MED SURG FINAL HESI 2024 ACTUAL EXAM ALL QUESTIONS
AND WELL ELABORATED ANSWERS UPDATED VERSION
||COMPLETE A+ GUIDE
A female client with a nasogastric tube attached to low suction states
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that she is nauseated. The nurse assesses that there has been no
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drainage through the nasogastric tube in the last 2 hours. Which action
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should the nurse take first? - answer-Reposition the client on her side.
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The priority is to determined if the tube is functioning correctly, which
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would relieve the client's nausea. The least invasive intervention is to
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reposition the client (B), should be attempted first, followed by (A & C)
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if these are unsuccessful then (D).
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When assigning clients on a medical-surgical floor to a RN and a LPN, it
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is best for the charge nurse to assign which client to the LPN?
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A. A child with bacterial meningitis with recent seizures.
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B. An older adult client with pneumonia and viral meningitis.
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C. A female client in isolation wiht meningococcal meningitis.
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D. A male client 1 day post-op after drainage of a brain abscess. -
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answer-B. Is the most stable. A, C, D have an increased risk for elevated
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ICP.
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Which description of symptoms is characteristic of a client diagnosed
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with trigeminal neuralgia (tic douloureux)?
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A. Tinnitus, vertigo, and hearing difficulties.
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B. Sudden, stabbing, severe pain over the lip and chin.
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C. Unilateral facial weakness and paralysis.
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D. Difficulty in talking, chewing, and swallowing. - answer-B. Trigeminal
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neuralgia is characterized by paroxysms of pain, similar to an electric
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shock, in the area innervated by one or more branches of the
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trigeminal nerve.
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A. Characteristic of Meniere's
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C. Characteristic of Bell palsey
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D. Characteristic of disorders of the hypoglossal (12th cranial nerve)
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Which abnormal lab finding indicates that a client with diabetes needs
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further evaluation for diabetic nephropathy?
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A. Hypokalemia
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B. Microalbuminauria
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C. Elevated serum lipids
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D. Ketonuria - answer-B. Microalbuminuria is the earliest sign of
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nephropathy and indicates the need for follow-up evaluation.
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Hyperkalemia (A) is associated with end stage renal disease caused by
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diabetic nephropathy. (C) may be elevated in end stage renal disease.
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(D) may signal the onset of DKA.
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An older male client comes to the geriatric screening clinic
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complaining of pain in his left calf. The nurse notices a reddened area
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on the calf of his right leg that is warm to touch and the nurse suspects
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that the client may have thrombophlebitis. Which addition
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assessment is most important for the nurse to perform?
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,Page 3 of 114
A. Measure calf circumference.
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B. Auscultate the client's breath sounds.
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C. Observe for ecchymosis and petechiae.
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D. Obtain the client's blood pressure. - answer-B. Since the client may
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have a pulmonary embolus secondary to the thrombophlebitis.
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A. Would support the nurses assessment.
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C. Least helpful since bruising is not associated with thrombophlebitis.
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D. Less important then auscultation.
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The nurse know that a client taking diuretics must be assessed for the
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development of hypokalemia, and that hypokalemia will create
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changes in the client's normal ECG tracing. Which ECG change would
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be an expected finding in the client with hypokalemia?
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A. Tall, spiked T waves
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B. A prolonged QT interval
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C. A widening QRS complex
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D. Presence of a U wave - answer-D. A U wave is a positive deflection
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following the T wave and is often present with hypokalemia. A, B, C
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indicate hyperkalemia.
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An older client is admitted with a diagnosis of bacterial pneumonia.
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The nurse's assessment of the client will most likely reveal which S/SX?
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A. Leukocytosis and febrile.
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B. Polycythemia and crackles.
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C. Pharyngitis and sputum production.
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, Page 4 of 114
D. Confusion and tachycardia. - answer-D. The onset of pneumonia is
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the older may be signaled by general deterioration, confusion,
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increased heart rate or increased respiratory rate.
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(A, B, C) are often absent in the older with bacterial pneumonia.
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The nurse observes ventricular fibrillation on telemetry and upon
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entering the clients bathroom finds the client unconscious on the
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floor. What intervention should the nurse implement first?
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A. Administer an antidysrhythmic medication.
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B. Start cardiopulmonary resuscitation.
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C. Defibrillate the client at 200 joules.
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D. Assess the client's pulse oximetry. - answer-B. Ventricular fibrillation
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is a life-threatening dysrhythmia and CPR should be started
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immediately. A & C are appropriate but B is the priority. D does not
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address the seriousness of the situation.
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An older female client with dementia is transferred from a long term
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care unit to an acute care unit. The client's children express concern
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that their mother's confusion is worsening. How should the nurse
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respond?
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A. "It is to be expected that older people will experience progressive
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confusion."
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B. "Confusion in an older person often follows relocation to new
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surroundings."
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