HESI MEDICAL SURGICAL STUDY GUIDE EXAM 2026/2027
QUESTIONS AND SOLUTIONS RATED A+
✔✔A young woman is being treated with amoxicillin (Amoxil) for a urinary tract infection.
Which is the highest priority instruction for the nurse to give this client?
A) "You may experience an irregular heartbeat while on the drug."
B) "Watch for blood in your urine while taking this drug."
C) "Use a second form of birth control while on the drug."
D) "You will experience increased menstrual bleeding while on this drug." - ✔✔C
The client should use a second form of birth control because penicillin seems to reduce
the effectiveness of estrogen-containing contraceptives. She should not experience
increased menstrual bleeding, an irregular heartbeat, or blood in her urine while taking
the medication.
✔✔The nurse prepares to teach a patient recovering from a myocardial infarction (MI)
about combination durg therapy based on "best practice" for controlling hypertension.
Which drugs does the nurse include in the teaching plan? SELECT ALL THAT APPLY!!!
A) NSAID's
B) Aspirin
C) Aldosterone antagonists
D) ACE Inhibitors or ARB's
E) Central alpha Agonists
F) Beta Blockers
G) Diuretics - ✔✔B,C,D,F,G
✔✔The nurse is caring for a client who is disoriented as the result of a stroke. Which
action does the nurse implement to help orient this client?
A) Turn on the television to a 24-hour news station.
B) Provide auditory and visual stimulation simultaneously.
C) Ask the family to bring in pictures familiar to the client.
D) Maintain a calm and quite environment by minimizing visitors. - ✔✔C
For the client with disorientation, the nurse can request that the family bring in pictures
or objects that are familiar to the client. The nurse explains what the object or picture
represents in simple terms. These stimuli can be presented several times daily. Visitors
can also be familiar stimuli to reorient the client. Too much stimuli and constant stimuli
can lead to further confusion.
✔✔The nurse is caring for an anorexic client who is severely malnourished. A
nasogastric feeding tube is inserted, and tube feedings are started. Which laboratory
finding is the best indication that the client's nutritional status is improving?
,A) Creatinine has dropped from 1.9 to 0.5 mg/dL.
B) Blood urea nitrogen (BUN) level has dropped from 15 to 11 mg/dL.
C) Prealbumin level has risen from 9 to 13 mg/dL.
D) Sodium has risen from 130 to 144 mg/dL. - ✔✔C
The prealbumin level is a good measure of nutritional status because its half-life is only
2 days, so it reflects current nutritional status. The client's prealbumin level is rising and
almost normal, indicating that the client's nutritional status is improving. The other
laboratory values are more reflective of fluid balance and kidney function.
✔✔When conducting a health history assessment, the nurse would want to know what
important information about the patient's elimination status? (Select all that apply.)
A) Time of day patient defecates
B) Patient's preferences for toileting
C) List of medications taken by patient
D) Recent changes in elimination patterns
E) Changes in color, consistency, or odor of stool or urine
F) Discomfort or pain with elimination - ✔✔C,D,E,F
Recent changes in elimination patterns, color, consistency, or odor are important for the
nurse to know concerning elimination. Discomfort or pain during elimination is important
for the nurse to know. A nurse should also know which medications the patient is on as
this may affect elimination. Time of day is not important, nor is the patient's preferences
for toileting. They are personal preferences and do not affect elimination.
✔✔A confused client is hospitalized for possible pneumonia and is admitted from the
emergency department with an indwelling catheter in place. During interdisciplinary
rounds the following day, what question by the nurse takes priority?
A) "Can we discontinue the in-dwelling catheter?"
B) "Will the client be able to return home?"
C) "Should we get another chest x-ray today?"
D) "Do you want daily weights on this client?" - ✔✔A
An in-dwelling catheter dramatically increases the risks of urinary tract infection and
urosepsis. Nursing staff should ensure that catheters are left in place only as long as
they are medically needed. The nurse should inquire about removing the catheter. All
other questions might be appropriate, but because of client safety, this question takes
priority.
✔✔The nurse is assessing a client who had a stroke in the right cerebral hemisphere.
Which neurologic deficit does the nurse assess for in this client?
