MED-SURG II HESI TEST BANK 2025
ACTUAL EXAM 150 QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS)
|AGRADE
A nurse is reinforcing teaching with a client who has HIV
and is being discharged to home. Which of the following
instructions should the nurse include in the teaching?
A. Take temperature once a day.
B. Wash the armpits and genitals with a gentle cleanser
daily.
C. Change the litter boxes while wearing gloves.
D. Wash dishes in warm water. - answerA.
A nurse is caring for a client who is postoperative following
a tracheostomy, and has copious and tenacious
secretions. Which of the following is an acceptable method
for the nurse to use to thin this client's secretions?
A. Provide humidified oxygen.
B. Perform chest physiotherapy prior to suctioning.
,C. Prelubricate the suction catheter tip with sterile saline
when suctioning the airway.
D. Hyperventilate the client with 100% oxygen before
suctioning the airway.. - answerA.
Following admission, a client with a vascular occlusion of
the right lower extremity calls the nurse and reports
difficulty sleeping because of cold feet. Which of the
following nursing actions should the nurse take to promote
the client's comfort?
A. Rub the client's feet briskly for several minutes.
B. Obtain a pair of slipper socks for the client.
C. Increase the client's oral fluid intake.
D. Place a moist heating pad under the client's feet. -
answerB.
A nurse is caring for a client is who is 4 hr postoperative
following a transurethral resection of the prostate (TURP).
Which of the following is the priority finding for the nurse
report to the provider?
A. Emesis of 100 mL
B. Oral temperature of 37.5° C (99.5° F)
C. Thick, red-colored urine
D. Pain level of 4 on a 0 to 10 rating scale - answerC.
A nurse is caring for a client who has a temperature of
39.7° C (103.5° F) and has a prescription for a
hypothermia blanket. The nurse should monitor the client
for which of the following adverse effects of the
hypothermia blanket?
A. Shivering
B. Infection
C. Burns
D. Hypervolemia - answerA.
,A nurse is reinforcing teaching about exercise with a client
who has type 1 diabetes mellitus. Which of the following
statements by the client indicates an understanding of the
teaching?
A. "I will carry a complex carbohydrate snack with me
when I exercise."
B. "I should exercise first thing in the morning before
eating breakfast."
C. "I should avoid injecting insulin into my thigh if I am
going to go running."
D. "I will not exercise if my urine is positive for ketones." -
answerD.
A nurse notes a small section of bowel protruding from the
abdominal incision of a client who
is postoperative. After calling for assistance, which of the
following actions should the nurse take first?
A. Cover the client's wound with a moist, sterile dressing.
B. Have the client lie supine with knees flexed.
C. Check the client's vital signs.
D. Inform the client about the need to return to surgery. -
answerA.
A nurse is collecting data from a client who has alcohol
use disorder and is experiencing metabolic acidosis.
Which of the following manifestations should the nurse
expect?
A. Cool, clammy skin.
B. Hyperventilation
C. Increased blood pressure
D. Bradycardia - answerB.
, A nurse is reinforcing discharge teaching with a client
following a cataract extraction. Which of the following
should the nurse include in the teaching?
A. Avoid bending at the waist.
B. Remove the eye shield at bedtime.
C. Limit the use of laxatives if constipated.
D. Seeing flashes of light is an expected finding following
extraction. - answerA.
A nurse is caring for a client who has heart failure and has
been taking digoxin 0.25 mg daily. The client refuses
breakfast and reports nausea. Which of the following
actions should the nurse take first?
1) Suggest that the client rests before eating the meal.
2) Request a dietary consult.
3) Check the client's vital signs.
4) Request an order for an antiemetic. - answerC
A nurse is caring for a client who is 3 days postoperative
following a cholecystectomy. The nurse suspects the
client's wound is infected because the drainage from the
dressing is yellow and thick. Which of the following
findings should the nurse report as the type of drainage
found?
1) Sanguineous
2) Serous
3) Serosanguineous
4) Purulent - answerD.
A nurse is reinforcing discharge teaching to a client
following arthroscopic surgery. To prevent postoperative
complications which of the following actions should be
reinforced during the teaching?
