ADVANCED MED SURG HESI FINAL RN V2
CERTIFICATION EVALUATION TEST 2026
COMPLETE QUESTIONS AND ANSWERS 100
PERCENT CORRECT
◉ The nurse is providing dietary instructions to a 68-year-old client
who is at high risk for development of coronary heart disease (CHD).
Which information should the nurse include?
A) Limit dietary selection of cholesterol to 300 mg per day
B) Increase intake of soluble fiber to 10 to 25 grams per day.
C) Decrease plant stanols and sterols to less than 2 grams/day.
D) Ensure saturated fat is less than 30% of total caloric intake.
Answer: B) Increase intake of soluble fiber to 10 to 25 grams per
day.
Rationale: To reduce risk factors associated with coronary heart
disease, the daily intake of soluble fiber (B) should be increased to
between 10 and 25 gm. Cholesterol intake (A) should be limited to
180 mg/day or less. Intake of plant stanols and sterols is
recommended at 2 g/day (C). Saturated fat (D) intake should be
limited to 7% of total daily calories.
,◉ A splint is prescribed for nighttime use by a client with
rheumatoid arthritis. Which statement by the nurse provides the
most accurate explanation for use of the splints?
A) Prevention of deformities.
B) Avoidance of joint trauma.
C) Relief of joint inflammation.
D) Improvement in joint strength.. Answer: A) Prevention of
deformities.
Rationale: Splints may be used at night by clients with rheumatoid
arthritis to prevent deformities (A) caused by muscle spasms and
contractures. Splints are not used for (B). (C) is usually treated with
medications, particularly those classified as non-steroidal
antiinflammatory drugs (NSAIDs). For (D), a prescribed exercise
program is indicated.
◉ A 32-year-old female client complains of severe abdominal pain
each month before her menstrual period, painful intercourse, and
painful defecation. Which additional history should the nurse obtain
that is consistent with the client's complaints?
A) Frequent urinary tract infections.
B) Inability to get pregnant.
C) Premenstrual syndrome.
,D) Chronic use of laxatives.. Answer: B) Inability to get pregnant.
Rationale: Dysmenorrhea, dyspareunia, and difficulty or painful
defecation are common symptoms of endometriosis, which is the
abnormal displacement of endometrial tissue in the dependent
areas of the pelvic peritoneum. A history of infertility (B) is another
common finding associated with endometriosis. Although (A, C, and
D) are common, nonspecific gynecological complaints, the most
common complaints of the client with endometriosis are pain and
infertility.
◉ A client with a 16-year history of diabetes mellitus is having renal
function tests because of recent fatigue, weakness, elevated blood
urea nitrogen, and serum creatinine levels. Which finding should the
nurse conclude as an early symptom of renal insufficiency?
A) Dyspnea.
B) Nocturia.
C) Confusion.
D) Stomatitis.. Answer: B) Nocturia.
Rationale: As the glomerular filtration rate decreases in early renal
insufficiency, metabolic waste products, including urea, creatinine,
and other substances, such phenols, hormones, electrolytes,
accumulate in the blood. In the early stage of renal insufficiency,
, polyuria results from the inability of the kidneys to concentrate
urine and contribute to nocturia (B). (A, C, and D) are more common
in the later stages of renal failure.
◉ A client with heart disease is on a continuous telemetry monitor
and has developed sinus bradycardia. In determining the possible
cause of the bradycardia, the nurse assesses the client's medication
record. Which medication is most likely the cause of the
bradycardia?
A) Propanolol (Inderal).
B) Captopril (Capoten).
C) Furosemide (Lasix).
D) Dobutamine (Dobutrex).. Answer: A) Propanolol (Inderal).
Rationale: Inderal (A) is a beta adrenergic blocking agent, which
causes decreased heart rate and decreased contractility. Neither (B),
an ACE inhibitor, nor (C), a loop diuretic, causes bradycardia. (D) is a
sympathomimetic, direct acting cardiac stimulant, which would
increase the heart rate.
◉ A client has been taking oral corticosteroids for the past five days
because of seasonal allergies. Which assessment finding is of most
concern to the nurse?
