Page 1 of 62
MEDSURG HESI AND RATIONALE EXAM COMPREHENSIVE
2026 QUESTIONS EXAM LATEST VERSION SOLVED
QUESTIONS & ANSWERS VERIFIED 100 %
A patient who is admitted to the hospital with a duodenal ulcer develops signs
of acute duodenal perforation. Which action would the nurse expect to take
first?
Administer an H2 blocker.
Administer pain medication.
Insert a nasogastric (NG) tube.
Prepare the patient for laparoscopic surgery.
Insert a nasogastric (NG) tube.
The immediate focus of management for a patient with a perforation is to stop the
spillage of gastric or duodenal contents into the peritoneal cavity and restore blood
volume. An NG tube is inserted into the stomach to provide continuous aspiration
and gastric decompression, to stop spillage through the perforation, and prevent
peritonitis.
Which type of angina occurs in the absence of significant coronary artery
disease (CAD)?
Silent
Unstable
Substernal
Microvascular
Microvascular
Microvascular angina occurs in the absence of coronary atherosclerosis or
vasospasm. It is mainly associated with abnormalities of coronary microcirculation.
Silent ischemia mostly occurs in patients with diabetes because diabetic neuropathy
affects the nerves that innervate the cardiovascular system.
Unstable angina occurs because of the rupture of thickened plaque.
Patients commonly have substernal pain during angina or MI; substernal is not a
specific type of angina
, Page 2 of 62
Which type of pain is associated with fibromyalgia?
Acute Localized Intermittent Widespread
Widespread
Which laboratory test is used to identify the presence of a small amount of
blood in gastric secretions and stools?
Guaiac test
Liver enzyme studies
Complete blood count (CBC)
Serum amylase determination
Guaiac test
Which prescribed medication would the nurse associate with the treatment of
a patient reporting a full-bladder feeling and frequently leaking small amounts
of urine during the day and night since they had a hemorrhoidectomy?
Diazepam Finasteride Oxybutynin Bethanechol Solifenacin
Finasteride
Bethanechol
Finasteride decreases outlet resistance, and bethanechol is used to enhance
bladder contractions; both are beneficial for the patient's condition.
Diazepam is used to relax the external sphincter. Oxybutynin and solifenacin
decrease bladder spasms that lead to urinary leakage
Which complication of diabetes can be treated with hyperbaric oxygen?
Diabetic foot ulcers
Diabetic nephropathy
Neuropathic arthropathy
Peripheral vascular disease
Diabetic foot ulcers
A patient has had esophageal surgery and a jejunostomy feeding tube is
inserted to administer oral fluids. Which finding would indicate leakage of
feeding into the mediastinum?
Pain
Dyspnea
Acid reflux
Tachycardia
Increased temperature
Pain
Dyspnea
Increased temperature
Which drug class may result in weight gain as a side effect?
Biguanides Meglitinides Dopamine agonist
Meglitinides
Which instruction would the nurse provide for a patient who is diagnosed with
Addison disease?
, Page 3 of 62
Carry an emergency kit with 100 mg of oral hydrocortisone.
Increase the dosage of corticosteroids in stressful situations such as rigorous
physical activity.
Plan to undergo hormone therapy for 3 to 5 years.
Follow a sodium-restricted diet.
Increase the dosage of corticosteroids in stressful situations such as rigorous
physical activity.
Adrenocortical insufficiency (hypofunction of the adrenal cortex) may be from a
primary cause such as Addison disease. The mainstay is often lifelong hormone
therapy with glucocorticoids and mineralocorticoids. The patient with Addison
disease needs an increased dosage of corticosteroids in stressful situations to
prevent addisonian crisis. Examples of situations requiring corticosteroid adjustment
are fever, influenza, tooth extraction, and rigorous physical activity, such as playing
sports on a hot day
Which finding aids in confirming the diagnosis of rheumatic fever?
Presence of albuminuria
Presence of polyarthralgia
Decreased hemoglobin count
Presence of subcutaneous nodules
Positive throat culture for group A streptococci
Presence of polyarthralgia
Presence of subcutaneous nodules
Positive throat culture for group A streptococci
The nurse anticipates which medication prescription for a female patient with
Addison disease?
Estrogen replacement therapy
Daily glucocorticoid replacement (one-third on awakening in morning, two-
thirds in evening)
Daily mineralocorticoid (fludrocortisone) in the evening
Androgen replacement with dehydroepiandrosterone (DHEA)
Androgen replacement with dehydroepiandrosterone (DHEA)
Which definition describes osteoarthritis (OA)?
