HESI - Medical Surgical Nursing Exam
HESI - MEDICAL SURGICAL NURSING EXAM NEWEST / HESI - MEDICAL
SURGICAL NURSING PREPARATION / HESI - MEDICAL SURGICAL
NURSING PRACTICE EXAM WITH COMPLETE QUESTIONS AND CORRECT
ANSWERS |ALREADY GRADED A+||BRAND NEW VERSIONS!!
A nurse is caring for several clients. Which client does the nurse assess most
carefully for hyperkalemia?
a. client with type 2 diabetes taking an oral anti-diabetic agent
b. client with heart failure using a salt substitute
c. client taking a thiazide diuretic for hypertension
d. client taking non-steroidal anti-inflammatory drugs daily
B
Many salt substitutes are composed of potassium chloride. Heavy use cna
contribute to the development of hyperkalemia. The client should be taught to
read labels and to choose a salt substitute that does not contain potassium.
NSAIDs promote the retention of sodium but not potassium.
An older adult client presents with signs and symptoms related to dig toxicity.
Which age related change may have contributed to this problem?
a. decreased renal blood flow
b. increased gastrointestinal motility
c. decreased ratio of adipose tissue to lean body mass
d. increased total body water
A
Decreased renal blood flow and reduced glomerular filtration can result in
slower medication excretion time, potentially leading to toxic drug
accumulation. Aging results in decreased total body water and gastrointestinal
1|Page
, HESI - Medical Surgical Nursing Exam
motility and an increase in the ratio of adipose tissue to lean body mass, but is
not related to dig toxicity.
A client is being treated for dehydration. Which statement made by the client
indicates understanding of this condition?
a. I will use a salt substitute when making and eating my meals.
b. I must drink a quart of water or other liquid each day.
c. I will not drink liquids after 6 PM so I won't have to get up at night.
d. I will weigh myself each morning before I eat or drink.
D
Because 1 L of water weighs 1 kg, change in body weight is a good measure of
excess fluid loss or fluid retention. Weight loss greater than 0.5 lb daily is
indicative of excessive fluid loss. The other statements are not indicative of
practices that will prevent dehydration.
The nurse notes that the handgrip of the client with hypokalemia has diminished
since the previous assessment one hour ago. Which intervention by the nurse is
the priority?
a. assess the client's respiratory rate, rhythm, and depth
b. document findings and monitor the client
c. measure the client's pulse and blood pressure
d. call the health care provider
A
In a client with hypokkalemia, progressive skeletal muscle weakness is
associated with increasing severity of hypokalemia. The most life-threatening
complication of hypokalemia is respiratory insufficiency. It is imperative for the
nurse to perform a respiratory assessment first to make sure that the client is
not in immediate jeopardy. Next, the nurse would call the health care provider
to obtain orders for potassium replacement.
2|Page
, HESI - Medical Surgical Nursing Exam
The physician orders Lasix (furosemide) 60 mg po every day for your patient. On
hand you have Lasix 40 mg. How many tablets will you give the patient?
a. 3
b. 1
c. 1 1/2
d. 2 1/5
C
60/40 (desired/have)
A client has been taught to restrict dietary sodium. Which food selection by the
client indicates to the nurse that teaching has been effective?
a. a grilled cheese sandwich with tomato soup
b. Chinese take-out, including steamed rice
c. a chicken leg, one slice of bread with butter, and steamed carrots
d. slices of ham and cheese on whole grain crackers
C
Clients on restricted sodium diets generally should avoid processed, smoked,
and pickled foods and those with sauces and other condiments. Foods lowest in
sodium include fish, poultry, and fresh produce. The chinese food likely would
have soy sauce, the tomato soup is processed, and the crackers are a snack food
- a category of foods often high in sodium.
When a client is assessed, which behavior best indicates that he or she is
experiencing changes associated with acute pain?
a. inability to concentrate
b. expressed hopelessness
c. psychosocial withdrawal
d. anger and hostility
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, HESI - Medical Surgical Nursing Exam
A
The characteristics most common to chronic pain are psychosocial withdrawal,
anger and hostility, depression, and hopelessness. The inability to concentrate is
associated much more with acute pain, before any physiologic or behavioral
adaptation has occurred.
A nurse is caring for several clients at risk for overhydration. The nurse assesses
the older client with which finding first?
A) Has had diabetes mellitus for 12 years
B) Had abdominal surgery and has a nasogastric tube
C) Just received 3 units of packed red blood cells
D) Uses sodium-containing antacids frequently
C
Blood replacement therapy involves intravenous fluid administration, which
inherently increases the risk for overhydration. The fact that the fluid consists of
packed red blood cells greatly increases the risk, because this fluid increases the
colloidal oncotic pressure of the blood, causing fluid to move from interstitial
and intracellular spaces into the plasma volume. An older adult may not have
sufficient cardiac or renal reserve to manage this extra fluid.
The client with a stroke was admitted to a medical-surgical unit. Which tasks does
the nurse delegate to the unlicensed assistive personnel?
A) Assess level of consciousness.
B) Evaluate the pulse oximetry reading.
C) Assist the client with meals.
D) Complete the nursing care plan.
