RN Medical Surgical HESI Exam Preparation
RN MEDICAL SURGICAL HESI EXAM PREPARATION FOR
2025/2026 COMPLETE 200 QUESTIONS AND CORRECT
ANSWERS |ALREADY GRADED A+||BRAND NEW!!
A client arrives at the medical-surgical unit 4 hours after a transurethral
resection of the prostate. A triple-lumen catheter for continuous bladder
irrigation with normal saline is infusing and the nurse observes dark, pink-tinged
outflow with blood clots in the tubing and collection bag.
Which action should the nurse take?
A. Decrease the flow rate.
B. Irrigate the catheter manually.
C. Discontinue infusing solution.
D. Monitor catheter drainage.
B. Irrigate the catheter manually.
Manually irrigating the catheter is the most appropriate action when blood clots
are observed in the tubing and collection bag. Clots can obstruct the catheter and
disrupt the continuous bladder irrigation, leading to urinary retention and
increased discomfort for the client. Manual irrigation can help dislodge and
remove these clots, ensuring the patency of the catheter and the effectiveness of
the irrigation.
The nurse is preparing a client for discharge who was recently diagnosed with
Addison’s disease. Which instruction is most important for the nurse to include
in this client’s discharge teaching plan?
A. Take prescribed cortisone accurately.
B. Use a walker when weakness occurs.
1|Page
, RN Medical Surgical HESI Exam Preparation
C. Avoid extreme environmental temperatures.
D. Increase daily intake of sodium in diet.
A. Take prescribed cortisone accurately.
Taking prescribed cortisone accurately is the most important instruction for a
client diagnosed with Addison's disease. Cortisone is a type of glucocorticoid
replacement therapy that helps to manage the symptoms of Addison's disease
and prevent adrenal crisis, a life-threatening condition characterized by acute
insufficiency of adrenal hormones.
A nurse is caring for a patient in the post-anesthesia care unit (PACU) who
underwent a procedure two hours ago.
The nurse observes the following vital signs: heart rate 140 beats/minute, blood
pressure 140/90 mm Hg, and respirations 26 breaths/minute.
Which intervention is most important for the nurse to implement?
A. Apply oxygen at 10 L via non-rebreather mask and monitor pulse oximeter.
B. Medicate for pain and monitor vital signs according to protocol.
C. Encourage the client to splint the incision with a pillow to cough and deep
breathe.
D. Administer intravenous fluid bolus as prescribed by the healthcare provider.
A. Apply oxygen at 10 L via non-rebreather mask and monitor pulse oximeter.
The nurse assesses a client with cirrhosis and finds 4+ pitting edema of the feet
and legs, and massive ascites. Which mechanism contributes to edema and
ascites in clients with cirrhosis?
A. Decreased renin-angiotensin response related to an increase in renal blood
flow.
2|Page
, RN Medical Surgical HESI Exam Preparation
B. Hypoalbuminemia that results in a decreased colloidal oncotic pressure.
C. Hyperaldosteronism causing an increased sodium reabsorption in renal tubules.
D. Decreased portacaval pressure with greater collateral circulation.
B. Hypoalbuminemia that results in a decreased colloidal oncotic pressure.
Hypoalbuminemia, or low levels of albumin in the blood, is a common occurrence
in cirrhosis. Albumin is a protein that helps maintain oncotic pressure, which
keeps fluid in the blood vessels. When albumin levels are low, fluid can leak out of
the blood vessels and accumulate in the abdomen (ascites) and in the tissues,
causing edema.
The nurse is caring for a client diagnosed with psoriasis vulgaris who is receiving
a psoralen and ultraviolet A light (PUVA) treatment.
Which assessment finding indicates that the client has been overexposed to the
treatment?
A. Brown, rough, greasy, wart-like papules on the face.
B. Thick skin plaques topped by silvery white scales.
C. Requires sunglasses because sunlight hurts eyes.
D. Tenderness upon palpation and generalized erythema.
D. Tenderness upon palpation and generalized erythema.
Tenderness upon palpation and generalized erythema are signs of overexposure
to PUVA treatment. If a patient is overexposed to PUVA, they may experience a
burning sensation, discomfort, and redness at the treatment site.
Which action should the nurse implement to reduce the risk of vesicant
extravasation in the client who is receiving intravenous chemotherapy?
A. Keep the head of the bed elevated until the treatment is completed.
3|Page
, RN Medical Surgical HESI Exam Preparation
B. Instruct the client to drink plenty of fluids during the treatment.
C. Monitor the client’s intravenous site hourly during the treatment.
D. Administer an antiemetic before starting the chemotherapy.
C. Monitor the client's intravenous site hourly during the treatment.
Monitoring the client's intravenous site hourly during the treatment is a key action
to reduce the risk of vesicant extravasation. Regular monitoring allows for early
detection of any signs of extravasation, such as swelling or redness at the IV site.
A client is diagnosed with chronic kidney disease and needs to begin dialysis.
Which condition entered on the client’s medical record should the nurse
recognize as a contraindication for peritoneal dialysis?
A. Latent hepatitis C.
B. Crohn’s disease with colectomy.
C. History of nephrotic syndrome.
D. Type 2 diabetes mellitus.
B. Crohn's disease with colectomy.
Crohn's disease with colectomy is a contraindication for peritoneal dialysis. The
presence of extensive adhesions and fibrosis from the surgery can make the
peritoneum unsuitable for dialysis.
A client with right hydronephrosis and a history of renal calculi is preparing for
discharge following a retrograde pyelogram.
Which instruction should the nurse include in the client’s discharge instructions?