A) Agraphia
,B) Aphasia
C) Impaired olfaction
D) Impaired proprioception - ✔✔D
A stroke to the right cerebral hemisphere causes impaired visual and spatial awareness.
The client may present with impaired proprioception and may be disoriented as to time
and place. The right cerebral hemisphere does not control speech, smell, or the client's
ability to write.
✔✔A client has newly diagnosed diabetes. To delay the onset of microvascular and
macrovascular complications in this client, the nurse stresses that the client take which
action?
A) Restrict fluid intake.
B) Prevent ketosis.
C) Control hyperglycemia.
D) Prevent hypoglycemia. - ✔✔C
Hyperglycemia is a critical factor in the pathogenesis of long-term diabetic
complications. Maintaining tight glycemic control will help delay the onset of
complications. Preventing hypoglycemia and ketosis, although important, is not as
important as maintaining daily glycemic control. Restricting fluid intake is not part of the
treatment plan for clients with diabetes.
✔✔Which interventions are necessary to provide safe, quality care to a patient receiving
enteral tube feedings? SELECT ALL THAT APPLY!!
A) check the residual volume every 4-6 hours
B) use clean technique when changing the feeding system
C) keep the head of the beg elevated at least 30 degrees
D) change the feeding bag & tubing every 12 hours
E) allow closed system containers to hang for 24 hours - ✔✔A,B,C,E
✔✔A client with a pressure ulcer has the following laboratory values: white blood count
8000/mm3, prealbumin 15.2 mg/dL, albumin 4.2 mg/dL, and lymphocyte count
2000/mm3. Which action by the nurse is most appropriate?
A) Request a dietary consult.
B) Assess the client's vital signs.
C) Document the findings.
D) Place the client in isolation. - ✔✔A
Albumin, prealbumin, and lymphocyte counts all give information related to nutritional
status. The albumin and lymphocyte counts given are normal. The white blood cell
count is not directly related to nutritional status. The prealbumin count is low and is a
, more specific indicator of nutritional status than is the albumin count. This puts the client
at risk for impaired wound healing, so the nurse should request a dietary consult.
✔✔A nurse is explaining to a student nurse about perfusion. The nurse knows the
student understands the concept of perfusion when the student states, "Perfusion
A) is a normal function of the body, and I don't have to be concerned about it."
B) varies as a person ages, so I would expect changes in the body."
C) is monitored by the physician, and I just follow orders."
D) is monitored by vital signs and capillary refill." - ✔✔D
The best method to monitor perfusion is to monitor vital signs and capillary refill. This
allows the nurse to know if perfusion is adequate to maintain vital organs. The nurse
does have to be concerned about perfusion. Perfusion is not only monitored by the
physician but the nurse too. Perfusion does not always change as the person ages.
✔✔The nurse is a assessing a client with hypertension. Which client outcome is
indicative of effective hypertension management?
A) No complaints of sexual dysfunction occur.
B) Pedal edema is not present in the lower legs.
C) No indication of renal impairment is present.
D) The blood pressure reading is 148/94 mm Hg. - ✔✔C
One expected outcome for a client with hypertension is for the client to have no
evidence of target organ damage, such as renal or heart disease, that can occur with
poorly managed hypertension. Development of pedal edema is not directly related to
the management of hypertension. Side effects of some hypertensive agents may
interfere with sexual function, but this does not relate to the effectiveness of treatment
for hypertension. The blood pressure reading is too high to demonstrate effective
management.
✔✔What statement indicates that the client understands teaching about neutropenia?
A) "I will call my doctor if I have an increase in temperature."
B) "My grandchildren may get an infection from me."
C) "I need to use a soft toothbrush."
D) "I have to wear a mask at all times." - ✔✔A
Bone marrow suppression leads to neutropenia and increases the client's risk for
infection. Decreased numbers of neutrophils and other white blood cells can minimize
the clinical manifestations of infection. For this reason, the client may not develop a high
temperature, even with severe infection, and any elevation of temperature should be
reported immediately to the health care provider. The client does not need to wear a
mask or use a soft toothbrush (although if the client has low platelets, he or she should
use a soft toothbrush to avoid causing trauma). The client is not contagious.
