2025 HESI MED-SURG RN CUSTOM EXAM FOR MED SURG II
CLASS COMPLETE ALL 160 QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS)
Question 1
A nurse is caring for a client newly diagnosed with deep vein thrombosis
(DVT). The client has a prescription for a heparin infusion. Which of the
following lab values should the nurse monitor to ensure the therapeutic
effect of heparin?
A) Prothrombin Time (PT)
B) International Normalized Ratio (INR)
C) Activated Partial Thromboplastin Time (aPTT)
D) Platelet count
E) D-dimer
Correct Answer: C) Activated Partial Thromboplastin Time (aPTT)
Rationale: Heparin is an anticoagulant that potentiates the action of
antithrombin, primarily affecting the intrinsic clotting pathway. Its
therapeutic effect is monitored by the activated partial
thromboplastin time (aPTT).
Question 2
A nurse is assessing a client with acute pancreatitis. Which of the following
clinical manifestations should the nurse expect to find?
A) Right upper quadrant pain radiating to the right shoulder.
B) Severe epigastric pain radiating to the back.
C) Rebound tenderness in the right lower quadrant.
D) Left lower quadrant pain with rebound tenderness.
E) Jaundice with dark urine.
Correct Answer: B) Severe epigastric pain radiating to the back.
Rationale: Acute pancreatitis typically presents with sudden onset,
severe epigastric pain that often radiates to the back, accompanied
by nausea, vomiting, and abdominal tenderness.
,Question 3
A nurse is caring for a client with heart failure. The client has a new
prescription for metoprolol. The nurse should instruct the client to report
which of the following adverse effects?
A) Tachycardia
B) Hypertension
C) Bradycardia
D) Hyperglycemia
E) Constipation
Correct Answer: C) Bradycardia
Rationale: Metoprolol is a beta-blocker that decreases heart rate.
Significant bradycardia (e.g., heart rate < 60 bpm or dizziness)
should be reported to the provider as it indicates potential over-
medication.
Question 4
A nurse is assessing a client who has a suspected ruptured cerebral
aneurysm with a subarachnoid hemorrhage. Which of the following is a
classic clinical manifestation?
A) Gradual onset of unilateral weakness.
B) "Worst headache of my life" sudden onset.
C) Visual aura followed by a throbbing headache.
D) Facial drooping without headache.
E) Seizure activity without loss of consciousness.
Correct Answer: B) "Worst headache of my life" sudden onset.
Rationale: The sudden onset of an excruciating headache, often
described as "the worst headache of my life," is the hallmark
symptom of a subarachnoid hemorrhage, commonly caused by a
ruptured cerebral aneurysm.
Question 5
A nurse is caring for a client post-thyroidectomy. The nurse should monitor
,for which of the following signs of hypocalcemia?
A) Hyperactive bowel sounds.
B) Positive Chvostek's sign and Trousseau's sign.
C) Muscle weakness and fatigue.
D) Shortened QT interval on ECG.
E) Increased deep tendon reflexes.
Correct Answer: B) Positive Chvostek's sign and Trousseau's sign.
Rationale: Thyroidectomy can inadvertently damage or remove the
parathyroid glands, leading to hypocalcemia (low calcium).
Hypocalcemia increases neuromuscular excitability, manifesting as
muscle spasms, tingling, and positive Chvostek's (facial twitching)
and Trousseau's (carpal spasm) signs.
Question 6
A nurse is assessing a client who has a new colostomy. The nurse should
recognize that a healthy stoma appears:
A) Pale and dry.
B) Dusky and retracted.
C) Pink or beefy red and moist.
D) Black and necrotic.
E) Bluish and swollen.
Correct Answer: C) Pink or beefy red and moist.
Rationale: A healthy stoma is pink or beefy red and moist, indicating
good vascular perfusion. Any other color (pale, dusky, black, blue)
can signify ischemia or necrosis and requires immediate attention.
Question 7
A nurse is caring for a client who is diagnosed with Addison's disease. Which
of the following electrolyte imbalances should the nurse anticipate?
A) Hypernatremia
B) Hyperkalemia
C) Hypercalcemia
, D) Hypophosphatemia
E) Metabolic alkalosis
Correct Answer: B) Hyperkalemia
Rationale: Addison's disease is characterized by adrenal insufficiency,
leading to decreased production of aldosterone. Aldosterone's
primary role is to promote sodium reabsorption and potassium
excretion. Its deficiency leads to sodium loss and potassium
retention (hyperkalemia).
Question 8
A nurse is preparing to administer an intravenous (IV) push medication. The
nurse should flush the IV line with normal saline before and after
administering the medication to prevent which of the following?
A) Infiltration
B) Phlebitis
C) Medication incompatibility or clogging of the line.
D) Air embolism
E) Fluid overload
Correct Answer: C) Medication incompatibility or clogging of the line.
Rationale: Flushing ensures the IV line is patent and clears any
residual infusates that could interact with the IV push medication. It
also ensures the full dose reaches the patient and prevents clogging
of the line.
Question 9
A nurse is assessing a client with suspected acute kidney injury (AKI) in the
oliguric phase. Which of the following findings should the nurse expect?
A) Polyuria and hypovolemia.
B) Decreased urine output and fluid overload.
C) Normal electrolyte levels.
D) Hypertension and tachycardia.