A. Use an incentive spirometer.
4|Page
RN MEDICAL SURGICAL HESI EXAM PREPARATION FOR
2025/2026 COMPLETE 200 QUESTIONS AND CORRECT
ANSWERS |ALREADY GRADED A+||BRAND NEW!!
A client arrives at the medical-surgical unit 4 hours after a transurethral
resection of the prostate. A triple-lumen catheter for continuous bladder
irrigation with normal saline is infusing and the nurse observes dark, pink-tinged
outflow with blood clots in the tubing and collection bag.
Which action should the nurse take?
A. Decrease the flow rate.
B. Irrigate the catheter manually.
C. Discontinue infusing solution.
D. Monitor catheter drainage.
B. Irrigate the catheter manually.
Manually irrigating the catheter is the most appropriate action when blood clots
are observed in the tubing and collection bag. Clots can obstruct the catheter and
disrupt the continuous bladder irrigation, leading to urinary retention and
increased discomfort for the client. Manual irrigation can help dislodge and
remove these clots, ensuring the patency of the catheter and the effectiveness of
the irrigation.
The nurse is preparing a client for discharge who was recently diagnosed with
Addison’s disease. Which instruction is most important for the nurse to include
in this client’s discharge teaching plan?
A. Take prescribed cortisone accurately.
B. Use a walker when weakness occurs.
1|Page
, RN Medical Surgical HESI Exam Preparation
C. Avoid extreme environmental temperatures.
D. Increase daily intake of sodium in diet.
A. Take prescribed cortisone accurately.
Taking prescribed cortisone accurately is the most important instruction for a
client diagnosed with Addison's disease. Cortisone is a type of glucocorticoid
replacement therapy that helps to manage the symptoms of Addison's disease
and prevent adrenal crisis, a life-threatening condition characterized by acute
insufficiency of adrenal hormones.
A nurse is caring for a patient in the post-anesthesia care unit (PACU) who
underwent a procedure two hours ago.
The nurse observes the following vital signs: heart rate 140 beats/minute, blood
pressure 140/90 mm Hg, and respirations 26 breaths/minute.
Which intervention is most important for the nurse to implement?
A. Apply oxygen at 10 L via non-rebreather mask and monitor pulse oximeter.
B. Medicate for pain and monitor vital signs according to protocol.
C. Encourage the client to splint the incision with a pillow to cough and deep
breathe.
D. Administer intravenous fluid bolus as prescribed by the healthcare provider.
A. Apply oxygen at 10 L via non-rebreather mask and monitor pulse oximeter.
The nurse assesses a client with cirrhosis and finds 4+ pitting edema of the feet
and legs, and massive ascites. Which mechanism contributes to edema and
ascites in clients with cirrhosis?
A. Decreased renin-angiotensin response related to an increase in renal blood
flow.
2|Page
, RN Medical Surgical HESI Exam Preparation
B. Hypoalbuminemia that results in a decreased colloidal oncotic pressure.
C. Hyperaldosteronism causing an increased sodium reabsorption in renal tubules.
D. Decreased portacaval pressure with greater collateral circulation.
B. Hypoalbuminemia that results in a decreased colloidal oncotic pressure.
Hypoalbuminemia, or low levels of albumin in the blood, is a common occurrence
in cirrhosis. Albumin is a protein that helps maintain oncotic pressure, which
keeps fluid in the blood vessels. When albumin levels are low, fluid can leak out of
the blood vessels and accumulate in the abdomen (ascites) and in the tissues,
causing edema.
The nurse is caring for a client diagnosed with psoriasis vulgaris who is receiving
a psoralen and ultraviolet A light (PUVA) treatment.
Which assessment finding indicates that the client has been overexposed to the
treatment?
A. Brown, rough, greasy, wart-like papules on the face.
B. Thick skin plaques topped by silvery white scales.
C. Requires sunglasses because sunlight hurts eyes.
D. Tenderness upon palpation and generalized erythema.
D. Tenderness upon palpation and generalized erythema.
Tenderness upon palpation and generalized erythema are signs of overexposure
to PUVA treatment. If a patient is overexposed to PUVA, they may experience a
burning sensation, discomfort, and redness at the treatment site.
Which action should the nurse implement to reduce the risk of vesicant
extravasation in the client who is receiving intravenous chemotherapy?
A. Keep the head of the bed elevated until the treatment is completed.
3|Page
, RN Medical Surgical HESI Exam Preparation
B. Instruct the client to drink plenty of fluids during the treatment.
C. Monitor the client’s intravenous site hourly during the treatment.
D. Administer an antiemetic before starting the chemotherapy.
C. Monitor the client's intravenous site hourly during the treatment.
Monitoring the client's intravenous site hourly during the treatment is a key action
to reduce the risk of vesicant extravasation. Regular monitoring allows for early
detection of any signs of extravasation, such as swelling or redness at the IV site.
A client is diagnosed with chronic kidney disease and needs to begin dialysis.
Which condition entered on the client’s medical record should the nurse
recognize as a contraindication for peritoneal dialysis?
A. Latent hepatitis C.
B. Crohn’s disease with colectomy.
C. History of nephrotic syndrome.
D. Type 2 diabetes mellitus.
B. Crohn's disease with colectomy.
Crohn's disease with colectomy is a contraindication for peritoneal dialysis. The
presence of extensive adhesions and fibrosis from the surgery can make the
peritoneum unsuitable for dialysis.
A client with right hydronephrosis and a history of renal calculi is preparing for
discharge following a retrograde pyelogram.
Which instruction should the nurse include in the client’s discharge instructions?
A. Use an incentive spirometer.
4|Page
