Page 1 of 108
MEDICAL SURGICAL NURSING HESI REAL
EXAMQUESTIONS WITH ANSWERS TESTED
AND APPROVED!!!
A client with heart failure is prescribed enalapril (Vasotec). What is the nurse's
priority teaching for this client?
A) "Avoid using aspirin-containing products."
B) "Take your medication with food."
C) "Check your pulse daily."
D) "Avoid using salt substitutes." -- ANSWER--D
Angiotensin-converting enzyme (ACE) inhibitors inhibit the excretion of
potassium. Hyperkalemia can be a life-threatening side effect, and clients
should be taught to limit potassium intake. Salt substitutes are composed of
potassium chloride.
The nurse is assessing a client who reports claudication after walking a distance
of one block. The nurse notes a painful ulcer on the fourth toe of the client's
right foot. What condition do these findings correlate with?
A) Peripheral arterial disease
B) Deep vein thrombosis
, Page 2 of 108
C) Diabetic foot ulceration
D) Peripheral venous disease -- ANSWER--A
Arterial disease is characterized by claudication after walking short distances.
Ulcerations caused by peripheral arterial disease are painful and initially are
located at the most distal points on the extremity. Diabetic ulcers and venous
ulcers are seldom painful and usually tend to occur where pressure is applied.
Following surgery, Mario complains of mild incisional pain while performing
deep- breathing and coughing exercises. The nurse's best response would be:
A. "Pain will become less each day."
B. "This is a normal reaction after surgery."
C. "With a pillow, apply pressure against the incision."
D. "I will give you the pain medication the physician ordered." -- ANSWER-
Answer: (C) "With a pillow, apply pressure against the incision."
Applying pressure against the incision with a pillow will help lessen the
intraabdominal pressure created by coughing which causes tension on the
incision that leads to pain.
The nurse needs to carefully assess the complaint of pain of the elderly because
older people
A. are expected to experience chronic pain
B. have a decreased pain threshold
C. experience reduced sensory perception
, Page 3 of 108
D. have altered mental function -- ANSWER--Answer: (C) experience
reduced sensory perception
Degenerative changes occur in the elderly. The response to pain in the elderly
maybe lessened because of reduced acuity of touch, alterations in neural
pathways and diminished processing of sensory data.
Mary received AtropineSO4 as a pre-medication 30 minutes ago and is now
complaining of dry mouth and her PR is higher, than before the medication was
administered. The nurse's best
A. The patient is having an allergic reaction to the drug.
B. The patient needs a higher dose of this drug
C. This is normal side-effect of AtSO4
D. The patient is anxious about upcoming surgery -- ANSWER--Answer:
(C)
This is normal side-effect of AtSO4
Atropine sulfate is a vagolytic drug that decreases oropharyngeal secretions and
increases the heart rate.
Ana's postoperative vital signs are a blood pressure of 80/50 mm Hg, a pulse of
140, and respirations of 32. Suspecting shock, which of the following orders
would the nurse question?
A. Put the client in modified Trendelenberg's position.
B. Administer oxygen at 100%.
C. Monitor urine output every hour.
, Page 4 of 108
D. Administer Demerol 50mg IM q4h -- ANSWER--Answer: (D)
Administer
Demerol 50mg IM q4h
Administering Demerol, which is a narcotic analgesic, can depress respiratory
and cardiac function and thus not given to a patient in shock. What is needed is
promotion for adequate oxygenation and perfusion. All the other interventions
can be expected to be done by the nurse.
A client has been admitted to the intensive care unit with worsening pulmonary
manifestations of heart failure. What is the nurse's best action? A) Administer
loop diuretics as prescribed.
B) Begin cardiopulmonary resuscitation (CPR).
C) Promote rest and minimize activities.
D) Place the client in a high Fowler's position. -- ANSWER--A
The client with worsening heart failure is most at risk for pulmonary edema as a
consequence of fluid retention. Administering diuretics will decrease the fluid
overload, thereby decreasing the incidence of pulmonary edema. High Fowler's
position might help the client breathe easier but will not solve the problem. CPR
is not warranted in this situation. Rest is important for clients with heart failure,
but this is not the priority.
What information about nutrition does the nurse teach a client with chronic
obstructive pulmonary disease (COPD)? (Select all that apply.)
