HESI RN- MED SURG 342 ACTUAL EXAMINATION TEST-2026
FACULTY OF NURSING (PN) END OF TERM EXAM PAPER 1
QUESTIONS AND VERIFIED CORRECT ANSWERS |HIGHER TIER
FINAL SPRING EXAM [ 2025\2026 UPDATE]
PASS GUARANTEED | GRADE A+
The nurse is caring for a client with a chest tube to water seal drainage that was inserted 10
days ago because of a ruptured bullae and pneumothorax. Which finding should the nurse
report to the health care provider before the chest tube is removed?
A.
Tidaling of water in water seal chamber
B.
Bilateral muffled breath sounds at bases
C.
Temperature of 101°F
D.
Absence of chest tube drainage for 2 days
A
Rationale:Tidaling (rising and falling of water with respirations) in the water seal chamber
should be reported to the health care provider before the chest tube is removed to rule out an
unresolved pneumothorax or persistent air leak, which is characteristic of a ruptured bullae
caused by abnormally wide changes in negative intrathoracic pressure. Option B may indicate
hypoventilation from chest tube discomfort and usually improves when the chest tube is
removed. Option C usually indicates an infection, which may not be related to the chest tube.
Option D is an expected finding.
,In caring for a client with acute diverticulitis, which assessment data warrants an immediate
nursing action?
A.
The client has a rigid hard abdomen and elevated WBC.
B.
The client has left lower quadrant pain and an elevated temperature.
C.
The client is refusing to eat any of the meal and is complaining of nausea.
D.
The client has not had a bowel movement in 2 days and has a soft abdomen.
A
Rationale:A hard rigid abdomen and elevated WBC is indicative of peritonitis, which is a medical
emergency and should be reported to the health care provider immediately. Options B and C
are expected clinical manifestations of diverticulitis. Option D does not warrant immediate
intervention.
Which foods will the nurse recommend for the client with tuberculosis being discharged to
home? (Select all that apply.)
A.
Bean soup
B.
Spinach
C.
Apples
D.
, Bananas
E.
Dark chocolate
F.
Shellfish
A, B, E, F
Rationale:Apples and bananas are good sources of fiber but are low in protein and iron. The
remaining foods are high in iron along with organ meats, all legumes, red meat, pumpkin seeds,
quinoa, turkey, broccoli, and tofu.
Which statement reflects the highest priority nursing diagnosis for an older client recently
admitted to the hospital for a new-onset cardiac dysrhythmia?
A.
Diarrhea related to medication side effects
B.
Anxiety related to fear of recurrent anginal episodes
C.
Altered nutrition related to high serum lipid levels
D.
Risk for injury related to syncope and confusion
D
Rationale:The loss of cardiac function in aging decreases cardiac output, so dysrhythmias,
particularly tachycardias, are poorly tolerated. With onset of a tachycardic or bradycardic
dysrhythmia, cardiac output is compromised further, placing the client at risk of syncope and
falling, as well as confusion. Option A is of high priority but less so than maintaining client
safety. Clients may experience option B as a result of a newly diagnosed cardiac condition, but
this nursing diagnosis does not have the priority of option D. Option C also does not have the
priority of option D.
FACULTY OF NURSING (PN) END OF TERM EXAM PAPER 1
QUESTIONS AND VERIFIED CORRECT ANSWERS |HIGHER TIER
FINAL SPRING EXAM [ 2025\2026 UPDATE]
PASS GUARANTEED | GRADE A+
The nurse is caring for a client with a chest tube to water seal drainage that was inserted 10
days ago because of a ruptured bullae and pneumothorax. Which finding should the nurse
report to the health care provider before the chest tube is removed?
A.
Tidaling of water in water seal chamber
B.
Bilateral muffled breath sounds at bases
C.
Temperature of 101°F
D.
Absence of chest tube drainage for 2 days
A
Rationale:Tidaling (rising and falling of water with respirations) in the water seal chamber
should be reported to the health care provider before the chest tube is removed to rule out an
unresolved pneumothorax or persistent air leak, which is characteristic of a ruptured bullae
caused by abnormally wide changes in negative intrathoracic pressure. Option B may indicate
hypoventilation from chest tube discomfort and usually improves when the chest tube is
removed. Option C usually indicates an infection, which may not be related to the chest tube.
Option D is an expected finding.
,In caring for a client with acute diverticulitis, which assessment data warrants an immediate
nursing action?
A.
The client has a rigid hard abdomen and elevated WBC.
B.
The client has left lower quadrant pain and an elevated temperature.
C.
The client is refusing to eat any of the meal and is complaining of nausea.
D.
The client has not had a bowel movement in 2 days and has a soft abdomen.
A
Rationale:A hard rigid abdomen and elevated WBC is indicative of peritonitis, which is a medical
emergency and should be reported to the health care provider immediately. Options B and C
are expected clinical manifestations of diverticulitis. Option D does not warrant immediate
intervention.
Which foods will the nurse recommend for the client with tuberculosis being discharged to
home? (Select all that apply.)
A.
Bean soup
B.
Spinach
C.
Apples
D.
, Bananas
E.
Dark chocolate
F.
Shellfish
A, B, E, F
Rationale:Apples and bananas are good sources of fiber but are low in protein and iron. The
remaining foods are high in iron along with organ meats, all legumes, red meat, pumpkin seeds,
quinoa, turkey, broccoli, and tofu.
Which statement reflects the highest priority nursing diagnosis for an older client recently
admitted to the hospital for a new-onset cardiac dysrhythmia?
A.
Diarrhea related to medication side effects
B.
Anxiety related to fear of recurrent anginal episodes
C.
Altered nutrition related to high serum lipid levels
D.
Risk for injury related to syncope and confusion
D
Rationale:The loss of cardiac function in aging decreases cardiac output, so dysrhythmias,
particularly tachycardias, are poorly tolerated. With onset of a tachycardic or bradycardic
dysrhythmia, cardiac output is compromised further, placing the client at risk of syncope and
falling, as well as confusion. Option A is of high priority but less so than maintaining client
safety. Clients may experience option B as a result of a newly diagnosed cardiac condition, but
this nursing diagnosis does not have the priority of option D. Option C also does not have the
priority of option D.
