HESI MED SURG EXIT EXAM STUDY GUIDE
2026 QUESTIONS WITH ANSWERS GRADED
A+
◉ 2. The healthcare provider prescribes 15 mg/kg of Streptomycin for
an infant weighing 4 pounds.
The drug is diluted in 25 ml of D5W to run over 8 hours. How much
Streptomycin will the
infant receive?
a. 9 mg.
b. 18 mg.
c. 27 mg.
d. 36 mg. Answer: ANS: C
4 lbs / 2.2 = 1.8 kg. 1.8 x 15 = 27 mg (C).
NOTE, the fact that the drug is diluted in 25 ml of D5W, is not relevant
to the calculation
requested
◉ In assessing a client with preeclampsia who is receiving magnesium
sulfate, the nurse
determines that her deep tendon reflexes are 1+; respiratory rate is 12
breaths/minute;
urinary output is 90 ml in 4 hours; magnesium sulfate level is 9 mg/dl.
Based on these
findings, what intervention should the nurse implement?
,a. Continue the magnesium sulfate infusion as prescribed.
b. Decrease the magnesium sulfate infusion by one-half.
c. Stop the magnesium sulfate infusion immediately.
d. Administer calcium gluconate immediately.. Answer: ANS: C
The client is exhibiting symptoms of magnesium sulfate toxicity--
decreased reflexes (normal is
+2), a low normal respiratory rate (normal is 12 to 20 breaths/min), a
less than average
urinary output (30 ml/hour is average), and a low magnesium sulfate
level (normal is 4 to
8mg/dl). Based on these findings, the nurse should stop the infusion (C).
(A) is
contraindicated. (B) would not fully alleviate the magnesium sulfate
toxicity symptoms. (D)
(the antagonist for magnesium sulfate) would be indicated if the
respiratory rate were less
than 12 breaths/minute.
◉ A client is on a mechanical ventilator. Which client response indicates
that the neuromuscular
blocker tubocurarine chloride (Tubarine) is effective?
a. The client's expremities are paralyzed.
b. The peripheral nerve stimulator causes twitching.
c. The client clinches fist upon command.
d. The client's Glagow Coma Scale score is 14. Answer: ANS: A
,This medication causes paralysis (A) following intravenous injection.
Peak effects persist for
35 to 60 minutes. (B and C) would not be possible if the medication is
effective. The Glasgow
coma scale is used to evaluate the neurological status of the client and
does not evaluate the
effectiveness (D) of this medication.
◉ 5. An elderly female client comes to the clinic for a regular check-up.
The client tells the nurse
that she has increased her daily doses of acetaminophen (Tylenol) for the
past month to
control joint pain. Based on this client's comment, what previous lab
values should the nurse
compare with today's lab report?
a. Look at last quarter's hemoglobin and hematocrit, expecting an
increase today due
to dehydration.
b. Look for an increase in today's LDH compared to the previous one to
assess
for possible liver damage. c. Expect to find an increase in today's APTT
as compared to last quarter's due
to bleeding.
d. Determine if there is a decrease in serum potassium due to renal
compromise.. Answer: ANS: B
, Frequent and/or large doses of acetaminophen can cause an increase in
liver enzymes,
indicating possible liver damage (B). If the client reported unusual
bleeding, or an increase in
aspirin usage, it would be important for the nurse to assess for increased
bleeding and monitor
(A and/or C). (D) is not affected by increases in acetaminophen doses.
◉ 6. Aspirin is prescribed for a 9-year-old child with rheumatic fever to
control the inflammatory
process, promote comfort, and reduce fever. What intervention is most
important for the
nurse to implement?
a. Instruct the parents to hold the aspirin until the child has first had a
tepid sponge
bath.
b. Administer the aspirin with at least two ounces of water or juice.
c. Notify the healthcare provider if the child complains of ringing in the
ears.
d. Advise the parents to question the child about seeing yellow halos
around objects. Answer: ANS: C
Ringing in the ears (tinnitus) (C) is an important sign of aspirin
overdosage and should be
reported immediately. Though a tepid sponge bath may lower the child's
temperature, the
2026 QUESTIONS WITH ANSWERS GRADED
A+
◉ 2. The healthcare provider prescribes 15 mg/kg of Streptomycin for
an infant weighing 4 pounds.
