Medical –Surgical Exit HESI Questions & Answer
1. An adult client was diagnosed with acute pancreatic 9 days ago. The nurse interprets that the
client is recovering from this episode if the serum lipase level decreases to which of the
following values, which is just below the upper limit of normal?
a) 20 unit/L
b) 80 unit/L
c) 135 unit/L
d) 350 unit/L
The normal serum lipase level is 10 to 140 units/L. The client who is recovering from acute
pancreatitis usually has elevated lipase levels for about 10 days after the onset of symptoms.
This makes lipase a valuable test in monitoring the client’s pancreatic function because serum
amylase levels usually return to normal 3 days after the onset of symptoms. Option C is the only
option that contains a value just below the upper limit of normal.
1. A client is receiving a continuous intravenous infusion of heparin sodium to treat deep vein
thrombosis. The client’s activated partial thromboplastin (aPTT) time is 65 seconds. Nurse
Jessie anticipates that which action is needed?
The normal activated partial thromboplastin time (aPTT) varies between 20 and 36 seconds,
depending on the type of activator used in testing. The therapeutic dose of heparin for treatment
of deep vein thrombosis is to keep the aPTT between 1.5 and 2.5 times normal. Thus, the
client’s aPTT is within the therapeutic range, and the dose should remain unchanged
1. Discontinuing the heparin infusion
2. Increasing the rate of the heparin infusion
3. Decreasing the rate of the heparin infusion
4. Leaving the rate of the heparin infusion as is
2. A female client with atrial fibrillation who is receiving maintenance therapy of warfarin sodium
(Coumadin) has a prothrombin time of 35 seconds. Based on the prothrombin time, nurse
Daniel anticipates which of the following orders?
The normal prothrombin time (PT) is 9.6 to 11.8 seconds (male adult) or 9.5 to 11.3 seconds
(female adult). A therapeutic PT level is 1.5 to 2.0 times higher than the normal level. Because
the value of 35 seconds is high (and perhaps near the critical range), the nurse should anticipate
that the client would not receive further doses at this time.
a. Adding a dose of heparin sodium
b. Holding the next dose of warfarin
c. Increasing the next dose of warfarin
d. Administering the next dose of warfarin
3. An adult client has had laboratory work done as part of a routine physical examination. Nurse
Amy interprets that the client may have a mild degree of renal insufficiency if which of the
following serum creatine levels is noted?
The normal serum creatinine level for adults is 0.6 to 1.3 mg/dL. The client with a mild degree
of renal insufficiency would have a slightly elevated level. A creatinine level of 0.2 mg/dL is
low, and a level of 0.5 mg/dL is just below normal. A creatinine level of 3.5 mg/dL may be
associated with acute or chronic renal failure.
, 4. Why is the burned client allowed NO “free” water?
Water may interfere with electrolyte balance
5. STD that has remissions and exacerbation in both males and females ?
Herpes Simplex Type II?
6. A male client arrives in the emergency room complaining of chest pain that began 4 hours ago.
A troponin T blood specimen is obtained, and the results indicate a level of 0.6 ng/mL. Nurse
Celeste interprets that this result indicates a?
Troponin is a regulatory protein found in striated muscle. The troponins function together in
the contractile apparatus for striated muscle in skeletal muscle and in the myocardium.
Increased amounts of troponins are released into the bloodstream when an infarction causes
damage to the myocardium. A troponin T value that is higher higher than 0.1 to 0.2 ng/mL is
consistent with a myocardial infarction. A normal troponin I level is lower than 0.6 ng/mL.
a. Normal level
b. Low value that indicates possible gastritis
c. Level that indicates a myocardial infraction
d. Level that indicates the presence of possible angina
7. Prevention of thromboembolism in immobilized patients with musculoskeletal problems?
Passive range of motion exercises, elastic stockings, and elevation of foot of bed 25 degrees to
increase venous return.
8. A client has been admitted to the hospital for urinary tract infection and dehydration. Nurse
Veronica determines that the client has received adequate volume replacement if the blood urea
nitrogen level drops to:
The normal blood urea nitrogen level is 8 to 25 mg/dL. Values such as those in options C and D
reflect continued dehydration. Option A reflects a lower than normal value, which may occur
with fluid volume overload, among other conditions.
a. 3 mg/dL
b. 15 mg/dL
c. 29 mg/dL
d. 35 mg/dL
9. Patient having trouble with peripheral vision-what best for nurse to do?
orient patient to surroundings (something about the environment)
10. Medication dosing-heparin 25000 units at 7ml/hr doctor changed rate to 900 units what is the
mls/hr Med was ordered 100mg in 4 divided doses in 24 hours available in 25mg, how many
will you give every 6 hours?
Math questions are easy.
11. Nurse Venus is assigned to a 40-year-old client who has a diagnosis of chronic pancreatitis. The
nurse reviews the laboratory result, anticipating a laboratory report that indicating a laboratory
report that indicates a serum amylase level of?
The normal serum amylase level is 25 to 151 units/L. With chronic cases of pancreatitis, the rise
in serum amylase levels usually does not exceed three times the normal value. In acute
pancreatitis, the value may exceed five times the normal value.
