1
HESI
HESI RN MEDICAL SURGICAL EXAM QU
N N N N N
ESTIONS AND A NSWERS UPDATED (2024/2
N N N N
025) (VERIFIED A NSWERS)
N N
Anphysicalntherapistn(PT)nplacesnangaitn belt nonnanclientnandn isnassistingnthemn
withnambulationnfromnthenbedntonthenchair.n Asntheyngetn upnoutnofnthenbed,nthe
ynreportnbeingndizzynandnbeginntonfall.nThen PTncarefully nallowsn themntonfalln b
ackntonthenbednandnnotifiesn then primarynnurse.n Whichnwrittenndocumentatio
nnshouldnthennursenputninnthenclient'snrecord?n
A)nClientnexperiencednorthostaticnhypotensionnwhenngettingnoutnofnbed.
B)nPTnreportednclientncomplainednofndizzinessnwhenngettingnoutnofnbed,nandn
gaitnbeltnwasnusedntonallow nclientn tonfallnbacknontonthen bed.
C)nPTnnotifiednthenprimaryn nursen thatnthenclientn couldnnotn ambulatenatn thisnt
imenbecausenofndizziness.
D)nClientnhadndifficultynambulatingnfromn thenbednton thenchairnwhenn accompa
niednbynthenPT,nvariancenreport ncompleted.n-
nANS n✓B) nPTnreportednclient ncomplainednofndizzinessnwhen ngettingnout nofn bed, nand
ngait nbelt nwasnusedntonallownclient ntonfall nbacknontonthenbed.
Rationale:nThisndocumentationnprovidesn thenfactualndatanofntheneventsnthatn
occurred.nA)Thennursenisnmakingnann assumptionnthatnthendizzinessnwasncaus
ednbynorthostaticnhypotension.nC)nNotnallnthenpertinentnfactsnaren includedninn
thisndocumentation.
D)nAnvariancenreportnshouldnnevernben documentedn innthenclient'snrecord.
Annewnnursengraduatenisncaringnfornanpostoperativenclientnwithnthenfollowing
narterialnbloodngases n(ABGs): npH,n7.30; nPCO2, n60n mmn Hg; nPO2,n 80nmmnHg; n bic
arbonate,n24nmEq/L;nandnO2nsaturation,n96%.nWhichnofnthesenactionsnbyn the
nnew ngraduatenis nindicated?
HESI RN
n
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HESI
A)nEncouragenthenclientntonusen then incentivenspirometernandn toncough.
B)nAdministernoxygennbynnasalncannula.
C)nRequestnanprescriptionnfornsodiumnbicarbonatenfromn then healthncarenpro
vider.
D)nInformnthenchargennursenthatn nonchangesninntherapynaren needed.n-
ANSn✓A)nEncouragenthenclientntonusenthenincentivenspirometernandntoncough.
n
Rationale:nRespiratorynacidosisn isncausednbynCO2nretentionnandn impairednch
estnexpansionnsecondaryntonanesthesia.nThennursentakesnstepsntonpromotenC
O2nelimination,nincludingn maintainingn anpatentnairwaynandnexpandingnthenl
ungsnthroughnbreathingntechniques.nO2nisn notnindicatednbecausen Po2nandnox
ygennsaturationnarenwithinnthennormalnrange.nSodiumn bicarbonatenisn notn ind
icatednbecausenthenbicarbonatenlevelnisn inn then normalnrange;npromotingn excr
etionnofnrespiratorynacidsnisnthen priorityninnrespiratory nacidosis.n Postnanesth
esia,nthenclientnwillnneedn interventionsnasndescribedninnAnabovenornmaynprog
ressntonanstatenofnsomnolencenandnunresponsiveness.
Thennursenisnprovidingndietaryn instructionsnton an68-year-
oldnclientnwhonisnatnhighnrisknforndevelopmentnofncoronarynheartndiseasen(CH
D).nWhichninformationnshouldnthennurseninclude?
A)nLimitndietarynselection nofncholesterolnton300nmgn pernday
B)nIncreasenintakenofnsolublenfibern ton10nton 25ngramsnpern day.n
C)nDecreasenplantnstanolsnandnsterolsnton lessnthann 2ngrams/day.n
D)nEnsurensaturatednfatnisnlessnthann30%nofntotaln caloricnintake.n-
ANSn✓B)nIncreasenintakenofnsolublenfibernton10nton25ngramsn pern day. n
n
Rationale:nTonreducenrisknfactorsnassociatednwithncoronary nheartndisease,n th
endailynintakenofnsolublenfibern (B)nshouldnbenincreasedntonbetween n10nandn25
ngm.nCholesterolnintaken(A)nshouldnben limitednto n180nmg/daynornless.nIntaken
ofnplantnstanolsnandnsterolsnisnrecommendednatn2n g/dayn(C).nSaturatednfatn(D
)nintakenshouldnbenlimitedn ton7%nofntotalndailyncalories.
