HESI NUR 209 Medical Surgical Nursing II Questions and Answers Practice Questions with
Solutions Newest | Already Graded A+
Question 1
A client diagnosed with Human Immunodeficiency Virus (HIV) is concerned about getting
opportunistic infections. Which intervention should the nurse recommend to help prevent these
infections?
A. Clean toothbrushes once a week.
B. Bathe daily using an antimicrobial soap.
C. Eat a fresh garden salad at least once a day.
D. Wash all dishes in cool, soapy water.
E. Use a communal hot tub for relaxation.
Correct Answer: B) Bathe daily using an antimicrobial soap.
Rationale: Daily bathing with an antimicrobial soap reduces the bacterial load on the skin,
which is a primary defense mechanism against opportunistic pathogens in
immunocompromised clients. Toothbrushes should be cleaned daily (or through a
dishwasher), raw fruits and vegetables (salads) should be avoided due to the risk of
bacterial contamination, and dishes should be washed in hot, soapy water or a dishwasher
to ensure sterilization.
Question 2
The nurse is conducting a health assessment interview with a client diagnosed with HIV. Which
statement by the client requires the nurse to address it immediately?
A. "When I injected heroin in the past, I was exposed to HIV."
B. "I don't fully understand how these antiretroviral drugs work."
C. "I remember to take my antiretroviral drugs almost every day."
D. "My sex drive is weaker than it used to be since starting medications."
E. "I feel more tired in the afternoons than I did last year."
Correct Answer: C) "I remember to take my antiretroviral drugs almost every day."
Rationale: Antiretroviral therapy (ART) requires 95% or greater adherence to be
successful. Taking medications "almost every day" implies missed doses, which can rapidly
lead to the development of drug-resistant HIV strains and treatment failure. While the
other statements require education or further assessment, adherence is the highest priority
to prevent clinical progression.
Question 3
An HIV-positive client with a CD4+ count of 15 cells/mm³ is admitted with a fever and
abdominal pain. Which healthcare provider request should the nurse implement first?
A. Obtain a 12-lead electrocardiogram (ECG).
B. Request a portable chest x-ray.
C. Obtain blood cultures from two different sites.
D. Administer cefazolin 500 mg IVPB.
E. Administer an oral antipyretic for the fever.
Correct Answer: C) Obtain blood cultures from two different sites.
, 2
Rationale: In a severely immunocompromised client (AIDS stage) presenting with fever,
sepsis is a major concern. Blood cultures must be obtained before starting antibiotics so
that the results are not masked by the medication. Antibiotics should be given as soon as
possible, but only after the cultures are drawn. ECG and x-rays are secondary to
identifying the causative organism.
Question 4
The nurse is assigned to the following four clients. Which client should the nurse assess first?
A. A client with HIV and Kaposi's sarcoma with increased swelling of a lesion on the arm.
B. A client with a history of liver transplant taking cyclosporine with an elevated temperature.
C. A client admitted for a monthly dose of immune globulin for Bruton's agammaglobulinemia.
D. A client receiving abdominal radiation with a decreased total lymphocyte count.
E. A client with HIV who reports a dry cough for the last two weeks.
Correct Answer: B) A client with a history of liver transplant taking cyclosporine with an
elevated temperature.
Rationale: A post-transplant client on immunosuppressants (cyclosporine) who develops a
fever is at extreme risk for overwhelming, life-threatening infection or organ rejection. This
is a medical emergency. The other clients are relatively stable: Kaposi's sarcoma lesions
often swell, a low lymphocyte count is expected with radiation, and immune globulin
infusions are routine.
Question 5
A nurse is teaching a client about the progression of HIV to AIDS. Which laboratory value is the
primary indicator that the client has reached AIDS (Stage 3)?
A. A viral load exceeding 100,000 copies/mL.
B. A CD4+ T-cell count below 200 cells/mm³.
C. A positive Western Blot test.
D. A white blood cell count of 4,000/mm³.
E. A hemoglobin level of 10 g/dL.
Correct Answer: B) A CD4+ T-cell count below 200 cells/mm³.
Rationale: According to the CDC, a diagnosis of AIDS is made when a client is HIV-positive
and either has a CD4+ T-cell count of less than 200 cells/mm³ or develops an AIDS-defining
opportunistic infection, regardless of the CD4 count.
Question 6
Which Opportunistic Infection (OI) is a common cause of fungal pneumonia in clients with
AIDS and requires prophylactic treatment when CD4 counts drop below 200?
