PN Hesi Med Surg Exam 2025 Test Bank 1 With 400 Real
Exam Prep Questions And Correct Answers With Detailed
Rationales/ Hesi PN Med Surg Exam/ Pn Hesi Medical
Surgical
Question 1
A client with chronic obstructive pulmonary disease (COPD) is experiencing
dyspnea. The nurse should place the client in which position?
A) Supine with legs elevated.
B) Prone.
C) High Fowler's or orthopneic position.
D) Trendelenburg.
E) Semi-Fowler's with feet dangling.
Correct Answer: C) High Fowler's or orthopneic position
Rationale: Clients with COPD experience difficulty breathing, and
placing them in a high Fowler's (upright) or orthopneic position
(leaning forward with arms supported) helps to maximize lung
expansion and ease respiratory effort by reducing pressure on the
diaphragm.
Question 2
A nurse is caring for a client post-appendectomy. Which client statement
indicates the need for further nursing intervention?
A) "My pain is a 3 out of 10."
B) "I'm still feeling a little nauseous."
C) "I haven't passed gas since surgery."
D) "I walked to the bathroom this morning."
E) "I've been drinking plenty of water."
Correct Answer: C) "I haven't passed gas since surgery."
Rationale: Absence of flatus post-surgery, especially after abdominal
surgery, can indicate a paralytic ileus, a serious complication where
intestinal motility is impaired. This requires prompt assessment and
intervention. Mild pain, nausea, ambulation, and fluid intake are
generally expected or positive findings.
,Question 3
Which finding is an early sign of hypoxemia in an adult client?
A) Bradypnea.
B) Cyanosis.
C) Restlessness and agitation.
D) Bradycardia.
E) Hypotension.
Correct Answer: C) Restlessness and agitation
Rationale: Restlessness and agitation are often the earliest signs of
hypoxemia (low oxygen in the blood) as the brain is sensitive to
oxygen deprivation. Bradypnea, cyanosis, bradycardia, and
hypotension are typically late or severe signs.
Question 4
A client with deep vein thrombosis (DVT) is prescribed warfarin. The nurse
understands that which lab value is used to monitor the effectiveness of
warfarin therapy?
A) Partial thromboplastin time (PTT).
B) International Normalized Ratio (INR).
C) Platelet count.
D) Hemoglobin (Hgb).
E) D-dimer.
Correct Answer: B) International Normalized Ratio (INR)
Rationale: The International Normalized Ratio (INR) is the standard
lab test used to monitor the therapeutic effects of warfarin, an oral
anticoagulant. PTT monitors heparin, and D-dimer screens for
clotting activity.
Question 5
When preparing to administer medication via a nasogastric (NG) tube, what
is the priority nursing action?
A) Mix all medications together to administer simultaneously.
,B) Crush all enteric-coated tablets.
C) Verify tube placement.
D) Administer the medication rapidly.
E) Place the client in a supine position.
Correct Answer: C) Verify tube placement
Rationale: Verifying tube placement (e.g., by checking gastric pH,
observing aspirate, or noting placement during initial x-ray
confirmation) is the priority action before administering anything
through an NG tube to prevent aspiration into the lungs.
Question 6
A client is diagnosed with type 2 diabetes mellitus. The nurse should include
which instruction in the client's discharge teaching regarding foot care?
A) "Wear tight-fitting shoes to support your feet."
B) "Inspect your feet daily for cuts, sores, or changes."
C) "Soak your feet in hot water daily to improve circulation."
D) "Cut your toenails in a rounded fashion for comfort."
E) "Avoid moisturizing your feet to prevent fungal infections."
Correct Answer: B) "Inspect your feet daily for cuts, sores, or changes."
Rationale: Daily foot inspection is critical for diabetic clients to detect
any injuries or changes early, as neuropathy can mask pain and poor
circulation can impair healing, leading to serious complications.
Tight shoes, hot water, rounded toenail cutting, and avoiding
moisturizing (especially dry skin) are all contraindicated.
Question 7
A nurse is caring for a client with a new colostomy. The stoma appears dusky
and bluish. What is the nurse's priority action?
A) Document the finding and reassess in 1 hour.
B) Apply a warm compress to the stoma.
C) Notify the physician immediately.
D) Change the ostomy appliance.
, E) Encourage increased fluid intake.
Correct Answer: C) Notify the physician immediately
Rationale: A dusky, bluish, or black stoma indicates impaired blood
flow and potential ischemia or necrosis, which is a surgical
emergency. The physician must be notified immediately.
Question 8
Which diet modification is typically recommended for a client with a hiatal
hernia to reduce symptoms?
A) High-fat, low-fiber diet.
B) Large, infrequent meals.
C) Small, frequent meals.
D) Foods high in citrus and spices.
E) Lying down immediately after eating.
Correct Answer: C) Small, frequent meals
Rationale: Small, frequent meals are recommended for hiatal hernia
clients to prevent overfilling the stomach, which can push stomach
contents into the esophagus and worsen reflux symptoms. Avoiding
foods that exacerbate symptoms and not lying down after eating
are also important.
Question 9
A client is admitted with left-sided heart failure. Which clinical manifestation
would the nurse expect to find?
A) Peripheral edema.
B) Jugular venous distention.
C) Pulmonary congestion (e.g., crackles).
D) Hepatomegaly.
E) Ascites.
