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HESI RN MEDICAL SURGICAL EXAM QUESTIONS AND ANSWERS 2024
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HESI RN MEDICAL SURGICAL EXAM QUESTIONS AND ANSWERS 2024
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HESI RN MEDICAL SURGICAL EXAM QUESTIONS ANDANSWERS 2024
An ER nurse is completing an assessment on a patient that is alert but struggles to
answer questions. When she attempts to talk, she slurs her speech and appears very
frightened. What additional clinical manifestation does the nurse expect to find if nacy's
sysmptoms have been caused by a brain attack (stroke)?
A. A carotid bruit
B. A hypotensive blood pressure
C. hyperreflexic deep tendon relexes.
D. Decreased bowel sounds - Answers -A) A carotid bruit.
Rationale: the carotid artery (artery to the brain) is narrowed in clients with a brain
attack. A bruit is an abnormal sound heard on auscultation resulting from interference
with normal blood flow. Usually the blood pressure is hypertensive. Initially flaccid
paralysis occurs, resulting in hyporefkexic deep tendon reflexes. Bowel sounds are not
indicative of a brain attack.
Which clinical manifestation further supports an assessment of a left-sided brain attack?
A) Visual field deficit on the left side.
B) Spatial-perceptual deficits.
C) Paresthesia of the left side.
D) Global aphasia.
D) Global aphasia. - Answers -D) Global aphasia.
Rationale: Global aphasia refers to difficulty speaking, listening, and understanding, as
well as difficulty reading and writing. Symptoms vary from person to person. Aphasia
may occur secondary to any brain injury involving the left hemisphere. Visual field
deficits, spatial-perceptual deficits, and paresthsia of the left side usually occur with
right-sided brain attack.
When preparing a patient for a noncontrast computed tomography (CT) scan STAT,
what nursing intervention should the nurse implement?
A) Determine if the client has any allergies to iodine
B) Explain that the client will not be able to move her head throughout the CT scan.
C) Premedicate the client to decrease pain prior to having the procedure.
D) Provide an explanation of relaxation exercises prior to the procedure. - Answers -B)
Explain that the client will not be able to move her head throughout the CT scan.
,Rationale: Because head motion will distort the images, Nancy will have to remain still
throughout the procedure. Allergies to iodine is important if contrast dye is being used
for the CT scan. Premedicating the client to decrease pain prior to the procedure is
unnecessary because CT scanning is a noninvasive and painless procedure. Providing
an explanation of relaxation exercises prior to the procedure is a worthwhile intervention
to decrease anxiety but is not of highest priority.
A neurologist prescribes a magnetic resonance imaging (MRI) of the head STAT for a
patient. Which data warrants immediate intervention by the nurse concerning this
diagnostic test?
A) Elevated blood pressure.
B) Allergy to shell fish.
C) Right hip replacement.
D) History of atrial fibrillation. - Answers -C) Right hip replacement.
The magnetic field generated by the MRI is so strong that metal-containing items are
strongly attracted to the magnet. Because the hip joint is made of metal, a lead shield
must be used during the procedure. Elevated blood pressure, an allergy to shell fish,
and a history of atrial fibrillation would not affect the MRI.
A client's daughter is sitting by her mother's bedside who was recently transferred to the
Intermediate Care Unit. She states "I don't understand what a brain attack is. The
healthcare provider told me my mother is in serious condition and they are going to run
several tests. I just don't know what is going on. What happened to my mother?" What
is the best response by the nurse?
A) "I am sorry, but according to the Health Insurance Portability and Accounting Act
(HIPAA), I cannot give you any information."
B) "Your mother has had a stroke, and the blood supply to the brain has been blocked."
C) "How do you feel about what the healthcare provider said?"
D) "I will call the healthcare provider so he/she can talk to you about your mother's
serious condition." - Answers -B) "Your mother has had a stroke, and the blood supply
to the brain has been blocked."
Rationale: The nurse can discuss what a diagnosis means. Nancy is unable to make
decisions, so the next of kin, her daughter, Gail, needs sufficient information to make
informed decisions. The nurse has the knowledge, and the responsibility, to explain
Nancy's condition to Gail. The nurse should give facts first, and then address her
feelings after the information is provided.
A splint is prescribed for nighttime use by a client with rheumatoid arthritis. Which
statement by the nurse provides the most accurate explanation for use of the splints?
A) Prevention of deformities.