E) Improved glomerular filtration rate (GFR).
CLASS COMPLETE ALL 160 QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS)
Question 1
A nurse is caring for a client newly diagnosed with deep vein thrombosis
(DVT). The client has a prescription for a heparin infusion. Which of the
following lab values should the nurse monitor to ensure the therapeutic
effect of heparin?
A) Prothrombin Time (PT)
B) International Normalized Ratio (INR)
C) Activated Partial Thromboplastin Time (aPTT)
D) Platelet count
E) D-dimer
Correct Answer: C) Activated Partial Thromboplastin Time (aPTT)
Rationale: Heparin is an anticoagulant that potentiates the action of
antithrombin, primarily affecting the intrinsic clotting pathway. Its
therapeutic effect is monitored by the activated partial
thromboplastin time (aPTT).
Question 2
A nurse is assessing a client with acute pancreatitis. Which of the following
clinical manifestations should the nurse expect to find?
A) Right upper quadrant pain radiating to the right shoulder.
B) Severe epigastric pain radiating to the back.
C) Rebound tenderness in the right lower quadrant.
D) Left lower quadrant pain with rebound tenderness.
E) Jaundice with dark urine.
Correct Answer: B) Severe epigastric pain radiating to the back.
Rationale: Acute pancreatitis typically presents with sudden onset,
severe epigastric pain that often radiates to the back, accompanied
by nausea, vomiting, and abdominal tenderness.
,Question 3
A nurse is caring for a client with heart failure. The client has a new
prescription for metoprolol. The nurse should instruct the client to report
which of the following adverse effects?
A) Tachycardia
B) Hypertension
C) Bradycardia
D) Hyperglycemia
E) Constipation
Correct Answer: C) Bradycardia
Rationale: Metoprolol is a beta-blocker that decreases heart rate.
Significant bradycardia (e.g., heart rate < 60 bpm or dizziness)
should be reported to the provider as it indicates potential over-
medication.
Question 4
A nurse is assessing a client who has a suspected ruptured cerebral
aneurysm with a subarachnoid hemorrhage. Which of the following is a
classic clinical manifestation?
A) Gradual onset of unilateral weakness.
B) "Worst headache of my life" sudden onset.
C) Visual aura followed by a throbbing headache.
D) Facial drooping without headache.
E) Seizure activity without loss of consciousness.
Correct Answer: B) "Worst headache of my life" sudden onset.
Rationale: The sudden onset of an excruciating headache, often
described as "the worst headache of my life," is the hallmark
symptom of a subarachnoid hemorrhage, commonly caused by a
ruptured cerebral aneurysm.
Question 5
A nurse is caring for a client post-thyroidectomy. The nurse should monitor
,for which of the following signs of hypocalcemia?
A) Hyperactive bowel sounds.
B) Positive Chvostek's sign and Trousseau's sign.
C) Muscle weakness and fatigue.
D) Shortened QT interval on ECG.
E) Increased deep tendon reflexes.
Correct Answer: B) Positive Chvostek's sign and Trousseau's sign.
Rationale: Thyroidectomy can inadvertently damage or remove the
parathyroid glands, leading to hypocalcemia (low calcium).
Hypocalcemia increases neuromuscular excitability, manifesting as
muscle spasms, tingling, and positive Chvostek's (facial twitching)
and Trousseau's (carpal spasm) signs.
Question 6
A nurse is assessing a client who has a new colostomy. The nurse should
recognize that a healthy stoma appears:
A) Pale and dry.
B) Dusky and retracted.
C) Pink or beefy red and moist.
D) Black and necrotic.
E) Bluish and swollen.
Correct Answer: C) Pink or beefy red and moist.
Rationale: A healthy stoma is pink or beefy red and moist, indicating
good vascular perfusion. Any other color (pale, dusky, black, blue)
can signify ischemia or necrosis and requires immediate attention.
Question 7
A nurse is caring for a client who is diagnosed with Addison's disease. Which
of the following electrolyte imbalances should the nurse anticipate?
A) Hypernatremia
B) Hyperkalemia
C) Hypercalcemia
, D) Hypophosphatemia
E) Metabolic alkalosis
Correct Answer: B) Hyperkalemia
Rationale: Addison's disease is characterized by adrenal insufficiency,
leading to decreased production of aldosterone. Aldosterone's
primary role is to promote sodium reabsorption and potassium
excretion. Its deficiency leads to sodium loss and potassium
retention (hyperkalemia).
Question 8
A nurse is preparing to administer an intravenous (IV) push medication. The
nurse should flush the IV line with normal saline before and after
administering the medication to prevent which of the following?
A) Infiltration
B) Phlebitis
C) Medication incompatibility or clogging of the line.
D) Air embolism
E) Fluid overload
Correct Answer: C) Medication incompatibility or clogging of the line.
Rationale: Flushing ensures the IV line is patent and clears any
residual infusates that could interact with the IV push medication. It
also ensures the full dose reaches the patient and prevents clogging
of the line.
Question 9
A nurse is assessing a client with suspected acute kidney injury (AKI) in the
oliguric phase. Which of the following findings should the nurse expect?
A) Polyuria and hypovolemia.
B) Decreased urine output and fluid overload.
C) Normal electrolyte levels.
D) Hypertension and tachycardia.
E) Improved glomerular filtration rate (GFR).