Correct Answer: C) Pulmonary congestion (e.g., crackles)
Rationale: Left-sided heart failure primarily affects the lungs, leading
to a backup of blood into the pulmonary circulation. This causes
Exam Prep Questions And Correct Answers With Detailed
Rationales/ Hesi PN Med Surg Exam/ Pn Hesi Medical
Surgical
Question 1
A client with chronic obstructive pulmonary disease (COPD) is experiencing
dyspnea. The nurse should place the client in which position?
A) Supine with legs elevated.
B) Prone.
C) High Fowler's or orthopneic position.
D) Trendelenburg.
E) Semi-Fowler's with feet dangling.
Correct Answer: C) High Fowler's or orthopneic position
Rationale: Clients with COPD experience difficulty breathing, and
placing them in a high Fowler's (upright) or orthopneic position
(leaning forward with arms supported) helps to maximize lung
expansion and ease respiratory effort by reducing pressure on the
diaphragm.
Question 2
A nurse is caring for a client post-appendectomy. Which client statement
indicates the need for further nursing intervention?
A) "My pain is a 3 out of 10."
B) "I'm still feeling a little nauseous."
C) "I haven't passed gas since surgery."
D) "I walked to the bathroom this morning."
E) "I've been drinking plenty of water."
Correct Answer: C) "I haven't passed gas since surgery."
Rationale: Absence of flatus post-surgery, especially after abdominal
surgery, can indicate a paralytic ileus, a serious complication where
intestinal motility is impaired. This requires prompt assessment and
intervention. Mild pain, nausea, ambulation, and fluid intake are
generally expected or positive findings.
,Question 3
Which finding is an early sign of hypoxemia in an adult client?
A) Bradypnea.
B) Cyanosis.
C) Restlessness and agitation.
D) Bradycardia.
E) Hypotension.
Correct Answer: C) Restlessness and agitation
Rationale: Restlessness and agitation are often the earliest signs of
hypoxemia (low oxygen in the blood) as the brain is sensitive to
oxygen deprivation. Bradypnea, cyanosis, bradycardia, and
hypotension are typically late or severe signs.
Question 4
A client with deep vein thrombosis (DVT) is prescribed warfarin. The nurse
understands that which lab value is used to monitor the effectiveness of
warfarin therapy?
A) Partial thromboplastin time (PTT).
B) International Normalized Ratio (INR).
C) Platelet count.
D) Hemoglobin (Hgb).
E) D-dimer.
Correct Answer: B) International Normalized Ratio (INR)
Rationale: The International Normalized Ratio (INR) is the standard
lab test used to monitor the therapeutic effects of warfarin, an oral
anticoagulant. PTT monitors heparin, and D-dimer screens for
clotting activity.
Question 5
When preparing to administer medication via a nasogastric (NG) tube, what
is the priority nursing action?
A) Mix all medications together to administer simultaneously.
,B) Crush all enteric-coated tablets.
C) Verify tube placement.
D) Administer the medication rapidly.
E) Place the client in a supine position.
Correct Answer: C) Verify tube placement
Rationale: Verifying tube placement (e.g., by checking gastric pH,
observing aspirate, or noting placement during initial x-ray
confirmation) is the priority action before administering anything
through an NG tube to prevent aspiration into the lungs.
Question 6
A client is diagnosed with type 2 diabetes mellitus. The nurse should include
which instruction in the client's discharge teaching regarding foot care?
A) "Wear tight-fitting shoes to support your feet."
B) "Inspect your feet daily for cuts, sores, or changes."
C) "Soak your feet in hot water daily to improve circulation."
D) "Cut your toenails in a rounded fashion for comfort."
E) "Avoid moisturizing your feet to prevent fungal infections."
Correct Answer: B) "Inspect your feet daily for cuts, sores, or changes."
Rationale: Daily foot inspection is critical for diabetic clients to detect
any injuries or changes early, as neuropathy can mask pain and poor
circulation can impair healing, leading to serious complications.
Tight shoes, hot water, rounded toenail cutting, and avoiding
moisturizing (especially dry skin) are all contraindicated.
Question 7
A nurse is caring for a client with a new colostomy. The stoma appears dusky
and bluish. What is the nurse's priority action?
A) Document the finding and reassess in 1 hour.
B) Apply a warm compress to the stoma.
C) Notify the physician immediately.
D) Change the ostomy appliance.
, E) Encourage increased fluid intake.
Correct Answer: C) Notify the physician immediately
Rationale: A dusky, bluish, or black stoma indicates impaired blood
flow and potential ischemia or necrosis, which is a surgical
emergency. The physician must be notified immediately.
Question 8
Which diet modification is typically recommended for a client with a hiatal
hernia to reduce symptoms?
A) High-fat, low-fiber diet.
B) Large, infrequent meals.
C) Small, frequent meals.
D) Foods high in citrus and spices.
E) Lying down immediately after eating.
Correct Answer: C) Small, frequent meals
Rationale: Small, frequent meals are recommended for hiatal hernia
clients to prevent overfilling the stomach, which can push stomach
contents into the esophagus and worsen reflux symptoms. Avoiding
foods that exacerbate symptoms and not lying down after eating
are also important.
Question 9
A client is admitted with left-sided heart failure. Which clinical manifestation
would the nurse expect to find?
A) Peripheral edema.
B) Jugular venous distention.
C) Pulmonary congestion (e.g., crackles).
D) Hepatomegaly.
E) Ascites.
Correct Answer: C) Pulmonary congestion (e.g., crackles)
Rationale: Left-sided heart failure primarily affects the lungs, leading
to a backup of blood into the pulmonary circulation. This causes