MEDICAL SURGICAL NURSING HESI REAL
EXAMQUESTIONS WITH ANSWERS TESTED
AND APPROVED!!!
A client with heart failure is prescribed enalapril (Vasotec). What is the nurse's
priority teaching for this client?
A) "Avoid using aspirin-containing products."
B) "Take your medication with food."
C) "Check your pulse daily."
D) "Avoid using salt substitutes." -- ANSWER--D
Angiotensin-converting enzyme (ACE) inhibitors inhibit the excretion of
potassium. Hyperkalemia can be a life-threatening side effect, and clients
should be taught to limit potassium intake. Salt substitutes are composed of
potassium chloride.
The nurse is assessing a client who reports claudication after walking a distance
of one block. The nurse notes a painful ulcer on the fourth toe of the client's
right foot. What condition do these findings correlate with?
A) Peripheral arterial disease
B) Deep vein thrombosis
, Page 2 of 108
C) Diabetic foot ulceration
D) Peripheral venous disease -- ANSWER--A
Arterial disease is characterized by claudication after walking short distances.
Ulcerations caused by peripheral arterial disease are painful and initially are
located at the most distal points on the extremity. Diabetic ulcers and venous
ulcers are seldom painful and usually tend to occur where pressure is applied.
Following surgery, Mario complains of mild incisional pain while performing
deep- breathing and coughing exercises. The nurse's best response would be:
A. "Pain will become less each day."
B. "This is a normal reaction after surgery."
C. "With a pillow, apply pressure against the incision."
D. "I will give you the pain medication the physician ordered." -- ANSWER-
Answer: (C) "With a pillow, apply pressure against the incision."
Applying pressure against the incision with a pillow will help lessen the
intraabdominal pressure created by coughing which causes tension on the
incision that leads to pain.
The nurse needs to carefully assess the complaint of pain of the elderly because
older people
A. are expected to experience chronic pain
B. have a decreased pain threshold
C. experience reduced sensory perception
, Page 3 of 108
D. have altered mental function -- ANSWER--Answer: (C) experience
reduced sensory perception
Degenerative changes occur in the elderly. The response to pain in the elderly
maybe lessened because of reduced acuity of touch, alterations in neural
pathways and diminished processing of sensory data.
Mary received AtropineSO4 as a pre-medication 30 minutes ago and is now
complaining of dry mouth and her PR is higher, than before the medication was
administered. The nurse's best
A. The patient is having an allergic reaction to the drug.
B. The patient needs a higher dose of this drug
C. This is normal side-effect of AtSO4
D. The patient is anxious about upcoming surgery -- ANSWER--Answer:
(C)
This is normal side-effect of AtSO4
Atropine sulfate is a vagolytic drug that decreases oropharyngeal secretions and
increases the heart rate.
Ana's postoperative vital signs are a blood pressure of 80/50 mm Hg, a pulse of
140, and respirations of 32. Suspecting shock, which of the following orders
would the nurse question?
A. Put the client in modified Trendelenberg's position.
B. Administer oxygen at 100%.
C. Monitor urine output every hour.
, Page 4 of 108
D. Administer Demerol 50mg IM q4h -- ANSWER--Answer: (D)
Administer
Demerol 50mg IM q4h
Administering Demerol, which is a narcotic analgesic, can depress respiratory
and cardiac function and thus not given to a patient in shock. What is needed is
promotion for adequate oxygenation and perfusion. All the other interventions
can be expected to be done by the nurse.
A client has been admitted to the intensive care unit with worsening pulmonary
manifestations of heart failure. What is the nurse's best action? A) Administer
loop diuretics as prescribed.
B) Begin cardiopulmonary resuscitation (CPR).
C) Promote rest and minimize activities.
D) Place the client in a high Fowler's position. -- ANSWER--A
The client with worsening heart failure is most at risk for pulmonary edema as a
consequence of fluid retention. Administering diuretics will decrease the fluid
overload, thereby decreasing the incidence of pulmonary edema. High Fowler's
position might help the client breathe easier but will not solve the problem. CPR
is not warranted in this situation. Rest is important for clients with heart failure,
but this is not the priority.
What information about nutrition does the nurse teach a client with chronic
obstructive pulmonary disease (COPD)? (Select all that apply.)