The drug is diluted in 25 ml of D5W to run over 8 hours. How much
Streptomycin will the
infant receive?
a. 9 mg.
b. 18 mg.
c. 27 mg.
d. 36 mg. Answer: ANS: C
4 lbs / 2.2 = 1.8 kg. 1.8 x 15 = 27 mg (C).
NOTE, the fact that the drug is diluted in 25 ml of D5W, is not relevant
to the calculation
requested
◉ In assessing a client with preeclampsia who is receiving magnesium
sulfate, the nurse
determines that her deep tendon reflexes are 1+; respiratory rate is 12
breaths/minute;
urinary output is 90 ml in 4 hours; magnesium sulfate level is 9 mg/dl.
Based on these
findings, what intervention should the nurse implement?
,a. Continue the magnesium sulfate infusion as prescribed.
b. Decrease the magnesium sulfate infusion by one-half.
c. Stop the magnesium sulfate infusion immediately.
d. Administer calcium gluconate immediately.. Answer: ANS: C
The client is exhibiting symptoms of magnesium sulfate toxicity--
decreased reflexes (normal is
+2), a low normal respiratory rate (normal is 12 to 20 breaths/min), a
less than average
urinary output (30 ml/hour is average), and a low magnesium sulfate
level (normal is 4 to
8mg/dl). Based on these findings, the nurse should stop the infusion (C).
(A) is
contraindicated. (B) would not fully alleviate the magnesium sulfate
toxicity symptoms. (D)
(the antagonist for magnesium sulfate) would be indicated if the
respiratory rate were less
than 12 breaths/minute.
◉ A client is on a mechanical ventilator. Which client response indicates
that the neuromuscular
blocker tubocurarine chloride (Tubarine) is effective?
a. The client's expremities are paralyzed.
b. The peripheral nerve stimulator causes twitching.
c. The client clinches fist upon command.
d. The client's Glagow Coma Scale score is 14. Answer: ANS: A
,This medication causes paralysis (A) following intravenous injection.
Peak effects persist for
35 to 60 minutes. (B and C) would not be possible if the medication is
effective. The Glasgow
coma scale is used to evaluate the neurological status of the client and
does not evaluate the
effectiveness (D) of this medication.
◉ 5. An elderly female client comes to the clinic for a regular check-up.
The client tells the nurse
that she has increased her daily doses of acetaminophen (Tylenol) for the
past month to
control joint pain. Based on this client's comment, what previous lab
values should the nurse
compare with today's lab report?
a. Look at last quarter's hemoglobin and hematocrit, expecting an
increase today due
to dehydration.
b. Look for an increase in today's LDH compared to the previous one to
assess
for possible liver damage. c. Expect to find an increase in today's APTT
as compared to last quarter's due
to bleeding.
d. Determine if there is a decrease in serum potassium due to renal
compromise.. Answer: ANS: B
, Frequent and/or large doses of acetaminophen can cause an increase in
liver enzymes,
indicating possible liver damage (B). If the client reported unusual
bleeding, or an increase in
aspirin usage, it would be important for the nurse to assess for increased
bleeding and monitor
(A and/or C). (D) is not affected by increases in acetaminophen doses.
◉ 6. Aspirin is prescribed for a 9-year-old child with rheumatic fever to
control the inflammatory
process, promote comfort, and reduce fever. What intervention is most
important for the
nurse to implement?
a. Instruct the parents to hold the aspirin until the child has first had a
tepid sponge
bath.
b. Administer the aspirin with at least two ounces of water or juice.
c. Notify the healthcare provider if the child complains of ringing in the
ears.
d. Advise the parents to question the child about seeing yellow halos
around objects. Answer: ANS: C
Ringing in the ears (tinnitus) (C) is an important sign of aspirin
overdosage and should be
reported immediately. Though a tepid sponge bath may lower the child's
temperature, the