HESI RN
n
, 3
HESI
Ansplintnisnprescribednfornnighttimen usenbyn anclientnwithnrheumatoidn arthriti
s.nWhichnstatementnbynthennursenprovidesn then mostnaccuratenexplanationnfo
rnusenofnthensplints?
A)nPreventionnofndeformities.n
B)nAvoidancenofnjointntrauma.n
C)nReliefnofnjointninflammation.n
D)nImprovementninnjointnstrength.n-nANSn✓A) nPrevention nofndeformities. n
Rationale:nSplintsnmayn benusednatn nightnby nclientsnwithnrheumatoidnarthritis
nto npreventndeformities n(A)ncausednbyn musclenspasms nandncontractures. nSpli
ntsnarennotnusednforn(B).n(C)nisnusuallyn treatednwithn medications,nparticularl
ynthosenclassifiednasnnon-
steroidalnantiinflammatoryn drugsn(NSAIDs).n Forn(D),nan prescribedn exercisen
programnisnindicated.
An32-year-
oldnfemalenclientncomplainsnofnseveren abdominaln painneachnmonthnbeforenhe
rnmenstrualnperiod,npainfulnintercourse,nandnpainfulndefecation.nWhichnaddi
tionalnhistorynshouldnthen nursenobtainnthatn isnconsistentnwithnthenclient'snco
mplaints?
A)nFrequentnurinaryntractninfections.
B)nInabilityntongetnpregnant.n
C)nPremenstrualnsyndrome.n
D)nChronicnusenofnlaxatives.n-nANSn✓B) nInability ntongetnpregnant. n
Rationale:nDysmenorrhea,ndyspareunia,nandndifficultynornpainfulndefecationn
arencommonnsymptomsnofnendometriosis,nwhichnisnthenabnormalndisplacem
entnofnendometrialntissueninnthendependentnareasnofnthenpelvicnperitoneum.n
Anhistorynofninfertilityn(B)nisnanothern commonnfindingnassociatednwithn endo
metriosis.nAlthoughn(A,nC,nandnD)narencommon,n nonspecificn gynecologicalnco
mplaints,nthenmostncommonn complaintsnofnthenclientnwithnendometriosisnar
enpainnandninfertility.
HESI RN
n
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HESI
Anclientnwithnan16-
yearnhistorynofndiabetesnmellitusnisn havingnrenalnfunctionn testsnbecausenofnre
centnfatigue,nweakness,nelevatednbloodnurean nitrogen,n andnserumn creatinine
nlevels.nWhichnfinding nshouldn then nursen concluden as nann earlynsymptomnof nre
nalninsufficiency?
A)nDyspnea.n
B)nNocturia.n
C)nConfusion.n
D)nStomatitis.n-nANSn✓B) nNocturia.
Rationale:nAsnthenglomerularnfiltrationnratendecreasesn innearlynrenaln insuffic
iency,nmetabolicnwastenproducts,nincludingnurea,ncreatinine,nandnothernsubs
tances,nsuchnphenols,nhormones,nelectrolytes,n accumulaten innthenblood.nInn th
enearlynstagenofnrenalninsufficiency,npolyuria nresultsnfromntheninabilitynofnthe
nkidneys nto nconcentratenurinenandncontributento nnocturian(B).n(A,nC,nandnD)n a
renmorencommonninnthenlaternstagesnofnrenalnfailure.
Anclientnwithnheartndiseasenisnonnancontinuousn telemetrynmonitornandn hasnde
velopednsinusnbradycardia.nInndeterminingn then possiblencausenofnthenbradyc
ardia,nthennursenassessesnthenclient'snmedicationnrecord.nWhichnmedicationn
isnmostnlikelynthencausenofnthenbradycardia?
A)nPropanololn(Inderal).n
B)nCaptopriln(Capoten).n
C)nFurosemiden(Lasix).n
D)nDobutaminen(Dobutrex).n-nANSn✓A) nPropanolol n(Inderal).
Rationale:nInderaln(A)nisn anbetanadrenergicnblockingnagent,nwhichncausesndec
reasednheartnratenandndecreasedncontractility.nNeithern(B),nannACEn inhibitor,
nnor n(C),nanloopndiuretic,ncauses nbradycardia. n(D)nis nansympathomimetic, ndire
ctnactingncardiacnstimulant,nwhichnwouldnincreasenthen heartnrate.