Joint destruction caused by an autoimmune process
Degeneration of articular cartilage in synovial joints
Overproduction of synovial fluid resulting in joint destruction
Breakdown of tissue in non-weight-bearing joints by enzymes
Degeneration of articular cartilage in synovial joints
A patient with cystic fibrosis (CF) may experience which condition?
Increased risk for obesity
Recurring lung infections
Decreased life expectancy
Abundant bronchial mucus
Altered pancreatic enzyme production
, Page 4 of 62
Recurring lung infections
Decreased life expectancy
Abundant bronchial mucus
Altered pancreatic enzyme production
CF is characterized by a persistent, chronic airway infection that cannot be cured
A patient with asthma is prescribed formoterol. Which directive would the
nurse include in the medication education provided to the patient?
"Take the medication once every 24 hours."
"Side effects include cold or flu-like symptoms."
"Formoterol is the best medication to take to obtain quick relief from
bronchospasms."
"Formoterol is not the only medication that you will need to treat your
asthma."
"If wheezing gets worse, there are other types of medications that are more
beneficial than formoterol."
"Side effects include cold or flu-like symptoms."
"Formoterol is not the only medication that you will need to treat your asthma."
"If wheezing gets worse, there are other types of medications that are more
beneficial than formoterol."
Which description of the Whipple procedure made by a patient demonstrates a
need for further education?
"It is the complete removal of the stomach."
"It is the complete removal of the duodenum."
"It is the removal of a portion of the bile duct."
"It is the removal of a portion of the pancreas."
"It is the complete removal of the stomach."
Which laboratory result confirms a diagnosis of Paget disease?
Increased serum calcium level
Decreased serum 25-hydroxyvitamin D
Elevated serum alkaline phosphatase levels
Decreased serum calcium or phosphorus levels
Elevated serum alkaline phosphatase levels
When a patient's clinical manifestations include hematuria, red blood cell
casts, and proteinuria, which underlying cause would the nurse associate with
this patient?
Hodgkin lymphoma
Obstructive uropathies
Focal glomerulonephritis
Systemic lupus erythematosus (SLE)
Acute poststreptococcal glomerulonephritis (APSGN)
Systemic lupus erythematosus (SLE)
Acute poststreptococcal glomerulonephritis (APSGN)
Hematuria, red blood cell casts, and proteinuria are clinical manifestations of rapidly
progressive glomerulonephritis (RPGN). SLE and APSGN are underlying causes of
RPGN.
MEDSURG HESI AND RATIONALE EXAM COMPREHENSIVE
2026 QUESTIONS EXAM LATEST VERSION SOLVED
QUESTIONS & ANSWERS VERIFIED 100 %
A patient who is admitted to the hospital with a duodenal ulcer develops signs
of acute duodenal perforation. Which action would the nurse expect to take
first?
Administer an H2 blocker.
Administer pain medication.
Insert a nasogastric (NG) tube.
Prepare the patient for laparoscopic surgery.
Insert a nasogastric (NG) tube.
The immediate focus of management for a patient with a perforation is to stop the
spillage of gastric or duodenal contents into the peritoneal cavity and restore blood
volume. An NG tube is inserted into the stomach to provide continuous aspiration
and gastric decompression, to stop spillage through the perforation, and prevent
peritonitis.
Which type of angina occurs in the absence of significant coronary artery
disease (CAD)?
Silent
Unstable
Substernal
Microvascular
Microvascular
Microvascular angina occurs in the absence of coronary atherosclerosis or
vasospasm. It is mainly associated with abnormalities of coronary microcirculation.
Silent ischemia mostly occurs in patients with diabetes because diabetic neuropathy
affects the nerves that innervate the cardiovascular system.
Unstable angina occurs because of the rupture of thickened plaque.
Patients commonly have substernal pain during angina or MI; substernal is not a
specific type of angina
, Page 2 of 62
Which type of pain is associated with fibromyalgia?
Acute Localized Intermittent Widespread
Widespread
Which laboratory test is used to identify the presence of a small amount of
blood in gastric secretions and stools?
Guaiac test
Liver enzyme studies
Complete blood count (CBC)
Serum amylase determination
Guaiac test
Which prescribed medication would the nurse associate with the treatment of
a patient reporting a full-bladder feeling and frequently leaking small amounts
of urine during the day and night since they had a hemorrhoidectomy?
Diazepam Finasteride Oxybutynin Bethanechol Solifenacin
Finasteride
Bethanechol
Finasteride decreases outlet resistance, and bethanechol is used to enhance
bladder contractions; both are beneficial for the patient's condition.
Diazepam is used to relax the external sphincter. Oxybutynin and solifenacin
decrease bladder spasms that lead to urinary leakage
Which complication of diabetes can be treated with hyperbaric oxygen?
