HESI Med Surgical Practice (evolve) ALL VERSIONS 2026 | LATEST AND ACCURATE REAL EXAM QUESTIONS WITH DETAILED ANSWERS | VERIFIED FOR GUARANTEED PASS | LATEST UPDATE

When planning care for a client with right renal calculi, which nursing problem has the highest priority? a. Acute pain related to movement of the stone. b. Impaired urinary elimination related to the obstructed flow of urine. c. Risk for infection related to urinary stasis. d. Deficient knowledge related to the need for prevention of recurrence of calculi. - answer_a. Acute pain related to movement of the stone. The nursing problem of the highest priority is "Acute pain related to the renal calculi's movement". The nurse is caring for a client scheduled to undergo the insertion of a percutaneous endoscopic gastrostomy (PEG) tube. The client asks the nurse to explain how a PEG tube differs from a gastrostomy tube (GT). Which explanation best describes how they are different? a. Method of insertion. b. Location of the tubes. c. Diameter of the tubes. d. Procedure for feedings. - answer_a. Method of insertion. The best explanation of how a PEG tube differs from a GT is by the method of insertion. GT insertion involves making an incision in the wall of the abdomen and suturing the tube to the gastric wall. A PEG tube is more commonly used due to the fact it does not require general anesthesia and is less invasive due to being inserted with endoscopic visualization through the esophagus into the stomach and then pulled through a small incision in the abdominal wall and held in place by a tiny plastic device called a "bumper" that holds the tube in place inside the stomach and a small water-filled balloon which keeps the stomach in place against the abdominal wall. A client with a chronic infection of Hepatitis C virus (HCV) is scheduled for a liver biopsy. Which intervention should the nurse perform after the procedure? a. Progress activity as soon as possible. b. Assess for signs of bleeding and hypovolemia. c. Place the client in the left lateral position. d. Monitor blood pressure, pulse and breathing every 4 hours. - answer_b. Assess for signs of bleeding and hypovolemia. Assessment for signs of bleeding should be implemented because internal bleeding is the greatest risk following a liver biopsy. A client with acute osteomyelitis has undergone surgical debridement of the diseased bone and asks the nurse how long will antibiotics have to be administered. Which information should the nurse communicate? a. Oral antibiotics for 2 to 4 months, then for dental procedure prophylaxis. b. Parenteral antibiotics for 4 to 6 weeks, then oral antibiotics for up to 1 year. c. Parenteral antibiotics for 4 to 8 weeks, then oral antibiotics for 4 to 8 weeks. d. Parenteral antibiotics for 2 to 3 weeks, then oral antibiotics for 4 weeks. - answer_c. Parenteral antibiotics for 4 to 8 weeks, then oral antibiotics for 4 to 8 weeks. Treatment of acute osteomyelitis requires the administration of high doses of parenteral antibiotics for 4 to 8 weeks, followed by oral antibiotics for another 4 to 8 weeks. The nurse should explain to a client with lung cancer that pleurodesis is performed to achieve which expected outcome? a. Prevent the formation of effusion fluid. b. Remove fluid from the intrapleural space. c. Debulk tumor to maintain patency of air passages. d. Relieve empyema after pneumonectomy. - answer_a. Prevent the formation of effusion fluid. Instillation of a sclerosing agent to create pleurodesis is aimed at preventing the formation of a pleural effusion by causing the pleural spaces to be sealed together, thereby preventing the accumulation of pleural fluid. A client, who speaks very little English, is being discharged following surgery. Which nurse should the nurse manager assign to provide the discharge instructions for the client? a. A graduate registered nurse (RN) with three weeks of experience. b. The registered nurse (RN) case manager for the unit with 1 year's experience. c. A "floating" registered nurse (RN) with five years of nursing experience. d. A Korean-American practical nurse (PN) with six years of nursing experience. - answer_b. The registered nurse (RN) case manager for the unit with 1 year's experience. The RN case manager is the best-qualified nurse to assess and provide discharge educational needs, obtain resources for the client, enhance coordination of care, and prevent fragmentation of care. Which is the priority nursing action while caring for a client on a ventilator when an electrical fire occurs in the intensive care unit? a. Tell another staff member to bring extinguishing equipment to the bedside. b. Close the doors to the client's area when attempting to extinguish the fire. c. Use a bag-valve-mask resuscitator while removing the client from the area. d. Implement an emergency protocol to remove the client from the ventilator. - answer_c. Use a bag-valve-mask resuscitator while removing the client from the area. A client on a ventilator should have respirations maintained with a manual bag-valve-mask resuscitator while being moved away from the oxygen wall outlet and fire source. Which client should be further assessed for an ectopic pregnancy? a. A 24-year-old with shoulder and lower abdominal quadrant pain. b. A 33-year-old with intermittent lower abdominal cramping. c. A 20-year-old with fever and right lower abdominal colic. d. A 40-year-old with jaundice and right lower abdominal pain. - answer_a. A 24-year-old with shoulder and lower abdominal quadrant 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. A female client with type 2 diabetes mellitus reports dysuria. Which assessment finding is most important for the nurse to report to the healthcare provider? a. Suprapublic pain and distention. b. Bounding pulse at 100 beats/minute. c. Fingerstick glucose of 300 mg/dL. d. Small vesicular perineal lesions. - answer_c. Fingerstick glucose of 300 mg/dL. Elevated fingerstick glucose levels need to be reported to the healthcare provider, so a plan of care can be adjusted to treat the elevated glucose level. Also, elevated glucose levels spill into the urine and provide a medium for bacterial growth. The nurse is providing postoperative instructions for a female client after a mastectomy. Which information should the nurse include in the teaching plan? (Select all that apply.) a. Empty surgical drains once a week using procedure gloves. b. Report inflammation of the incision site or the affected arm. c. Wear clothing with snug sleeves over the arm on the operative side. d. Avoid lifting more than 4.5 kg (10 pounds) or reaching above her head. - answer_b. Report inflammation of the incision site or the affected arm. d. Avoid lifting more than 4.5 kg (10 pounds) or reaching above her head. Part of a client's s/p mastectomy teaching plan should include reporting evidence of inflammation at the incision site or the affected arm, and avoiding lifting or reaching above their head. Which assessment finding should the nurse identify that indicates a client with an acute asthma exacerbation is beginning to improve after treatment? a. Wheezing becomes louder. b. Cough remains unproductive. c. Vesicular breath sounds decrease. d. Bronchodilators stimulate coughing. - answer_a. Wheezing becomes louder. In an acute asthma attack, airflow may be so significantly restricted that breath sounds and wheezing is diminished. If the client is successfully responding to bronchodilators and respiratory treatments, wheezing should become louder as the airflow increases in the airways. As the airways open and mucous is mobilized in response to treatment, the cough should become more productive. The nurse is caring for a client with peptic ulcer disease (PUD). Which assessment should the nurse identify and document that is consistent with PUD? (Select all that apply). a. Hematemesis. b. Gastric pain on an empty stomach. c. Colic-like pain with fatty food ingestion. d. Intolerance of spicy foods. e. Diarrhea and stearrhea. - answer_a. Hematemesis. b. Gastric pain on an empty stomach. d. Intolerance of spicy foods. Manifestations of PUD include hematemesis, gastric pain, and spicy food intolerance.