HESI RN
n
HESI
HESI RN MEDICAL SURGICAL EXAM QU
N N N N N
ESTIONS AND A NSWERS UPDATED (2024/2
N N N N
025) (VERIFIED A NSWERS)
N N
Anphysicalntherapistn(PT)nplacesnangaitn belt nonnanclientnandn isnassistingnthemn
withnambulationnfromnthenbedntonthenchair.n Asntheyngetn upnoutnofnthenbed,nthe
ynreportnbeingndizzynandnbeginntonfall.nThen PTncarefully nallowsn themntonfalln b
ackntonthenbednandnnotifiesn then primarynnurse.n Whichnwrittenndocumentatio
nnshouldnthennursenputninnthenclient'snrecord?n
A)nClientnexperiencednorthostaticnhypotensionnwhenngettingnoutnofnbed.
B)nPTnreportednclientncomplainednofndizzinessnwhenngettingnoutnofnbed,nandn
gaitnbeltnwasnusedntonallow nclientn tonfallnbacknontonthen bed.
C)nPTnnotifiednthenprimaryn nursen thatnthenclientn couldnnotn ambulatenatn thisnt
imenbecausenofndizziness.
D)nClientnhadndifficultynambulatingnfromn thenbednton thenchairnwhenn accompa
niednbynthenPT,nvariancenreport ncompleted.n-
nANS n✓B) nPTnreportednclient ncomplainednofndizzinessnwhen ngettingnout nofn bed, nand
ngait nbelt nwasnusedntonallownclient ntonfall nbacknontonthenbed.
Rationale:nThisndocumentationnprovidesn thenfactualndatanofntheneventsnthatn
occurred.nA)Thennursenisnmakingnann assumptionnthatnthendizzinessnwasncaus
ednbynorthostaticnhypotension.nC)nNotnallnthenpertinentnfactsnaren includedninn
thisndocumentation.
D)nAnvariancenreportnshouldnnevernben documentedn innthenclient'snrecord.
Annewnnursengraduatenisncaringnfornanpostoperativenclientnwithnthenfollowing
narterialnbloodngases n(ABGs): npH,n7.30; nPCO2, n60n mmn Hg; nPO2,n 80nmmnHg; n bic
arbonate,n24nmEq/L;nandnO2nsaturation,n96%.nWhichnofnthesenactionsnbyn the
nnew ngraduatenis nindicated?
HESI RN
n
, 2
HESI
A)nEncouragenthenclientntonusen then incentivenspirometernandn toncough.
B)nAdministernoxygennbynnasalncannula.
C)nRequestnanprescriptionnfornsodiumnbicarbonatenfromn then healthncarenpro
vider.
D)nInformnthenchargennursenthatn nonchangesninntherapynaren needed.n-
ANSn✓A)nEncouragenthenclientntonusenthenincentivenspirometernandntoncough.
n
Rationale:nRespiratorynacidosisn isncausednbynCO2nretentionnandn impairednch
estnexpansionnsecondaryntonanesthesia.nThennursentakesnstepsntonpromotenC
O2nelimination,nincludingn maintainingn anpatentnairwaynandnexpandingnthenl
ungsnthroughnbreathingntechniques.nO2nisn notnindicatednbecausen Po2nandnox
ygennsaturationnarenwithinnthennormalnrange.nSodiumn bicarbonatenisn notn ind
icatednbecausenthenbicarbonatenlevelnisn inn then normalnrange;npromotingn excr
etionnofnrespiratorynacidsnisnthen priorityninnrespiratory nacidosis.n Postnanesth
esia,nthenclientnwillnneedn interventionsnasndescribedninnAnabovenornmaynprog
ressntonanstatenofnsomnolencenandnunresponsiveness.
Thennursenisnprovidingndietaryn instructionsnton an68-year-
oldnclientnwhonisnatnhighnrisknforndevelopmentnofncoronarynheartndiseasen(CH
D).nWhichninformationnshouldnthennurseninclude?
A)nLimitndietarynselection nofncholesterolnton300nmgn pernday
B)nIncreasenintakenofnsolublenfibern ton10nton 25ngramsnpern day.n
C)nDecreasenplantnstanolsnandnsterolsnton lessnthann 2ngrams/day.n
D)nEnsurensaturatednfatnisnlessnthann30%nofntotaln caloricnintake.n-
ANSn✓B)nIncreasenintakenofnsolublenfibernton10nton25ngramsn pern day. n
n
Rationale:nTonreducenrisknfactorsnassociatednwithncoronary nheartndisease,n th
endailynintakenofnsolublenfibern (B)nshouldnbenincreasedntonbetween n10nandn25
ngm.nCholesterolnintaken(A)nshouldnben limitednto n180nmg/daynornless.nIntaken
ofnplantnstanolsnandnsterolsnisnrecommendednatn2n g/dayn(C).nSaturatednfatn(D
)nintakenshouldnbenlimitedn ton7%nofntotalndailyncalories.