ACTUAL EXAM 150 QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS)
|AGRADE
A nurse is reinforcing teaching with a client who has HIV
and is being discharged to home. Which of the following
instructions should the nurse include in the teaching?
A. Take temperature once a day.
B. Wash the armpits and genitals with a gentle cleanser
daily.
C. Change the litter boxes while wearing gloves.
D. Wash dishes in warm water. - answerA.
A nurse is caring for a client who is postoperative following
a tracheostomy, and has copious and tenacious
secretions. Which of the following is an acceptable method
for the nurse to use to thin this client's secretions?
A. Provide humidified oxygen.
B. Perform chest physiotherapy prior to suctioning.
,C. Prelubricate the suction catheter tip with sterile saline
when suctioning the airway.
D. Hyperventilate the client with 100% oxygen before
suctioning the airway.. - answerA.
Following admission, a client with a vascular occlusion of
the right lower extremity calls the nurse and reports
difficulty sleeping because of cold feet. Which of the
following nursing actions should the nurse take to promote
the client's comfort?
A. Rub the client's feet briskly for several minutes.
B. Obtain a pair of slipper socks for the client.
C. Increase the client's oral fluid intake.
D. Place a moist heating pad under the client's feet. -
answerB.
A nurse is caring for a client is who is 4 hr postoperative
following a transurethral resection of the prostate (TURP).
Which of the following is the priority finding for the nurse
report to the provider?
A. Emesis of 100 mL
B. Oral temperature of 37.5° C (99.5° F)
C. Thick, red-colored urine
D. Pain level of 4 on a 0 to 10 rating scale - answerC.
A nurse is caring for a client who has a temperature of
39.7° C (103.5° F) and has a prescription for a
hypothermia blanket. The nurse should monitor the client
for which of the following adverse effects of the
hypothermia blanket?
A. Shivering
B. Infection
C. Burns
D. Hypervolemia - answerA.
,A nurse is reinforcing teaching about exercise with a client
who has type 1 diabetes mellitus. Which of the following
statements by the client indicates an understanding of the
teaching?
A. "I will carry a complex carbohydrate snack with me
when I exercise."
B. "I should exercise first thing in the morning before
eating breakfast."
C. "I should avoid injecting insulin into my thigh if I am
going to go running."
D. "I will not exercise if my urine is positive for ketones." -
answerD.
A nurse notes a small section of bowel protruding from the
abdominal incision of a client who
is postoperative. After calling for assistance, which of the
following actions should the nurse take first?
A. Cover the client's wound with a moist, sterile dressing.
B. Have the client lie supine with knees flexed.
C. Check the client's vital signs.
D. Inform the client about the need to return to surgery. -
answerA.
A nurse is collecting data from a client who has alcohol
use disorder and is experiencing metabolic acidosis.
Which of the following manifestations should the nurse
expect?
A. Cool, clammy skin.
B. Hyperventilation
C. Increased blood pressure
D. Bradycardia - answerB.
, A nurse is reinforcing discharge teaching with a client
following a cataract extraction. Which of the following
should the nurse include in the teaching?
A. Avoid bending at the waist.
B. Remove the eye shield at bedtime.
C. Limit the use of laxatives if constipated.
D. Seeing flashes of light is an expected finding following
extraction. - answerA.
A nurse is caring for a client who has heart failure and has
been taking digoxin 0.25 mg daily. The client refuses
breakfast and reports nausea. Which of the following
actions should the nurse take first?
1) Suggest that the client rests before eating the meal.
2) Request a dietary consult.
3) Check the client's vital signs.
4) Request an order for an antiemetic. - answerC
A nurse is caring for a client who is 3 days postoperative
following a cholecystectomy. The nurse suspects the
client's wound is infected because the drainage from the
dressing is yellow and thick. Which of the following
findings should the nurse report as the type of drainage
found?
1) Sanguineous
2) Serous
3) Serosanguineous
4) Purulent - answerD.
A nurse is reinforcing discharge teaching to a client
following arthroscopic surgery. To prevent postoperative
complications which of the following actions should be
reinforced during the teaching?
