HESI - MEDICAL SURGICAL PRACTICE EXAM 2025/2026
QUESTIONS WITH CORRECT ANSWERS GRADED A+
The nurse is assessing a client's laboratory values following administration of
chemotherapy. Which lab value leads the nurse to suspect that the client is
experiencing tumor lysis syndrome (TLS)?
A. Serum PTT of 10 seconds
B. Serum calcium of 5 mg/dl
C. Oxygen saturation of 90%
D. Hemoglobin of 10 g/dl - (answers)B. Serum calcium of 5 mg/dl.
TLS results in hyperkalemia, hypocalcemia, hyperuricemia, and hyperphosphatemia.
A client is admitted to the hospital with a diagnosis of severe acute diverticulitis. Which
assessment finding should the nurse expect this client to exhibit?
A. Lower left quadrant pain and a low-grade fever
B. Severe pain at McBurney's point and nausea.
C. Abdominal pain and intermittent tenesmus
D. Exacerbations of severe diarrhea - (answers)A. Lower left quadrant pain and a low-
grade fever.
Left lower quadrant pain occurs with diverticulitis because the sigmoid colon is the most
common area for diverticula, and the inflammation of diverticula causes a low-grade
fever.
During CPR, when attempting to ventilate a client's lungs, the nurse notes that the chest
is not moving. What action should the nurse take first?
A. Use a laryngoscope to check for a foreign body lodged in the esophagus.
B. Reposition the head to validate that the head is in the proper position to open the
airway.
C. Turn the client to the side and administer three back blows.
D. Perform a finger sweep of the mouth to remove any vomitus - (answers)B.
Reposition the head to validate that the head is in the proper position to open the
airway.
, The most frequent cause of inadequate aeration of the client's lungs during CPR is
improper positioning of the head resulting in occlusion of the airway. A foreign body can
occlude the airway, but this is not common unless choking preceded the cardiac
emergency, and should not be the nurse's first action.
A client is admitted to the hospital with a medical diagnosis of pneumococcal
pneumonia. The nurse knows that the prognosis for gram-negative pneumonias (such
as E. coli, Klebsiella, Pseudomonas, and Proteus) is very poor because:
A. They occur in the lower love alveoli which are more sensitive to infection
B. Gram-negative organisms are more resistant to antibiotic therapy
C. They occur in healthy young adults who have recently been debilitated by an upper
respiratory infection.
D. Gram-negative pneumonias usually affect infants and small children. - (answers)B.
Gram-negative organisms are more resistant to antibiotic therapy
The gram-negative organisms are resistant to drug therapy which makes recovery very
difficult. Gram-negative pneumonias affect all lobes of the lung. The mean age for
contracting this type of pneumonia is 50 years, and it usually strikes debilitated persons
such as alcoholics, diabetics, and those with chronic lung diseases.
A client is placed on a mechanical ventilator following a cerebral hemorrhage, and
vecuronium bromide (Norcuron) 0.04 mg/kg q12 hours IV is prescribed. What is the
priority nursing diagnosis for this client?
A. Impaired communication related to paralysis of skeletal muscles.
B. High risk for infection related to increased intracranial pressure.
C. Potential for injury related to impaired lung expansion.
D. Social isolation related to inability to communicate. - (answers)A. Impaired
communication related to paralysis of skeletal muscles.
To increase the client's tolerance of endotracheal intubation and/or mechanical
ventilation, a skeletal-muscle relaxant, such as vecuronium, is usually prescribed.
Impaired communication is a serious outcome because the client cannot communicate
his/her needs due to intubation and diaphragmatic paralysis caused by the drug.
Although this client might also experience, it is not a priority when compared to A.
Infection is not related to increased intracranial pressure. The mechanical ventilator
provides consistent lung expansion.
QUESTIONS WITH CORRECT ANSWERS GRADED A+
The nurse is assessing a client's laboratory values following administration of
chemotherapy. Which lab value leads the nurse to suspect that the client is
experiencing tumor lysis syndrome (TLS)?
A. Serum PTT of 10 seconds
B. Serum calcium of 5 mg/dl
C. Oxygen saturation of 90%
D. Hemoglobin of 10 g/dl - (answers)B. Serum calcium of 5 mg/dl.
TLS results in hyperkalemia, hypocalcemia, hyperuricemia, and hyperphosphatemia.
A client is admitted to the hospital with a diagnosis of severe acute diverticulitis. Which
assessment finding should the nurse expect this client to exhibit?
A. Lower left quadrant pain and a low-grade fever
B. Severe pain at McBurney's point and nausea.
C. Abdominal pain and intermittent tenesmus
D. Exacerbations of severe diarrhea - (answers)A. Lower left quadrant pain and a low-
grade fever.
Left lower quadrant pain occurs with diverticulitis because the sigmoid colon is the most
common area for diverticula, and the inflammation of diverticula causes a low-grade
fever.
During CPR, when attempting to ventilate a client's lungs, the nurse notes that the chest
is not moving. What action should the nurse take first?
A. Use a laryngoscope to check for a foreign body lodged in the esophagus.
B. Reposition the head to validate that the head is in the proper position to open the
airway.
C. Turn the client to the side and administer three back blows.
D. Perform a finger sweep of the mouth to remove any vomitus - (answers)B.
Reposition the head to validate that the head is in the proper position to open the
airway.
, The most frequent cause of inadequate aeration of the client's lungs during CPR is
improper positioning of the head resulting in occlusion of the airway. A foreign body can
occlude the airway, but this is not common unless choking preceded the cardiac
emergency, and should not be the nurse's first action.
A client is admitted to the hospital with a medical diagnosis of pneumococcal
pneumonia. The nurse knows that the prognosis for gram-negative pneumonias (such
as E. coli, Klebsiella, Pseudomonas, and Proteus) is very poor because:
A. They occur in the lower love alveoli which are more sensitive to infection
B. Gram-negative organisms are more resistant to antibiotic therapy
C. They occur in healthy young adults who have recently been debilitated by an upper
respiratory infection.
D. Gram-negative pneumonias usually affect infants and small children. - (answers)B.
Gram-negative organisms are more resistant to antibiotic therapy
The gram-negative organisms are resistant to drug therapy which makes recovery very
difficult. Gram-negative pneumonias affect all lobes of the lung. The mean age for
contracting this type of pneumonia is 50 years, and it usually strikes debilitated persons
such as alcoholics, diabetics, and those with chronic lung diseases.
A client is placed on a mechanical ventilator following a cerebral hemorrhage, and
vecuronium bromide (Norcuron) 0.04 mg/kg q12 hours IV is prescribed. What is the
priority nursing diagnosis for this client?
A. Impaired communication related to paralysis of skeletal muscles.
B. High risk for infection related to increased intracranial pressure.
C. Potential for injury related to impaired lung expansion.
D. Social isolation related to inability to communicate. - (answers)A. Impaired
communication related to paralysis of skeletal muscles.
To increase the client's tolerance of endotracheal intubation and/or mechanical
ventilation, a skeletal-muscle relaxant, such as vecuronium, is usually prescribed.
Impaired communication is a serious outcome because the client cannot communicate
his/her needs due to intubation and diaphragmatic paralysis caused by the drug.
Although this client might also experience, it is not a priority when compared to A.
Infection is not related to increased intracranial pressure. The mechanical ventilator
provides consistent lung expansion.