HESI RN
n
, 3
HESI
Ansplintnisnprescribednfornnighttimen usenbyn anclientnwithnrheumatoidn arthriti
s.nWhichnstatementnbynthennursenprovidesn then mostnaccuratenexplanationnfo
rnusenofnthensplints?
A)nPreventionnofndeformities.n
B)nAvoidancenofnjointntrauma.n
C)nReliefnofnjointninflammation.n
D)nImprovementninnjointnstrength.n-nANSn✓A) nPrevention nofndeformities. n
Rationale:nSplintsnmayn benusednatn nightnby nclientsnwithnrheumatoidnarthritis
nto npreventndeformities n(A)ncausednbyn musclenspasms nandncontractures. nSpli
ntsnarennotnusednforn(B).n(C)nisnusuallyn treatednwithn medications,nparticularl
ynthosenclassifiednasnnon-
steroidalnantiinflammatoryn drugsn(NSAIDs).n Forn(D),nan prescribedn exercisen
programnisnindicated.
An32-year-
oldnfemalenclientncomplainsnofnseveren abdominaln painneachnmonthnbeforenhe
rnmenstrualnperiod,npainfulnintercourse,nandnpainfulndefecation.nWhichnaddi
tionalnhistorynshouldnthen nursenobtainnthatn isnconsistentnwithnthenclient'snco
mplaints?
A)nFrequentnurinaryntractninfections.
B)nInabilityntongetnpregnant.n
C)nPremenstrualnsyndrome.n
D)nChronicnusenofnlaxatives.n-nANSn✓B) nInability ntongetnpregnant. n
Rationale:nDysmenorrhea,ndyspareunia,nandndifficultynornpainfulndefecationn
arencommonnsymptomsnofnendometriosis,nwhichnisnthenabnormalndisplacem
entnofnendometrialntissueninnthendependentnareasnofnthenpelvicnperitoneum.n
Anhistorynofninfertilityn(B)nisnanothern commonnfindingnassociatednwithn endo
metriosis.nAlthoughn(A,nC,nandnD)narencommon,n nonspecificn gynecologicalnco
mplaints,nthenmostncommonn complaintsnofnthenclientnwithnendometriosisnar
enpainnandninfertility.
HESI RN
n
, 4
HESI
Anclientnwithnan16-
yearnhistorynofndiabetesnmellitusnisn havingnrenalnfunctionn testsnbecausenofnre
centnfatigue,nweakness,nelevatednbloodnurean nitrogen,n andnserumn creatinine
nlevels.nWhichnfinding nshouldn then nursen concluden as nann earlynsymptomnof nre
nalninsufficiency?
A)nDyspnea.n
B)nNocturia.n
C)nConfusion.n
D)nStomatitis.n-nANSn✓B) nNocturia.
Rationale:nAsnthenglomerularnfiltrationnratendecreasesn innearlynrenaln insuffic
iency,nmetabolicnwastenproducts,nincludingnurea,ncreatinine,nandnothernsubs
tances,nsuchnphenols,nhormones,nelectrolytes,n accumulaten innthenblood.nInn th
enearlynstagenofnrenalninsufficiency,npolyuria nresultsnfromntheninabilitynofnthe
nkidneys nto nconcentratenurinenandncontributento nnocturian(B).n(A,nC,nandnD)n a
renmorencommonninnthenlaternstagesnofnrenalnfailure.
Anclientnwithnheartndiseasenisnonnancontinuousn telemetrynmonitornandn hasnde
velopednsinusnbradycardia.nInndeterminingn then possiblencausenofnthenbradyc
ardia,nthennursenassessesnthenclient'snmedicationnrecord.nWhichnmedicationn
isnmostnlikelynthencausenofnthenbradycardia?
A)nPropanololn(Inderal).n
B)nCaptopriln(Capoten).n
C)nFurosemiden(Lasix).n
D)nDobutaminen(Dobutrex).n-nANSn✓A) nPropanolol n(Inderal).
Rationale:nInderaln(A)nisn anbetanadrenergicnblockingnagent,nwhichncausesndec
reasednheartnratenandndecreasedncontractility.nNeithern(B),nannACEn inhibitor,
nnor n(C),nanloopndiuretic,ncauses nbradycardia. n(D)nis nansympathomimetic, ndire
ctnactingncardiacnstimulant,nwhichnwouldnincreasenthen heartnrate.
HESI RN
n
