NGN RN MEDICAL SURGICAL HESI EXAM 2025 WITH 100% CORRECT
ANSWERS AND EXPLANATIONS
Question 1:
A 58-year-old client who underwent a laparoscopic cholecystectomy
24 hours ago is complaining of right upper quadrant pain, nausea, and
vomiting. Which of the following is the most appropriate first action
by the nurse?
A) Administer prescribed antiemetic
B) Monitor vital signs
C) Perform a focused abdominal assessment
D) Notify the healthcare provider immediately
Answer: C) Perform a focused abdominal assessment
Rationale: It is important to assess the client’s condition to identify any
complications, such as a bile leak or infection, before administering
medications. A focused abdominal assessment will help determine the
cause of the pain and guide appropriate interventions.
Question 2:
A 72-year-old client with congestive heart failure is admitted with
dyspnea and crackles in the lungs. The nurse assesses that the client
has 2+ pitting edema in both legs and a weight gain of 2 kg in the past
24 hours. Which action should the nurse take first?
A) Administer prescribed diuretic
B) Monitor vital signs
,C) Notify the healthcare provider
D) Elevate the client’s legs
Answer: A) Administer prescribed diuretic
Rationale: The priority in heart failure is to relieve fluid overload, which
is evidenced by edema, weight gain, and crackles. Administering a
diuretic will help to decrease the excess fluid and relieve symptoms.
Question 3:
A client with a history of type 2 diabetes mellitus is admitted with a
leg ulcer that has not improved despite treatment. The nurse observes
the ulcer is surrounded by red, inflamed tissue and there is a small
amount of purulent drainage. What is the most likely cause of the
wound not healing?
A) Inadequate nutrition
B) Infection
C) Poor blood circulation
D) Allergic reaction to the dressing
Answer: C) Poor blood circulation
Rationale: Clients with diabetes are at risk for poor circulation,
especially in the lower extremities. This can impair wound healing and
lead to infection. Proper management of blood glucose and improving
circulation can help in wound healing.
Question 4:
, A nurse is caring for a postoperative client who had a total hip
replacement. Which of the following interventions should be
prioritized to prevent complications in the immediate postoperative
period?
A) Encourage deep breathing exercises
B) Apply warm compresses to the incision site
C) Keep the affected leg in a neutral position
D) Encourage the client to flex the hip regularly
Answer: C) Keep the affected leg in a neutral position
Rationale: Keeping the affected leg in a neutral position is essential
after hip replacement surgery to prevent dislocation of the prosthesis.
This is a key intervention in the immediate postoperative period.
Question 5:
A client with chronic obstructive pulmonary disease (COPD) is
receiving oxygen therapy at 2 L/min via nasal cannula. The client’s
SpO2 is 90%. The nurse should take which action next?
A) Increase the oxygen flow rate to 4 L/min
B) Assess the client’s respiratory rate and effort
C) Discontinue the oxygen therapy
D) Notify the healthcare provider immediately
Answer: B) Assess the client’s respiratory rate and effort
Rationale: In COPD, oxygen therapy should be administered cautiously
to prevent respiratory depression. The nurse should first assess the
client’s respiratory status before adjusting oxygen flow rates.
ANSWERS AND EXPLANATIONS
Question 1:
A 58-year-old client who underwent a laparoscopic cholecystectomy
24 hours ago is complaining of right upper quadrant pain, nausea, and
vomiting. Which of the following is the most appropriate first action
by the nurse?
A) Administer prescribed antiemetic
B) Monitor vital signs
C) Perform a focused abdominal assessment
D) Notify the healthcare provider immediately
Answer: C) Perform a focused abdominal assessment
Rationale: It is important to assess the client’s condition to identify any
complications, such as a bile leak or infection, before administering
medications. A focused abdominal assessment will help determine the
cause of the pain and guide appropriate interventions.
Question 2:
A 72-year-old client with congestive heart failure is admitted with
dyspnea and crackles in the lungs. The nurse assesses that the client
has 2+ pitting edema in both legs and a weight gain of 2 kg in the past
24 hours. Which action should the nurse take first?
A) Administer prescribed diuretic
B) Monitor vital signs
,C) Notify the healthcare provider
D) Elevate the client’s legs
Answer: A) Administer prescribed diuretic
Rationale: The priority in heart failure is to relieve fluid overload, which
is evidenced by edema, weight gain, and crackles. Administering a
diuretic will help to decrease the excess fluid and relieve symptoms.
Question 3:
A client with a history of type 2 diabetes mellitus is admitted with a
leg ulcer that has not improved despite treatment. The nurse observes
the ulcer is surrounded by red, inflamed tissue and there is a small
amount of purulent drainage. What is the most likely cause of the
wound not healing?
A) Inadequate nutrition
B) Infection
C) Poor blood circulation
D) Allergic reaction to the dressing
Answer: C) Poor blood circulation
Rationale: Clients with diabetes are at risk for poor circulation,
especially in the lower extremities. This can impair wound healing and
lead to infection. Proper management of blood glucose and improving
circulation can help in wound healing.
Question 4:
, A nurse is caring for a postoperative client who had a total hip
replacement. Which of the following interventions should be
prioritized to prevent complications in the immediate postoperative
period?
A) Encourage deep breathing exercises
B) Apply warm compresses to the incision site
C) Keep the affected leg in a neutral position
D) Encourage the client to flex the hip regularly
Answer: C) Keep the affected leg in a neutral position
Rationale: Keeping the affected leg in a neutral position is essential
after hip replacement surgery to prevent dislocation of the prosthesis.
This is a key intervention in the immediate postoperative period.
Question 5:
A client with chronic obstructive pulmonary disease (COPD) is
receiving oxygen therapy at 2 L/min via nasal cannula. The client’s
SpO2 is 90%. The nurse should take which action next?
A) Increase the oxygen flow rate to 4 L/min
B) Assess the client’s respiratory rate and effort
C) Discontinue the oxygen therapy
D) Notify the healthcare provider immediately
Answer: B) Assess the client’s respiratory rate and effort
Rationale: In COPD, oxygen therapy should be administered cautiously
to prevent respiratory depression. The nurse should first assess the
client’s respiratory status before adjusting oxygen flow rates.
