2 TP • GRUS-DEM
HESI
HESI Health Education Systems Incorporated
EXCELLENCE IN NURSING ASSESSMENT
EST. 1983
Medical-Surgical Nursing Part 2
H E S I CO M P R E H E N S I V E E X A M I N AT I O N — V E R I F I E D A N S W E R S
INSTITUTION HESI / Elsevier Health Sciences COURSE CODE HESI-MS-PT2
PROGRAM Nursing — NCLEX Preparation ACADEMIC YEAR
EXAM TITLE HESI Med-Surg Pt (2) TOTAL QUESTIONS 55+ Questions
COURSE TITLE Medical-Surgical Nursing FORMAT Multiple Choice / Select All That Apply
EXAMINATION INSTRUCTIONS
▸ Select the single best answer unless "Select all that apply" is indicated.
▸ Questions cover medical-surgical nursing, pharmacology, prioritization, and clinical judgment.
▸ Verified answers with rationales are provided for comprehensive review.
▸ Pay close attention to priority-setting, electrolyte imbalances, and emergency interventions.
HESI MED-SURG PART 2 — COMPREHENSIVE EXAMINATION Questions 1 – 55+
1. A nurse is caring for a client with diabetes insipidus (DI). Which data warrants the most immediate intervention by
the nurse?
A. Urine output of 200 mL/hour.
B. Serum sodium of 185.
C. Specific gravity of 1.002.
D. Weight loss of 2 pounds in 24 hours.
CORRECT ANSWER B — Serum sodium of 185
RATIONALE A serum sodium of 185 mEq/L (normal 136-145) indicates severe hypernatremia, which is a life-threatening
complication of diabetes insipidus. Extreme hypernatremia can cause neurologic damage, seizures, and
coma. This requires immediate intervention to prevent irreversible harm.
2. The nurse is obtaining the admission history for a client with suspected peptic ulcer disease. Which subjective data
reported by the client supports this medical diagnosis?
A. Upper mid-abdominal pain described as gnawing and burning.
B. Right lower quadrant pain that radiates to the back.
C. Sharp, stabbing pain in the left upper quadrant.
D. Cramping lower abdominal pain with diarrhea.
CORRECT ANSWER A — Upper mid-abdominal pain described as gnawing and burning
RATIONALE The classic pain of peptic ulcer disease is epigastric (upper mid-abdominal) and is described as gnawing,
burning, or aching. This pain is related to the irritating effect of gastric acid on the ulcerated mucosa and is
often relieved by food or antacids.
,3. The nurse assesses a client newly diagnosed with hyperthyroidism and observes that the client's eyeballs are
protuberant, causing a wide-eyed appearance and eye discomfort. Based on this finding, which action should the
nurse include in the client's plan of care?
A. Apply warm compresses to the eyes.
B. Obtain a prescription for artificial tear drops.
C. Position the client flat in bed.
D. Instruct client to avoid wearing sunglasses.
CORRECT ANSWER B — Obtain a prescription for artificial tear drops
RATIONALE Exophthalmos (proptosis) in hyperthyroidism/Graves' disease causes the eyelids to not close completely,
leading to corneal dryness, irritation, and risk of ulceration. Artificial tears lubricate and protect the corneas,
which is essential for preventing complications.
4. To reduce the risk for pulmonary complications for a client with ALS, which intervention should the nurse
implement? (Select all that apply.)
A. Perform chest physiotherapy.
B. Teach the client breathing exercises.
C. Encourage use of incentive spirometer.
D. Restrict fluid intake.
CORRECT ANSWER A, B, C
RATIONALE ALS causes progressive weakness of respiratory muscles, increasing the risk for atelectasis and pneumonia.
Chest physiotherapy, breathing exercises, and incentive spirometry all help maintain lung expansion,
mobilize secretions, and prevent pulmonary complications.
5. A client is hospitalized with heart failure. Which intervention should the nurse implement to improve ventilation
and reduce venous return?
A. Place the client in high Fowler's position.
B. Position the client flat with legs elevated.
C. Place the client in Trendelenburg position.
D. Position the client in left lateral recumbent.
CORRECT ANSWER A — Place the client in high Fowler's position
RATIONALE High Fowler's position (sitting upright at 90 degrees) improves lung expansion by allowing the diaphragm to
descend, and reduces venous return (preload) by promoting venous pooling in the lower extremities. Both
effects help manage heart failure symptoms.