A. Mycobacterium avium complex (MAC).
B. Toxoplasmosis.
C. Pneumocystis jirovecii pneumonia (PCP).
D. Cytomegalovirus (CMV).
, 3
E. Candidiasis.
Correct Answer: C) Pneumocystis jirovecii pneumonia (PCP).
Rationale: PCP is a fungal infection that is the most common opportunistic respiratory
infection in people with AIDS. Prophylaxis (usually with TMP-SMX) is standard when CD4
counts fall below 200.
Question 7
A nurse is caring for a client with HIV who has developed wasting syndrome. Which dietary
intervention should the nurse implement?
A. Limit fluid intake during meals.
B. Provide three large, high-calorie meals a day.
C. Offer small, frequent, high-protein and high-calorie meals.
D. Implement a low-fat, high-fiber diet.
E. Restrict intake of dairy products.
Correct Answer: C) Offer small, frequent, high-protein and high-calorie meals.
Rationale: Wasting syndrome is characterized by unintended weight loss and malnutrition.
Small, frequent meals are better tolerated than large meals, and high protein/calorie
content is necessary to combat tissue wasting and maintain energy.
Question 8
What is the primary purpose of the "Viral Load" test in the management of a client with HIV?
A. To determine the initial diagnosis of HIV.
B. To measure the effectiveness of antiretroviral therapy (ART).
C. To count the number of remaining T-helper cells.
D. To identify the presence of antibodies.
E. To screen for opportunistic cancers.
Correct Answer: B) To measure the effectiveness of antiretroviral therapy (ART).
Rationale: Viral load tests measure the amount of HIV RNA in the blood. A decreasing viral
load indicates that ART is effectively suppressing the virus. The goal of therapy is an
"undetectable" viral load.
Question 9
A nurse is preparing to administer Cyclosporine to a post-kidney transplant client. Which
assessment finding would indicate a common side effect/toxicity of this medication?
A. Hypotension.
B. Decreased serum creatinine.
C. Increased blood urea nitrogen (BUN) and hypertension.
D. Hypoglycemia.
E. Excessive weight loss.
Correct Answer: C) Increased blood urea nitrogen (BUN) and hypertension.
Rationale: Cyclosporine is an immunosuppressant known for nephrotoxicity and causing
, 4
hypertension. Monitoring kidney function (BUN/Creatinine) and blood pressure is essential
during therapy.
Question 10
A client with HIV is diagnosed with Kaposi's Sarcoma (KS). How should the nurse describe
these lesions to the client's family?
A. Small, itchy white vesicles on the trunk.
B. Painful, fluid-filled blisters along a nerve path.
C. Reddish-purple, flat or raised skin lesions.
D. Hard, painless warts on the hands and feet.
E. Large, weeping ulcers with yellow drainage.
Correct Answer: C) Reddish-purple, flat or raised skin lesions.
Rationale: Kaposi's Sarcoma is a vascular malignancy associated with HIV/AIDS. It
typically presents as non-blanching, brownish-pink to deep purple macules, plaques, or
nodes on the skin or mucous membranes.
Question 11
When teaching an HIV-positive client about home safety, why does the nurse instruct them to
avoid cleaning bird cages or cat litter boxes?
A. To prevent the transmission of HIV to the pets.
B. To avoid exposure to Toxoplasmosis and Cryptococcosis.
C. Because animal dander triggers Kaposi’s Sarcoma.
D. To prevent the pets from becoming stressed.
E. Because the smell of animal waste causes nausea with ART.
Correct Answer: B) To avoid exposure to Toxoplasmosis and Cryptococcosis.
Rationale: Immunocompromised individuals are at high risk for zoonotic infections. Cat
feces may contain Toxoplasma gondii, and bird droppings often carry Cryptococcus, both
of which can cause severe neurological or respiratory disease in AIDS patients.
Question 12
A nurse is evaluating the skin of a client with Systemic Lupus Erythematosus (SLE). Which
finding is classic for this diagnosis?
A. A butterfly-shaped rash across the bridge of the nose and cheeks.
B. Scaly, silver plaques on the elbows and knees.
C. A circular "bullseye" rash on the thigh.
D. Petechiae and purpura on the lower extremities.
E. Thick, leathery skin on the fingertips.
Correct Answer: A) A butterfly-shaped rash across the bridge of the nose and cheeks.
Rationale: The "malar rash," or butterfly rash, is a hallmark clinical sign of SLE, occurring
in about 50% of patients. It is often triggered or worsened by sunlight (photosensitivity).