QUESTIONS AND SOLUTIONS RATED A+
✔✔A young woman is being treated with amoxicillin (Amoxil) for a urinary tract infection.
Which is the highest priority instruction for the nurse to give this client?
A) "You may experience an irregular heartbeat while on the drug."
B) "Watch for blood in your urine while taking this drug."
C) "Use a second form of birth control while on the drug."
D) "You will experience increased menstrual bleeding while on this drug." - ✔✔C
The client should use a second form of birth control because penicillin seems to reduce
the effectiveness of estrogen-containing contraceptives. She should not experience
increased menstrual bleeding, an irregular heartbeat, or blood in her urine while taking
the medication.
✔✔The nurse prepares to teach a patient recovering from a myocardial infarction (MI)
about combination durg therapy based on "best practice" for controlling hypertension.
Which drugs does the nurse include in the teaching plan? SELECT ALL THAT APPLY!!!
A) NSAID's
B) Aspirin
C) Aldosterone antagonists
D) ACE Inhibitors or ARB's
E) Central alpha Agonists
F) Beta Blockers
G) Diuretics - ✔✔B,C,D,F,G
✔✔The nurse is caring for a client who is disoriented as the result of a stroke. Which
action does the nurse implement to help orient this client?
A) Turn on the television to a 24-hour news station.
B) Provide auditory and visual stimulation simultaneously.
C) Ask the family to bring in pictures familiar to the client.
D) Maintain a calm and quite environment by minimizing visitors. - ✔✔C
For the client with disorientation, the nurse can request that the family bring in pictures
or objects that are familiar to the client. The nurse explains what the object or picture
represents in simple terms. These stimuli can be presented several times daily. Visitors
can also be familiar stimuli to reorient the client. Too much stimuli and constant stimuli
can lead to further confusion.
✔✔The nurse is caring for an anorexic client who is severely malnourished. A
nasogastric feeding tube is inserted, and tube feedings are started. Which laboratory
finding is the best indication that the client's nutritional status is improving?
,A) Creatinine has dropped from 1.9 to 0.5 mg/dL.
B) Blood urea nitrogen (BUN) level has dropped from 15 to 11 mg/dL.
C) Prealbumin level has risen from 9 to 13 mg/dL.
D) Sodium has risen from 130 to 144 mg/dL. - ✔✔C
The prealbumin level is a good measure of nutritional status because its half-life is only
2 days, so it reflects current nutritional status. The client's prealbumin level is rising and
almost normal, indicating that the client's nutritional status is improving. The other
laboratory values are more reflective of fluid balance and kidney function.
✔✔When conducting a health history assessment, the nurse would want to know what
important information about the patient's elimination status? (Select all that apply.)
A) Time of day patient defecates
B) Patient's preferences for toileting
C) List of medications taken by patient
D) Recent changes in elimination patterns
E) Changes in color, consistency, or odor of stool or urine
F) Discomfort or pain with elimination - ✔✔C,D,E,F
Recent changes in elimination patterns, color, consistency, or odor are important for the
nurse to know concerning elimination. Discomfort or pain during elimination is important
for the nurse to know. A nurse should also know which medications the patient is on as
this may affect elimination. Time of day is not important, nor is the patient's preferences
for toileting. They are personal preferences and do not affect elimination.
✔✔A confused client is hospitalized for possible pneumonia and is admitted from the
emergency department with an indwelling catheter in place. During interdisciplinary
rounds the following day, what question by the nurse takes priority?
A) "Can we discontinue the in-dwelling catheter?"
B) "Will the client be able to return home?"
C) "Should we get another chest x-ray today?"
D) "Do you want daily weights on this client?" - ✔✔A
An in-dwelling catheter dramatically increases the risks of urinary tract infection and
urosepsis. Nursing staff should ensure that catheters are left in place only as long as
they are medically needed. The nurse should inquire about removing the catheter. All
other questions might be appropriate, but because of client safety, this question takes
priority.
✔✔The nurse is assessing a client who had a stroke in the right cerebral hemisphere.
Which neurologic deficit does the nurse assess for in this client?