, 6. A client involved in a motor vehicle collision is admitted with a fractured left femur immobilized using a fracture
traction splint in preparation for an ORIF. The nurse determines the client's distal pulses are diminished in the left
foot. Which interventions should the nurse implement? (Select all that apply.)
A. Verify pedal pulses using Doppler pulse device.
B. Evaluate the application of the splint to the left leg.
C. Monitor left leg for pain, pallor, paresthesia, paralysis, pressure.
D. Remove the splint immediately.
CORRECT ANSWER A, B, C
RATIONALE Diminished distal pulses indicate possible vascular compromise. The nurse should verify with Doppler, check
the splint for improper application causing compression, and perform full neurovascular checks (6 Ps). The
splint should not be removed as it stabilizes the fracture.
7. The HCP prescribes diagnostic tests for a client whose chest x-ray indicates pneumonia. Which diagnostic test
should the nurse review for implementation of the most therapeutic treatment of the pneumonia?
A. Complete blood count.
B. Sputum culture and sensitivity.
C. Arterial blood gases.
D. Serum electrolyte panel.
CORRECT ANSWER B — Sputum culture and sensitivity
RATIONALE Sputum culture and sensitivity identifies the specific causative organism and determines which antibiotics
will be most effective (sensitivity). This allows for targeted, therapeutic antibiotic therapy rather than empiric
broad-spectrum treatment.
8. A client with a history of asthma and bronchitis arrives at the clinic with SOB, productive cough with thickened,
tenacious mucous, and the inability to walk up a flight of stairs without experiencing breathlessness. Which action
is most important for the nurse to instruct the client about self-care?
A. Increase the daily intake of oral fluids to liquefy secretions.
B. Use a humidifier only at night.
C. Take cough suppressant medication regularly.
D. Limit activity to conserve oxygen.
CORRECT ANSWER A — Increase the daily intake of oral fluids to liquefy secretions
RATIONALE Increasing oral fluid intake is the most effective non-pharmacologic method to thin and liquefy tenacious
respiratory secretions, making them easier to expectorate. Adequate hydration is essential for clients with
thick mucus and impaired airway clearance.
HESI
HESI Health Education Systems Incorporated
EXCELLENCE IN NURSING ASSESSMENT
EST. 1983
Medical-Surgical Nursing Part 2
H E S I CO M P R E H E N S I V E E X A M I N AT I O N — V E R I F I E D A N S W E R S
INSTITUTION HESI / Elsevier Health Sciences COURSE CODE HESI-MS-PT2
PROGRAM Nursing — NCLEX Preparation ACADEMIC YEAR
EXAM TITLE HESI Med-Surg Pt (2) TOTAL QUESTIONS 55+ Questions
COURSE TITLE Medical-Surgical Nursing FORMAT Multiple Choice / Select All That Apply
EXAMINATION INSTRUCTIONS
▸ Select the single best answer unless "Select all that apply" is indicated.
▸ Questions cover medical-surgical nursing, pharmacology, prioritization, and clinical judgment.
▸ Verified answers with rationales are provided for comprehensive review.
▸ Pay close attention to priority-setting, electrolyte imbalances, and emergency interventions.
HESI MED-SURG PART 2 — COMPREHENSIVE EXAMINATION Questions 1 – 55+
1. A nurse is caring for a client with diabetes insipidus (DI). Which data warrants the most immediate intervention by
the nurse?
A. Urine output of 200 mL/hour.
B. Serum sodium of 185.
C. Specific gravity of 1.002.
D. Weight loss of 2 pounds in 24 hours.
CORRECT ANSWER B — Serum sodium of 185
RATIONALE A serum sodium of 185 mEq/L (normal 136-145) indicates severe hypernatremia, which is a life-threatening
complication of diabetes insipidus. Extreme hypernatremia can cause neurologic damage, seizures, and
coma. This requires immediate intervention to prevent irreversible harm.
2. The nurse is obtaining the admission history for a client with suspected peptic ulcer disease. Which subjective data
reported by the client supports this medical diagnosis?