CERTIFICATION EVALUATION TEST 2026
COMPLETE QUESTIONS AND ANSWERS 100
PERCENT CORRECT
◉ The nurse is providing dietary instructions to a 68-year-old client
who is at high risk for development of coronary heart disease (CHD).
Which information should the nurse include?
A) Limit dietary selection of cholesterol to 300 mg per day
B) Increase intake of soluble fiber to 10 to 25 grams per day.
C) Decrease plant stanols and sterols to less than 2 grams/day.
D) Ensure saturated fat is less than 30% of total caloric intake.
Answer: B) Increase intake of soluble fiber to 10 to 25 grams per
day.
Rationale: To reduce risk factors associated with coronary heart
disease, the daily intake of soluble fiber (B) should be increased to
between 10 and 25 gm. Cholesterol intake (A) should be limited to
180 mg/day or less. Intake of plant stanols and sterols is
recommended at 2 g/day (C). Saturated fat (D) intake should be
limited to 7% of total daily calories.
,◉ A splint is prescribed for nighttime use by a client with
rheumatoid arthritis. Which statement by the nurse provides the
most accurate explanation for use of the splints?
A) Prevention of deformities.
B) Avoidance of joint trauma.
C) Relief of joint inflammation.
D) Improvement in joint strength.. Answer: A) Prevention of
deformities.
Rationale: Splints may be used at night by clients with rheumatoid
arthritis to prevent deformities (A) caused by muscle spasms and
contractures. Splints are not used for (B). (C) is usually treated with
medications, particularly those classified as non-steroidal
antiinflammatory drugs (NSAIDs). For (D), a prescribed exercise
program is indicated.
◉ A 32-year-old female client complains of severe abdominal pain
each month before her menstrual period, painful intercourse, and
painful defecation. Which additional history should the nurse obtain
that is consistent with the client's complaints?
A) Frequent urinary tract infections.
B) Inability to get pregnant.
C) Premenstrual syndrome.
,D) Chronic use of laxatives.. Answer: B) Inability to get pregnant.
Rationale: Dysmenorrhea, dyspareunia, and difficulty or painful
defecation are common symptoms of endometriosis, which is the
abnormal displacement of endometrial tissue in the dependent
areas of the pelvic peritoneum. A history of infertility (B) is another
common finding associated with endometriosis. Although (A, C, and
D) are common, nonspecific gynecological complaints, the most
common complaints of the client with endometriosis are pain and
infertility.
◉ A client with a 16-year history of diabetes mellitus is having renal
function tests because of recent fatigue, weakness, elevated blood
urea nitrogen, and serum creatinine levels. Which finding should the
nurse conclude as an early symptom of renal insufficiency?
A) Dyspnea.
B) Nocturia.
C) Confusion.
D) Stomatitis.. Answer: B) Nocturia.
Rationale: As the glomerular filtration rate decreases in early renal
insufficiency, metabolic waste products, including urea, creatinine,
and other substances, such phenols, hormones, electrolytes,
accumulate in the blood. In the early stage of renal insufficiency,
, polyuria results from the inability of the kidneys to concentrate
urine and contribute to nocturia (B). (A, C, and D) are more common
in the later stages of renal failure.
◉ A client with heart disease is on a continuous telemetry monitor
and has developed sinus bradycardia. In determining the possible
cause of the bradycardia, the nurse assesses the client's medication
record. Which medication is most likely the cause of the
bradycardia?
A) Propanolol (Inderal).
B) Captopril (Capoten).
C) Furosemide (Lasix).
D) Dobutamine (Dobutrex).. Answer: A) Propanolol (Inderal).
Rationale: Inderal (A) is a beta adrenergic blocking agent, which
causes decreased heart rate and decreased contractility. Neither (B),
an ACE inhibitor, nor (C), a loop diuretic, causes bradycardia. (D) is a
sympathomimetic, direct acting cardiac stimulant, which would
increase the heart rate.
◉ A client has been taking oral corticosteroids for the past five days
because of seasonal allergies. Which assessment finding is of most
concern to the nurse?