A) Agraphia
,B) Aphasia
C) Impaired olfaction
D) Impaired proprioception - ✔✔D
A stroke to the right cerebral hemisphere causes impaired visual and spatial awareness.
The client may present with impaired proprioception and may be disoriented as to time
and place. The right cerebral hemisphere does not control speech, smell, or the client's
ability to write.
✔✔A client has newly diagnosed diabetes. To delay the onset of microvascular and
macrovascular complications in this client, the nurse stresses that the client take which
action?
A) Restrict fluid intake.
B) Prevent ketosis.
C) Control hyperglycemia.
D) Prevent hypoglycemia. - ✔✔C
Hyperglycemia is a critical factor in the pathogenesis of long-term diabetic
complications. Maintaining tight glycemic control will help delay the onset of
complications. Preventing hypoglycemia and ketosis, although important, is not as
important as maintaining daily glycemic control. Restricting fluid intake is not part of the
treatment plan for clients with diabetes.
✔✔Which interventions are necessary to provide safe, quality care to a patient receiving
enteral tube feedings? SELECT ALL THAT APPLY!!
A) check the residual volume every 4-6 hours
B) use clean technique when changing the feeding system
C) keep the head of the beg elevated at least 30 degrees
D) change the feeding bag & tubing every 12 hours
E) allow closed system containers to hang for 24 hours - ✔✔A,B,C,E
✔✔A client with a pressure ulcer has the following laboratory values: white blood count
8000/mm3, prealbumin 15.2 mg/dL, albumin 4.2 mg/dL, and lymphocyte count
2000/mm3. Which action by the nurse is most appropriate?
A) Request a dietary consult.
B) Assess the client's vital signs.
C) Document the findings.
D) Place the client in isolation. - ✔✔A
Albumin, prealbumin, and lymphocyte counts all give information related to nutritional
status. The albumin and lymphocyte counts given are normal. The white blood cell
count is not directly related to nutritional status. The prealbumin count is low and is a
, more specific indicator of nutritional status than is the albumin count. This puts the client
at risk for impaired wound healing, so the nurse should request a dietary consult.
✔✔A nurse is explaining to a student nurse about perfusion. The nurse knows the
student understands the concept of perfusion when the student states, "Perfusion
A) is a normal function of the body, and I don't have to be concerned about it."
B) varies as a person ages, so I would expect changes in the body."
C) is monitored by the physician, and I just follow orders."
D) is monitored by vital signs and capillary refill." - ✔✔D
The best method to monitor perfusion is to monitor vital signs and capillary refill. This
allows the nurse to know if perfusion is adequate to maintain vital organs. The nurse
does have to be concerned about perfusion. Perfusion is not only monitored by the
physician but the nurse too. Perfusion does not always change as the person ages.
✔✔The nurse is a assessing a client with hypertension. Which client outcome is
indicative of effective hypertension management?
A) No complaints of sexual dysfunction occur.
B) Pedal edema is not present in the lower legs.
C) No indication of renal impairment is present.
D) The blood pressure reading is 148/94 mm Hg. - ✔✔C
One expected outcome for a client with hypertension is for the client to have no
evidence of target organ damage, such as renal or heart disease, that can occur with
poorly managed hypertension. Development of pedal edema is not directly related to
the management of hypertension. Side effects of some hypertensive agents may
interfere with sexual function, but this does not relate to the effectiveness of treatment
for hypertension. The blood pressure reading is too high to demonstrate effective
management.
✔✔What statement indicates that the client understands teaching about neutropenia?
A) "I will call my doctor if I have an increase in temperature."
B) "My grandchildren may get an infection from me."
C) "I need to use a soft toothbrush."
D) "I have to wear a mask at all times." - ✔✔A
Bone marrow suppression leads to neutropenia and increases the client's risk for
infection. Decreased numbers of neutrophils and other white blood cells can minimize
the clinical manifestations of infection. For this reason, the client may not develop a high
temperature, even with severe infection, and any elevation of temperature should be
reported immediately to the health care provider. The client does not need to wear a
mask or use a soft toothbrush (although if the client has low platelets, he or she should
use a soft toothbrush to avoid causing trauma). The client is not contagious.
