NURS HESI Med-Surg Exam Questions and
Answers Graded A+ | Latest Update 2025/2026
Which assessment is most important for the nurse to perform on a client
who is hospitalized for Guillain-Barre syndrome that is rapidly
progressing?
Respiratory effort.
Unsteady gait.
Intensity of pain.
Ability to eat.
Guillain-Barre syndrome causes paralysis or weakness that typically starts
at the feet and progresses upwards. As the condition progresses, the nurse
must ensure that the client is able to breathe effectively.
Heuther, Understanding Pathophysiology, 6th ed. p. 412
A male client comes into the clinic with a history of penile discharge
with painful, burning urination. Which action should the nurse
implement?
• Collect a culture of the penile discharge.
• Palpate the inguinal lymph nodes gently.
• Observe for scrotal swelling and redness.
• Express the discharge to determine color.
,Penile discharge with painful urination is commonly associated with
gonorrhea. The nurse should collect a culture of the penile discharge to
determine the cause of these symptoms. The cause must be determined or
confirmed through culture to identify the organism and ensure effective
treatment.
Jarvis Physical Examination and Health Assessment,
6th edition 3
A client with history of atrial fibrillation is admitted to the telemetry unit
with sudden
onset of shortness of breath. The nurse observes a new irregular heart
rhythm and should perform which assessment at this time?
• Check for a pulse deficit.
• Palpate the apical impulse.
• Inspect jugular vein pulse.
• Examine for a carotid bruit.
A client with a past history of atrial fibrillation may return to that
rhythm. Any signs of atrial fibrillation, such as sudden onset shortness
of breath, requires further investigation. The nurse should assess this
client for a pulse deficit because this condition occurs with atrial
fibrillation.
,Jarvis. (2016); Physical Examination and Health Assessment, (Chap 19)
7th ed., p. 481
4.
Which client should be further assessed for an ectopic pregnancy?
• A 24-year-old with shoulder and lower abdominal quadrant pain.
• A 33-year-old with intermittent lower abdominal cramping.
• A 20-year-old with fever and right lower abdominal colic.
• A 40-year-old with jaundice and right lower abdominal pain.
A 24-year-old with sudden onset of lower abdominal quadrant pain
should be assessed for an ectopic pregnancy. The pain can also be
referred to the shoulder and may be associated with vaginal bleeding.
Health Assessment for Nursing Practice, Wilson and
Giddens. p.269 5.
Which dietary assessment finding is most important for the nurse to
address when
caring for a client with diabetic nephropathy?
• Drinks a six pack of beer every day.
• Enjoys a hamburger once a month.
• Eats fortified breakfast cereal daily.
• Consumes beans and rice every day.
Drinking six beers every day is the dietary assessment finding most
, important for the nurse to address when caring for a client with diabetic
nephropathy. The usual can of beer is 12 ounces (355 mL). Clients with
diabetes are recommended to drink no more than 12 ounces of beer per
day because beer contains carbohydrates that can create unhealthy
fluctuations in blood glucose and promote poor glucose control.
Nephropathy is exacerbated by poor blood glucose
control. 6.
Which assessment finding is of greatest concern to the nurse who is caring
for a client with stomatitis?
• Cough brought on by swallowing.
• Sore throat caused by speaking.
• Painful and dry oral cavity.
• Unintended weight loss.
A cough brought on by swallowing is a sign of dysphagia, which is a
finding of particular concern in a client with stomatitis. Dysphagia
can cause numerous problems, including airway obstruction, and
should be reported to the healthcare provider immediately.
Answers Graded A+ | Latest Update 2025/2026
Which assessment is most important for the nurse to perform on a client
who is hospitalized for Guillain-Barre syndrome that is rapidly
progressing?
Respiratory effort.
Unsteady gait.
Intensity of pain.
Ability to eat.
Guillain-Barre syndrome causes paralysis or weakness that typically starts
at the feet and progresses upwards. As the condition progresses, the nurse
must ensure that the client is able to breathe effectively.
Heuther, Understanding Pathophysiology, 6th ed. p. 412
A male client comes into the clinic with a history of penile discharge
with painful, burning urination. Which action should the nurse
implement?
• Collect a culture of the penile discharge.
• Palpate the inguinal lymph nodes gently.
• Observe for scrotal swelling and redness.
• Express the discharge to determine color.
,Penile discharge with painful urination is commonly associated with
gonorrhea. The nurse should collect a culture of the penile discharge to
determine the cause of these symptoms. The cause must be determined or
confirmed through culture to identify the organism and ensure effective
treatment.
Jarvis Physical Examination and Health Assessment,
6th edition 3
A client with history of atrial fibrillation is admitted to the telemetry unit
with sudden
onset of shortness of breath. The nurse observes a new irregular heart
rhythm and should perform which assessment at this time?
• Check for a pulse deficit.
• Palpate the apical impulse.
• Inspect jugular vein pulse.
• Examine for a carotid bruit.
A client with a past history of atrial fibrillation may return to that
rhythm. Any signs of atrial fibrillation, such as sudden onset shortness
of breath, requires further investigation. The nurse should assess this
client for a pulse deficit because this condition occurs with atrial
fibrillation.
,Jarvis. (2016); Physical Examination and Health Assessment, (Chap 19)
7th ed., p. 481
4.
Which client should be further assessed for an ectopic pregnancy?
• A 24-year-old with shoulder and lower abdominal quadrant pain.
• A 33-year-old with intermittent lower abdominal cramping.
• A 20-year-old with fever and right lower abdominal colic.
• A 40-year-old with jaundice and right lower abdominal pain.
A 24-year-old with sudden onset of lower abdominal quadrant pain
should be assessed for an ectopic pregnancy. The pain can also be
referred to the shoulder and may be associated with vaginal bleeding.
Health Assessment for Nursing Practice, Wilson and
Giddens. p.269 5.
Which dietary assessment finding is most important for the nurse to
address when
caring for a client with diabetic nephropathy?
• Drinks a six pack of beer every day.
• Enjoys a hamburger once a month.
• Eats fortified breakfast cereal daily.
• Consumes beans and rice every day.
Drinking six beers every day is the dietary assessment finding most
, important for the nurse to address when caring for a client with diabetic
nephropathy. The usual can of beer is 12 ounces (355 mL). Clients with
diabetes are recommended to drink no more than 12 ounces of beer per
day because beer contains carbohydrates that can create unhealthy
fluctuations in blood glucose and promote poor glucose control.
Nephropathy is exacerbated by poor blood glucose
control. 6.
Which assessment finding is of greatest concern to the nurse who is caring
for a client with stomatitis?
• Cough brought on by swallowing.
• Sore throat caused by speaking.
• Painful and dry oral cavity.
• Unintended weight loss.
A cough brought on by swallowing is a sign of dysphagia, which is a
finding of particular concern in a client with stomatitis. Dysphagia
can cause numerous problems, including airway obstruction, and
should be reported to the healthcare provider immediately.