A. Upper mid-abdominal pain described as gnawing and burning.
B. Right lower quadrant pain that radiates to the back.
C. Sharp, stabbing pain in the left upper quadrant.
D. Cramping lower abdominal pain with diarrhea.
CORRECT ANSWER A — Upper mid-abdominal pain described as gnawing and burning
RATIONALE The classic pain of peptic ulcer disease is epigastric (upper mid-abdominal) and is described as gnawing,
burning, or aching. This pain is related to the irritating effect of gastric acid on the ulcerated mucosa and is
often relieved by food or antacids.
,3. The nurse assesses a client newly diagnosed with hyperthyroidism and observes that the client's eyeballs are
protuberant, causing a wide-eyed appearance and eye discomfort. Based on this finding, which action should the
nurse include in the client's plan of care?
A. Apply warm compresses to the eyes.
B. Obtain a prescription for artificial tear drops.
C. Position the client flat in bed.
D. Instruct client to avoid wearing sunglasses.
CORRECT ANSWER B — Obtain a prescription for artificial tear drops
RATIONALE Exophthalmos (proptosis) in hyperthyroidism/Graves' disease causes the eyelids to not close completely,
leading to corneal dryness, irritation, and risk of ulceration. Artificial tears lubricate and protect the corneas,
which is essential for preventing complications.
4. To reduce the risk for pulmonary complications for a client with ALS, which intervention should the nurse
implement? (Select all that apply.)
A. Perform chest physiotherapy.
B. Teach the client breathing exercises.
C. Encourage use of incentive spirometer.
D. Restrict fluid intake.
CORRECT ANSWER A, B, C
RATIONALE ALS causes progressive weakness of respiratory muscles, increasing the risk for atelectasis and pneumonia.
Chest physiotherapy, breathing exercises, and incentive spirometry all help maintain lung expansion,
mobilize secretions, and prevent pulmonary complications.
5. A client is hospitalized with heart failure. Which intervention should the nurse implement to improve ventilation
and reduce venous return?
A. Place the client in high Fowler's position.
B. Position the client flat with legs elevated.
C. Place the client in Trendelenburg position.
D. Position the client in left lateral recumbent.
CORRECT ANSWER A — Place the client in high Fowler's position
RATIONALE High Fowler's position (sitting upright at 90 degrees) improves lung expansion by allowing the diaphragm to
descend, and reduces venous return (preload) by promoting venous pooling in the lower extremities. Both
effects help manage heart failure symptoms.
, 6. A client involved in a motor vehicle collision is admitted with a fractured left femur immobilized using a fracture
traction splint in preparation for an ORIF. The nurse determines the client's distal pulses are diminished in the left
foot. Which interventions should the nurse implement? (Select all that apply.)
A. Verify pedal pulses using Doppler pulse device.
B. Evaluate the application of the splint to the left leg.
C. Monitor left leg for pain, pallor, paresthesia, paralysis, pressure.
D. Remove the splint immediately.
CORRECT ANSWER A, B, C
RATIONALE Diminished distal pulses indicate possible vascular compromise. The nurse should verify with Doppler, check
the splint for improper application causing compression, and perform full neurovascular checks (6 Ps). The
splint should not be removed as it stabilizes the fracture.
7. The HCP prescribes diagnostic tests for a client whose chest x-ray indicates pneumonia. Which diagnostic test
should the nurse review for implementation of the most therapeutic treatment of the pneumonia?
A. Complete blood count.
B. Sputum culture and sensitivity.
C. Arterial blood gases.
D. Serum electrolyte panel.
CORRECT ANSWER B — Sputum culture and sensitivity
RATIONALE Sputum culture and sensitivity identifies the specific causative organism and determines which antibiotics
will be most effective (sensitivity). This allows for targeted, therapeutic antibiotic therapy rather than empiric
broad-spectrum treatment.
8. A client with a history of asthma and bronchitis arrives at the clinic with SOB, productive cough with thickened,
tenacious mucous, and the inability to walk up a flight of stairs without experiencing breathlessness. Which action
is most important for the nurse to instruct the client about self-care?
A. Increase the daily intake of oral fluids to liquefy secretions.
B. Use a humidifier only at night.
C. Take cough suppressant medication regularly.
D. Limit activity to conserve oxygen.
CORRECT ANSWER A — Increase the daily intake of oral fluids to liquefy secretions
RATIONALE Increasing oral fluid intake is the most effective non-pharmacologic method to thin and liquefy tenacious
respiratory secretions, making them easier to expectorate. Adequate hydration is essential for clients with
thick mucus and impaired airway clearance.