Solutions Newest | Already Graded A+
Question 1
A client diagnosed with Human Immunodeficiency Virus (HIV) is concerned about getting
opportunistic infections. Which intervention should the nurse recommend to help prevent these
infections?
A. Clean toothbrushes once a week.
B. Bathe daily using an antimicrobial soap.
C. Eat a fresh garden salad at least once a day.
D. Wash all dishes in cool, soapy water.
E. Use a communal hot tub for relaxation.
Correct Answer: B) Bathe daily using an antimicrobial soap.
Rationale: Daily bathing with an antimicrobial soap reduces the bacterial load on the skin,
which is a primary defense mechanism against opportunistic pathogens in
immunocompromised clients. Toothbrushes should be cleaned daily (or through a
dishwasher), raw fruits and vegetables (salads) should be avoided due to the risk of
bacterial contamination, and dishes should be washed in hot, soapy water or a dishwasher
to ensure sterilization.
Question 2
The nurse is conducting a health assessment interview with a client diagnosed with HIV. Which
statement by the client requires the nurse to address it immediately?
A. "When I injected heroin in the past, I was exposed to HIV."
B. "I don't fully understand how these antiretroviral drugs work."
C. "I remember to take my antiretroviral drugs almost every day."
D. "My sex drive is weaker than it used to be since starting medications."
E. "I feel more tired in the afternoons than I did last year."
Correct Answer: C) "I remember to take my antiretroviral drugs almost every day."
Rationale: Antiretroviral therapy (ART) requires 95% or greater adherence to be
successful. Taking medications "almost every day" implies missed doses, which can rapidly
lead to the development of drug-resistant HIV strains and treatment failure. While the
other statements require education or further assessment, adherence is the highest priority
to prevent clinical progression.
Question 3
An HIV-positive client with a CD4+ count of 15 cells/mm³ is admitted with a fever and
abdominal pain. Which healthcare provider request should the nurse implement first?
A. Obtain a 12-lead electrocardiogram (ECG).
B. Request a portable chest x-ray.
C. Obtain blood cultures from two different sites.
D. Administer cefazolin 500 mg IVPB.
E. Administer an oral antipyretic for the fever.
Correct Answer: C) Obtain blood cultures from two different sites.
, 2
Rationale: In a severely immunocompromised client (AIDS stage) presenting with fever,
sepsis is a major concern. Blood cultures must be obtained before starting antibiotics so
that the results are not masked by the medication. Antibiotics should be given as soon as
possible, but only after the cultures are drawn. ECG and x-rays are secondary to
identifying the causative organism.
Question 4
The nurse is assigned to the following four clients. Which client should the nurse assess first?
A. A client with HIV and Kaposi's sarcoma with increased swelling of a lesion on the arm.
B. A client with a history of liver transplant taking cyclosporine with an elevated temperature.
C. A client admitted for a monthly dose of immune globulin for Bruton's agammaglobulinemia.
D. A client receiving abdominal radiation with a decreased total lymphocyte count.
E. A client with HIV who reports a dry cough for the last two weeks.
Correct Answer: B) A client with a history of liver transplant taking cyclosporine with an
elevated temperature.
Rationale: A post-transplant client on immunosuppressants (cyclosporine) who develops a
fever is at extreme risk for overwhelming, life-threatening infection or organ rejection. This
is a medical emergency. The other clients are relatively stable: Kaposi's sarcoma lesions
often swell, a low lymphocyte count is expected with radiation, and immune globulin
infusions are routine.
Question 5
A nurse is teaching a client about the progression of HIV to AIDS. Which laboratory value is the
primary indicator that the client has reached AIDS (Stage 3)?
A. A viral load exceeding 100,000 copies/mL.
B. A CD4+ T-cell count below 200 cells/mm³.
C. A positive Western Blot test.
D. A white blood cell count of 4,000/mm³.
E. A hemoglobin level of 10 g/dL.
Correct Answer: B) A CD4+ T-cell count below 200 cells/mm³.
Rationale: According to the CDC, a diagnosis of AIDS is made when a client is HIV-positive
and either has a CD4+ T-cell count of less than 200 cells/mm³ or develops an AIDS-defining
opportunistic infection, regardless of the CD4 count.
Question 6
Which Opportunistic Infection (OI) is a common cause of fungal pneumonia in clients with
AIDS and requires prophylactic treatment when CD4 counts drop below 200?
