning the client, should be attempted first, followed by
options A and C, unless either of these interventions is contraindicated. If
these measures are unsuccessful, the client may require option D.
The nurse is conducting an osteoporosis screening clinic at a health fair.
What information should the nurse provide to individuals who are at risk for
osteoporosis? (Select all that apply.)
A.
Encourage alcohol and smoking cessation.
B.
Suggest supplementing diet with vitamin E.
C.
Promote regular weight-bearing exercises.
D.
Implement a home safety plan to prevent falls.
E.
Propose a regular sleep pattern of 8 hours nightly. - A, C, D
Rationale:Options A, C, and D are factors that decrease the risk for
developing osteoporosis. Vitamin D and calcium are important supplements
to aid in the decrease of bone loss. Regular sleep patterns are important to
overall health but are not identified with a decreasing risk for osteoporosis.
PACK 2026 with verified QUESTION AND
ANSERS GRADED A+
The nurse is assessing a client with acute pancreatitis. Which finding
requires the most immediate intervention by the nurse?
A.
The client's amylase level is three times higher than the normal level.
B.
The client has a carpal spasm when taking a blood pressure.
C.
On a 1 to 10 scale, the client tells the nurse that her epigastric pain is at 7.
D.
The client states that she will continue to drink alcohol after going home. -
B
The nurse is assessing a client with acute pancreatitis. Which finding
requires the most immediate intervention by the nurse?
Rationale:A positive Trousseau sign indicates hypocalcemia and always
requires further assessment and intervention, regardless of the cause (40%
to 75% of those with acute pancreatitis experience hypocalcemia, which
can have serious, systemic effects). A key diagnostic finding of pancreatitis
is serum amylase and lipase levels that are two to five times higher than
the normal value. Severe boring pain is an expected symptom for this
diagnosis, but dealing with the hypocalcemia is a priority over administering
an analgesic. Long-term planning and teaching do not have the same
immediate importance as a positive Trousseau sign.
A 55-year-old male client has been admitted to the hospital with a medical
diagnosis of chronic obstructive pulmonary disease (COPD). Which risk
factor is the most significant in the development of this client's COPD?
A.
The client's father was diagnosed with COPD in his 50s.
B.
A close family member contracted tuberculosis last year.
, C.
The client smokes one to two packs of cigarettes per day.
D.
The client has been 40 pounds overweight for 15 years. - C
Rationale:Smoking, considered to be a modifiable risk factor, is the most
significant risk factor for the development of COPD. The exact mechanism
of genetic and hereditary implications for the development of COPD is still
under investigation, although exposure to similar predisposing factors (e.g.,
smoking or inhaling secondhand smoke) may increase the likelihood of
COPD incidence among family members. Options B and D do not exceed
the risks associated with cigarette smoking in the development of COPD.
In assessing a client diagnosed with primary aldosteronism, the nurse
expects the laboratory test results to indicate a decreased serum level of
which substance?
A.
Sodium
B.
Phosphate
C.
Potassium
D.
Glucose - C
Rationale:Clients with primary aldosteronism exhibit a profound decline in
serum levels of potassium; hypokalemia; hypertension is the most
prominent and universal sign. The serum sodium level is normal or
elevated, depending on the amount of water resorbed with the sodium.
Option B is influenced by parathyroid hormone (PTH). Option D is not
affected by primary aldosteronism.
The nurse is completing an admission interview for a client with Parkinson
disease. Which question will provide additional information about
manifestations that the client is likely to experience?
A.
"Have you ever experienced any paralysis of your arms or legs?"
B.
"Do you have frequent blackout spells?"
C.
"Have you ever been frozen in one spot, unable to move?"
D.
,"Do you have headaches, especially ones with throbbing pain?" - C
Rationale:Clients with Parkinson disease frequently experience difficulty in
initiating, maintaining, and performing motor activities. They may even
experience being rooted to the spot and unable to move. Parkinson
disease does not typically cause option A, B, or D.
Client census is often used to determine staffing needs. Which method of
obtaining census determination for a particular unit provides the best
formula for determining long-range staffing patterns?
A.
Midnight census
B.
Oncoming shift census
C.
Average daily census
D.
Hourly census - C
Rationale:An average daily census is determined by trend data and takes
into account seasonal and daily fluctuations, so it is the best method for
determining staffing needs. Options A and B provide data at a certain point
in time, and that data could change quickly. It is unrealistic to expect to
obtain an hourly census, and such data would only provide information
about a certain point in time.
A male client has just undergone a laryngectomy and has a cuffed
tracheostomy tube in place. When initiating bolus tube feedings
postoperatively, when should the nurse inflate the cuff?
A.
Immediately after feeding
B.
Just prior to tube feeding
C.
Continuous inflation is required
D.
Inflation is not required - B
Rationale:The cuff should be inflated before the feeding to block the
trachea and prevent food from entering if oral feedings are started while a
cuffed tracheostomy tube is in place. It should remain inflated throughout
the feeding to prevent aspiration of food into the respiratory system.
, Options A and D place the client at risk for aspiration. Option C places the
client at risk for tracheal wall necrosis.
A client with a nasogastric tube attached to low suction states that she is
nauseated. The nurse assesses that there has been no drainage through
the nasogastric tube in the last 2 hours. Which action should the nurse take
first?
A.
Irrigate the nasogastric tube with sterile normal saline.
B.
Reposition the client on her side.
C.
Advance the nasogastric tube 5 cm.
D.
Administer an intravenous antiemetic as prescribed. - B
Rationale:The immediate priority is to determine if the tube is functioning
correctly, which would then relieve the client's nausea. The least invasive
intervention, repositioning the client, should be attempted first, followed by
options A and C, unless either of these interventions is contraindicated. If
these measures are unsuccessful, the client may require option D.
The nurse is conducting an osteoporosis screening clinic at a health fair.
What information should the nurse provide to individuals who are at risk for
osteoporosis? (Select all that apply.)
A.
Encourage alcohol and smoking cessation.
B.
Suggest supplementing diet with vitamin E.
C.
Promote regular weight-bearing exercises.
D.
Implement a home safety plan to prevent falls.
E.
Propose a regular sleep pattern of 8 hours nightly. - A, C, D
Rationale:Options A, C, and D are factors that decrease the risk for
developing osteoporosis. Vitamin D and calcium are important supplements
to aid in the decrease of bone loss. Regular sleep patterns are important to
overall health but are not identified with a decreasing risk for osteoporosis.