B) Avoidance of joint trauma.
,C) Relief of joint inflammation.
D) Improvement in joint strength. - Answers -A) Prevention of deformities.
Rationale: Splints may be used at night by clients with rheumatoid arthritis to prevent
deformities (A) caused by muscle spasms and contractures. Splints are not used for (B).
(C) is usually treated with medications, particularly those classified as non-steroidal
antiinflammatory drugs (NSAIDs). For (D), a prescribed exercise program is indicated.
A 32-year-old female client complains of severe abdominal pain each month before her
menstrual period, painful intercourse, and painful defecation. Which additional history
should the nurse obtain that is consistent with the client's complaints?
A) Frequent urinary tract infections.
B) Inability to get pregnant.
C) Premenstrual syndrome.
D) Chronic use of laxatives. - Answers -B) Inability to get pregnant.
Rationale: Dysmenorrhea, dyspareunia, and difficulty or painful defecation are common
symptoms of endometriosis, which is the abnormal displacement of endometrial tissue
in the dependent areas of the pelvic peritoneum. A history of infertility (B) is another
common finding associated with endometriosis. Although (A, C, and D) are common,
nonspecific gynecological complaints, the most common complaints of the client with
endometriosis are pain and infertility.
A client with a 16-year history of diabetes mellitus is having renal function tests because
of recent fatigue, weakness, elevated blood urea nitrogen, and serum creatinine levels.
Which finding should the nurse conclude as an early symptom of renal insufficiency?
A) Dyspnea.
B) Nocturia.
C) Confusion.
D) Stomatitis. - Answers -B) Nocturia.
Rationale: As the glomerular filtration rate decreases in early renal insufficiency,
metabolic waste products, including urea, creatinine, and other substances, such
phenols, hormones, electrolytes, accumulate in the blood. In the early stage of renal
insufficiency, polyuria results from the inability of the kidneys to concentrate urine and
contribute to nocturia (B). (A, C, and D) are more common in the later stages of renal
failure.
A client with heart disease is on a continuous telemetry monitor and has developed
sinus bradycardia. In determining the possible cause of the bradycardia, the nurse
assesses the client's medication record. Which medication is most likely the cause of
the bradycardia?
A) Propanolol (Inderal).
, B) Captopril (Capoten).
C) Furosemide (Lasix).
D) Dobutamine (Dobutrex). - Answers -A) Propanolol (Inderal).
Rationale: Inderal (A) is a beta adrenergic blocking agent, which causes decreased
heart rate and decreased contractility. Neither (B), an ACE inhibitor, nor (C), a loop
diuretic, causes bradycardia. (D) is a sympathomimetic, direct acting cardiac stimulant,
which would increase the heart rate.
A client has been taking oral corticosteroids for the past five days because of seasonal
allergies. Which assessment finding is of most concern to the nurse?
A) White blood count of 10,000 mm3.
B) Serum glucose of 115 mg/dl.
C) Purulent sputum.
D) Excessive hunger. - Answers -C) Purulent sputum.
Rationale: Steroids cause immunosuppression, and a purulent sputum (C) is an
indication of infection, so this symptom is of greatest concern. Oral steroids may
increase (A) and often cause (D). (B) may remain normal, borderline, or increase while
taking oral steroids.
A female client receiving IV vasopressin (Pitressin) for esophageal varice rupture
reports to the nurse that she feels substernal tightness and pressure across her chest.
Which PRN protocol should the nurse initiate?
A) Start an IV nitroglycerin infusion.
B) Nasogastric lavage with cool saline.
C) Increase the vasopressin infusion.
D) Prepare for endotracheal intubation. - Answers -A) Start an IV nitroglycerin infusion.
Rationale: Vasopressin is used to promote vasoconstriction, thereby reducing bleeding.
Vasoconstriction of the coronary arteries can lead to angina and myocardial infarction,
and should be counteracted by IV nitroglycerin per prescribed protocol (A). (B) will not
resolve the cardiac problem. (C) will worsen the problem. Endotracheal intubation may
be needed if respiratory distress occurs (D).
A client with gastroesophageal reflux disease (GERD) has been experiencing severe
reflux during sleep. Which recommendation by the nurse is most effective to assist the
client?
A) Losing weight.
B) Decreasing caffeine intake.
C) Avoiding large meals.
D) Raising the head of the bed on blocks. - Answers -D) Raising the head of the bed on
blocks.
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