1. An adult client was diagnosed with acute pancreatic 9 days ago. The nurse interprets that the
client is recovering from this episode if the serum lipase level decreases to which of the
following values, which is just below the upper limit of normal?
a) 20 unit/L
b) 80 unit/L
c) 135 unit/L
d) 350 unit/L
The normal serum lipase level is 10 to 140 units/L. The client who is recovering from acute
pancreatitis usually has elevated lipase levels for about 10 days after the onset of symptoms.
This makes lipase a valuable test in monitoring the client’s pancreatic function because serum
amylase levels usually return to normal 3 days after the onset of symptoms. Option C is the only
option that contains a value just below the upper limit of normal.
1. A client is receiving a continuous intravenous infusion of heparin sodium to treat deep vein
thrombosis. The client’s activated partial thromboplastin (aPTT) time is 65 seconds. Nurse
Jessie anticipates that which action is needed?
The normal activated partial thromboplastin time (aPTT) varies between 20 and 36 seconds,
depending on the type of activator used in testing. The therapeutic dose of heparin for treatment
of deep vein thrombosis is to keep the aPTT between 1.5 and 2.5 times normal. Thus, the
client’s aPTT is within the therapeutic range, and the dose should remain unchanged
1. Discontinuing the heparin infusion
2. Increasing the rate of the heparin infusion
3. Decreasing the rate of the heparin infusion
4. Leaving the rate of the heparin infusion as is
2. A female client with atrial fibrillation who is receiving maintenance therapy of warfarin sodium
(Coumadin) has a prothrombin time of 35 seconds. Based on the prothrombin time, nurse
Daniel anticipates which of the following orders?
The normal prothrombin time (PT) is 9.6 to 11.8 seconds (male adult) or 9.5 to 11.3 seconds
(female adult). A therapeutic PT level is 1.5 to 2.0 times higher than the normal level. Because
the value of 35 seconds is high (and perhaps near the critical range), the nurse should anticipate
that the client would not receive further doses at this time.
a. Adding a dose of heparin sodium
b. Holding the next dose of warfarin
c. Increasing the next dose of warfarin
d. Administering the next dose of warfarin
3. An adult client has had laboratory work done as part of a routine physical examination. Nurse
Amy interprets that the client may have a mild degree of renal insufficiency if which of the
following serum creatine levels is noted?
The normal serum creatinine level for adults is 0.6 to 1.3 mg/dL. The client with a mild degree
of renal insufficiency would have a slightly elevated level. A creatinine level of 0.2 mg/dL is
low, and a level of 0.5 mg/dL is just below normal. A creatinine level of 3.5 mg/dL may be
associated with acute or chronic renal failure.
, 4. Why is the burned client allowed NO “free” water?
Water may interfere with electrolyte balance
5. STD that has remissions and exacerbation in both males and females ?
Herpes Simplex Type II?
6. A male client arrives in the emergency room complaining of chest pain that began 4 hours ago.
A troponin T blood specimen is obtained, and the results indicate a level of 0.6 ng/mL. Nurse
Celeste interprets that this result indicates a?
Troponin is a regulatory protein found in striated muscle. The troponins function together in
the contractile apparatus for striated muscle in skeletal muscle and in the myocardium.
Increased amounts of troponins are released into the bloodstream when an infarction causes
damage to the myocardium. A troponin T value that is higher higher than 0.1 to 0.2 ng/mL is
consistent with a myocardial infarction. A normal troponin I level is lower than 0.6 ng/mL.
a. Normal level
b. Low value that indicates possible gastritis
c. Level that indicates a myocardial infraction
d. Level that indicates the presence of possible angina
7. Prevention of thromboembolism in immobilized patients with musculoskeletal problems?
Passive range of motion exercises, elastic stockings, and elevation of foot of bed 25 degrees to
increase venous return.
8. A client has been admitted to the hospital for urinary tract infection and dehydration. Nurse
Veronica determines that the client has received adequate volume replacement if the blood urea
nitrogen level drops to:
The normal blood urea nitrogen level is 8 to 25 mg/dL. Values such as those in options C and D
reflect continued dehydration. Option A reflects a lower than normal value, which may occur
with fluid volume overload, among other conditions.
a. 3 mg/dL
b. 15 mg/dL
c. 29 mg/dL
d. 35 mg/dL
9. Patient having trouble with peripheral vision-what best for nurse to do?
orient patient to surroundings (something about the environment)
10. Medication dosing-heparin 25000 units at 7ml/hr doctor changed rate to 900 units what is the
mls/hr Med was ordered 100mg in 4 divided doses in 24 hours available in 25mg, how many
will you give every 6 hours?
Math questions are easy.
11. Nurse Venus is assigned to a 40-year-old client who has a diagnosis of chronic pancreatitis. The
nurse reviews the laboratory result, anticipating a laboratory report that indicating a laboratory
report that indicates a serum amylase level of?
The normal serum amylase level is 25 to 151 units/L. With chronic cases of pancreatitis, the rise
in serum amylase levels usually does not exceed three times the normal value. In acute
pancreatitis, the value may exceed five times the normal value.