Diabetic foot ulcers
Diabetic nephropathy
Neuropathic arthropathy
Peripheral vascular disease
Diabetic foot ulcers
A patient has had esophageal surgery and a jejunostomy feeding tube is
inserted to administer oral fluids. Which finding would indicate leakage of
feeding into the mediastinum?
Pain
Dyspnea
Acid reflux
Tachycardia
Increased temperature
Pain
Dyspnea
Increased temperature
Which drug class may result in weight gain as a side effect?
Biguanides Meglitinides Dopamine agonist
Meglitinides
Which instruction would the nurse provide for a patient who is diagnosed with
Addison disease?
, Page 3 of 62
Carry an emergency kit with 100 mg of oral hydrocortisone.
Increase the dosage of corticosteroids in stressful situations such as rigorous
physical activity.
Plan to undergo hormone therapy for 3 to 5 years.
Follow a sodium-restricted diet.
Increase the dosage of corticosteroids in stressful situations such as rigorous
physical activity.
Adrenocortical insufficiency (hypofunction of the adrenal cortex) may be from a
primary cause such as Addison disease. The mainstay is often lifelong hormone
therapy with glucocorticoids and mineralocorticoids. The patient with Addison
disease needs an increased dosage of corticosteroids in stressful situations to
prevent addisonian crisis. Examples of situations requiring corticosteroid adjustment
are fever, influenza, tooth extraction, and rigorous physical activity, such as playing
sports on a hot day
Which finding aids in confirming the diagnosis of rheumatic fever?
Presence of albuminuria
Presence of polyarthralgia
Decreased hemoglobin count
Presence of subcutaneous nodules
Positive throat culture for group A streptococci
Presence of polyarthralgia
Presence of subcutaneous nodules
Positive throat culture for group A streptococci
The nurse anticipates which medication prescription for a female patient with
Addison disease?
Estrogen replacement therapy
Daily glucocorticoid replacement (one-third on awakening in morning, two-
thirds in evening)
Daily mineralocorticoid (fludrocortisone) in the evening
Androgen replacement with dehydroepiandrosterone (DHEA)
Androgen replacement with dehydroepiandrosterone (DHEA)
Which definition describes osteoarthritis (OA)?
Joint destruction caused by an autoimmune process
Degeneration of articular cartilage in synovial joints
Overproduction of synovial fluid resulting in joint destruction
Breakdown of tissue in non-weight-bearing joints by enzymes
Degeneration of articular cartilage in synovial joints
A patient with cystic fibrosis (CF) may experience which condition?
Increased risk for obesity
Recurring lung infections
Decreased life expectancy
Abundant bronchial mucus
Altered pancreatic enzyme production
, Page 4 of 62
Recurring lung infections
Decreased life expectancy
Abundant bronchial mucus
Altered pancreatic enzyme production
CF is characterized by a persistent, chronic airway infection that cannot be cured
A patient with asthma is prescribed formoterol. Which directive would the
nurse include in the medication education provided to the patient?
"Take the medication once every 24 hours."
"Side effects include cold or flu-like symptoms."
"Formoterol is the best medication to take to obtain quick relief from
bronchospasms."
"Formoterol is not the only medication that you will need to treat your
asthma."
"If wheezing gets worse, there are other types of medications that are more
beneficial than formoterol."
"Side effects include cold or flu-like symptoms."
"Formoterol is not the only medication that you will need to treat your asthma."
"If wheezing gets worse, there are other types of medications that are more
beneficial than formoterol."
Which description of the Whipple procedure made by a patient demonstrates a
need for further education?
"It is the complete removal of the stomach."
"It is the complete removal of the duodenum."
"It is the removal of a portion of the bile duct."
"It is the removal of a portion of the pancreas."
"It is the complete removal of the stomach."
Which laboratory result confirms a diagnosis of Paget disease?
Increased serum calcium level
Decreased serum 25-hydroxyvitamin D
Elevated serum alkaline phosphatase levels
Decreased serum calcium or phosphorus levels
Elevated serum alkaline phosphatase levels
When a patient's clinical manifestations include hematuria, red blood cell
casts, and proteinuria, which underlying cause would the nurse associate with
this patient?
Hodgkin lymphoma
Obstructive uropathies
Focal glomerulonephritis
Systemic lupus erythematosus (SLE)
Acute poststreptococcal glomerulonephritis (APSGN)
Systemic lupus erythematosus (SLE)
Acute poststreptococcal glomerulonephritis (APSGN)
Hematuria, red blood cell casts, and proteinuria are clinical manifestations of rapidly
progressive glomerulonephritis (RPGN). SLE and APSGN are underlying causes of
RPGN.