C
The nurse needs to know the five rights of delegation: right task, right
4|Page
HESI - MEDICAL SURGICAL NURSING EXAM NEWEST / HESI - MEDICAL
SURGICAL NURSING PREPARATION / HESI - MEDICAL SURGICAL
NURSING PRACTICE EXAM WITH COMPLETE QUESTIONS AND CORRECT
ANSWERS |ALREADY GRADED A+||BRAND NEW VERSIONS!!
A nurse is caring for several clients. Which client does the nurse assess most
carefully for hyperkalemia?
a. client with type 2 diabetes taking an oral anti-diabetic agent
b. client with heart failure using a salt substitute
c. client taking a thiazide diuretic for hypertension
d. client taking non-steroidal anti-inflammatory drugs daily
B
Many salt substitutes are composed of potassium chloride. Heavy use cna
contribute to the development of hyperkalemia. The client should be taught to
read labels and to choose a salt substitute that does not contain potassium.
NSAIDs promote the retention of sodium but not potassium.
An older adult client presents with signs and symptoms related to dig toxicity.
Which age related change may have contributed to this problem?
a. decreased renal blood flow
b. increased gastrointestinal motility
c. decreased ratio of adipose tissue to lean body mass
d. increased total body water
A
Decreased renal blood flow and reduced glomerular filtration can result in
slower medication excretion time, potentially leading to toxic drug
accumulation. Aging results in decreased total body water and gastrointestinal
1|Page
, HESI - Medical Surgical Nursing Exam
motility and an increase in the ratio of adipose tissue to lean body mass, but is
not related to dig toxicity.
A client is being treated for dehydration. Which statement made by the client
indicates understanding of this condition?
a. I will use a salt substitute when making and eating my meals.
b. I must drink a quart of water or other liquid each day.
c. I will not drink liquids after 6 PM so I won't have to get up at night.
d. I will weigh myself each morning before I eat or drink.
D
Because 1 L of water weighs 1 kg, change in body weight is a good measure of
excess fluid loss or fluid retention. Weight loss greater than 0.5 lb daily is
indicative of excessive fluid loss. The other statements are not indicative of
practices that will prevent dehydration.
The nurse notes that the handgrip of the client with hypokalemia has diminished
since the previous assessment one hour ago. Which intervention by the nurse is
the priority?
a. assess the client's respiratory rate, rhythm, and depth
b. document findings and monitor the client
c. measure the client's pulse and blood pressure
d. call the health care provider
A
In a client with hypokkalemia, progressive skeletal muscle weakness is
associated with increasing severity of hypokalemia. The most life-threatening
complication of hypokalemia is respiratory insufficiency. It is imperative for the
nurse to perform a respiratory assessment first to make sure that the client is
not in immediate jeopardy. Next, the nurse would call the health care provider
to obtain orders for potassium replacement.
2|Page
, HESI - Medical Surgical Nursing Exam
The physician orders Lasix (furosemide) 60 mg po every day for your patient. On
hand you have Lasix 40 mg. How many tablets will you give the patient?
a. 3
b. 1
c. 1 1/2
d. 2 1/5
C
60/40 (desired/have)
A client has been taught to restrict dietary sodium. Which food selection by the
client indicates to the nurse that teaching has been effective?
a. a grilled cheese sandwich with tomato soup
b. Chinese take-out, including steamed rice
c. a chicken leg, one slice of bread with butter, and steamed carrots
d. slices of ham and cheese on whole grain crackers
C
Clients on restricted sodium diets generally should avoid processed, smoked,
and pickled foods and those with sauces and other condiments. Foods lowest in
sodium include fish, poultry, and fresh produce. The chinese food likely would
have soy sauce, the tomato soup is processed, and the crackers are a snack food
- a category of foods often high in sodium.
When a client is assessed, which behavior best indicates that he or she is
experiencing changes associated with acute pain?
a. inability to concentrate
b. expressed hopelessness
c. psychosocial withdrawal
d. anger and hostility
3|Page
, HESI - Medical Surgical Nursing Exam
A
The characteristics most common to chronic pain are psychosocial withdrawal,
anger and hostility, depression, and hopelessness. The inability to concentrate is
associated much more with acute pain, before any physiologic or behavioral
adaptation has occurred.
A nurse is caring for several clients at risk for overhydration. The nurse assesses
the older client with which finding first?
A) Has had diabetes mellitus for 12 years
B) Had abdominal surgery and has a nasogastric tube
C) Just received 3 units of packed red blood cells
D) Uses sodium-containing antacids frequently
C
Blood replacement therapy involves intravenous fluid administration, which
inherently increases the risk for overhydration. The fact that the fluid consists of
packed red blood cells greatly increases the risk, because this fluid increases the
colloidal oncotic pressure of the blood, causing fluid to move from interstitial
and intracellular spaces into the plasma volume. An older adult may not have
sufficient cardiac or renal reserve to manage this extra fluid.
The client with a stroke was admitted to a medical-surgical unit. Which tasks does
the nurse delegate to the unlicensed assistive personnel?
A) Assess level of consciousness.
B) Evaluate the pulse oximetry reading.
C) Assist the client with meals.
D) Complete the nursing care plan.
C
The nurse needs to know the five rights of delegation: right task, right
4|Page