A. Mycobacterium avium complex (MAC).
B. Toxoplasmosis.
C. Pneumocystis jirovecii pneumonia (PCP).
D. Cytomegalovirus (CMV).
, 3
E. Candidiasis.
Correct Answer: C) Pneumocystis jirovecii pneumonia (PCP).
Rationale: PCP is a fungal infection that is the most common opportunistic respiratory
infection in people with AIDS. Prophylaxis (usually with TMP-SMX) is standard when CD4
counts fall below 200.
Question 7
A nurse is caring for a client with HIV who has developed wasting syndrome. Which dietary
intervention should the nurse implement?
A. Limit fluid intake during meals.
B. Provide three large, high-calorie meals a day.
C. Offer small, frequent, high-protein and high-calorie meals.
D. Implement a low-fat, high-fiber diet.
E. Restrict intake of dairy products.
Correct Answer: C) Offer small, frequent, high-protein and high-calorie meals.
Rationale: Wasting syndrome is characterized by unintended weight loss and malnutrition.
Small, frequent meals are better tolerated than large meals, and high protein/calorie
content is necessary to combat tissue wasting and maintain energy.
Question 8
What is the primary purpose of the "Viral Load" test in the management of a client with HIV?
A. To determine the initial diagnosis of HIV.
B. To measure the effectiveness of antiretroviral therapy (ART).
C. To count the number of remaining T-helper cells.
D. To identify the presence of antibodies.
E. To screen for opportunistic cancers.
Correct Answer: B) To measure the effectiveness of antiretroviral therapy (ART).
Rationale: Viral load tests measure the amount of HIV RNA in the blood. A decreasing viral
load indicates that ART is effectively suppressing the virus. The goal of therapy is an
"undetectable" viral load.
Question 9
A nurse is preparing to administer Cyclosporine to a post-kidney transplant client. Which
assessment finding would indicate a common side effect/toxicity of this medication?
A. Hypotension.
B. Decreased serum creatinine.
C. Increased blood urea nitrogen (BUN) and hypertension.
D. Hypoglycemia.
E. Excessive weight loss.
Correct Answer: C) Increased blood urea nitrogen (BUN) and hypertension.
Rationale: Cyclosporine is an immunosuppressant known for nephrotoxicity and causing
, 4
hypertension. Monitoring kidney function (BUN/Creatinine) and blood pressure is essential
during therapy.
Question 10
A client with HIV is diagnosed with Kaposi's Sarcoma (KS). How should the nurse describe
these lesions to the client's family?
A. Small, itchy white vesicles on the trunk.
B. Painful, fluid-filled blisters along a nerve path.
C. Reddish-purple, flat or raised skin lesions.
D. Hard, painless warts on the hands and feet.
E. Large, weeping ulcers with yellow drainage.
Correct Answer: C) Reddish-purple, flat or raised skin lesions.
Rationale: Kaposi's Sarcoma is a vascular malignancy associated with HIV/AIDS. It
typically presents as non-blanching, brownish-pink to deep purple macules, plaques, or
nodes on the skin or mucous membranes.
Question 11
When teaching an HIV-positive client about home safety, why does the nurse instruct them to
avoid cleaning bird cages or cat litter boxes?
A. To prevent the transmission of HIV to the pets.
B. To avoid exposure to Toxoplasmosis and Cryptococcosis.
C. Because animal dander triggers Kaposi’s Sarcoma.
D. To prevent the pets from becoming stressed.
E. Because the smell of animal waste causes nausea with ART.
Correct Answer: B) To avoid exposure to Toxoplasmosis and Cryptococcosis.
Rationale: Immunocompromised individuals are at high risk for zoonotic infections. Cat
feces may contain Toxoplasma gondii, and bird droppings often carry Cryptococcus, both
of which can cause severe neurological or respiratory disease in AIDS patients.
Question 12
A nurse is evaluating the skin of a client with Systemic Lupus Erythematosus (SLE). Which
finding is classic for this diagnosis?
A. A butterfly-shaped rash across the bridge of the nose and cheeks.
B. Scaly, silver plaques on the elbows and knees.
C. A circular "bullseye" rash on the thigh.
D. Petechiae and purpura on the lower extremities.
E. Thick, leathery skin on the fingertips.
Correct Answer: A) A butterfly-shaped rash across the bridge of the nose and cheeks.
Rationale: The "malar rash," or butterfly rash, is a hallmark clinical sign of SLE, occurring
in about 50% of patients. It is often triggered or worsened by sunlight (photosensitivity).
