2023 Hesi Medical Surgical (Med Surg)Exit

Exam Version 2 (V2) All 55 Q&A

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 2023 MED-SURG
(MEDICAL SURGICAL)
HESI VERSION 2 (V2)
EXAM

ALL 55 QUESTIONS &

ANSWERS
(ALL ANSWERS ARE 100% CORRECT)
A+ - TAKEN 05/2023
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 1.
Patient Scenario: A 68-year-old patient presents to the hospital with abdominal pain and distension. The patient
has a history of chronic alcohol abuse. Which condition should the nurse suspect?

Answer: The nurse should suspect liver cirrhosis as the patient has a history of chronic alcohol abuse and presents with
abdominal pain and distension.

2. Patient Scenario: A 45-year-old patient with type 2 diabetes has a blood glucose level of 360 mg/dL. The patient
is experiencing symptoms of dehydration. What should the nurse suspect?

Answer: The nurse should suspect hyperglycemia as the patient's blood glucose level is significantly high, and symptoms
of dehydration are present.

3. Patient Scenario: A 72-year-old patient presents to the emergency department with chest pain and shortness of
breath. The patient has a history of hypertension and smoking. Which condition should the nurse suspect?

Answer: The nurse should suspect a myocardial infarction (heart attack) as the patient presents with chest pain and
shortness of breath, and has a history of hypertension and smoking.

4. Patient Scenario: A 55-year-old patient is admitted to the hospital with a suspected gastrointestinal bleed. The
patient is experiencing abdominal pain, weakness, and dizziness. What should the nurse suspect?

Answer: The nurse should suspect anemia as the patient is experiencing symptoms of abdominal pain, weakness, and
dizziness, which are common in patients with a gastrointestinal bleed.

5. Patient Scenario: A 65-year-old patient presents to the emergency department with acute onset of confusion
and lethargy. The patient has a history of hypertension and diabetes. Which condition should the nurse suspect?

Answer: The nurse should suspect hyperglycemia or hypoglycemia as the patient has a history of hypertension and
diabetes and is experiencing acute onset of confusion and lethargy.

6. Patient Scenario: A 50-year-old patient with a history of asthma presents to the clinic with shortness of breath
and wheezing. What is the appropriate nursing intervention?

Answer: The appropriate nursing intervention is to administer a bronchodilator medication and assess the patient's
oxygen saturation levels.

7. Patient Scenario: A 60-year-old patient with a history of heart failure presents to the clinic with edema in the legs
and difficulty breathing. What is the appropriate nursing intervention?

Answer: The appropriate nursing intervention is to administer diuretic medication and monitor the patient's fluid intake
and output.

8. Patient Scenario: A 45-year-old patient with a history of rheumatoid arthritis presents to the clinic with joint pain
and stiffness. What is the appropriate nursing intervention?

Answer: The appropriate nursing intervention is to administer non-steroidal anti-inflammatory drugs (NSAIDs) and assess
the patient's range of motion and mobility.

9. Patient Scenario: A 70-year-old patient with a history of chronic obstructive pulmonary disease (COPD) presents
to the clinic with increased difficulty breathing and coughing up blood. What is the appropriate nursing
intervention?

Answer: The appropriate nursing intervention is to administer bronchodilator medication and oxygen therapy, monitor
the patient's respiratory status, and assess for signs of respiratory distress.
 10. Patient Scenario: A 55-year-old patient with a history of chronic kidney disease presents to the clinic with
decreased urine output and swelling in the legs. What is the appropriate nursing intervention?

Answer: The appropriate nursing intervention is to monitor the patient's fluid intake and output, administer diuretic
medication, and assess the patient's electrolyte levels.

11. A patient with a history of heart failure presents with shortness of breath, fatigue, and edema. Which of the
following medications would you anticipate being prescribed?

Answer: A diuretic such as furosemide (Lasix)

12. A patient with chronic obstructive pulmonary disease (COPD) is admitted to the hospital with worsening
dyspnea. What interventions would you expect to be implemented?

Answer: Oxygen therapy, bronchodilator medication, and possibly corticosteroids.

13. A patient is receiving a blood transfusion when they suddenly develop a rash and difficulty breathing. What
action should the nurse take first?

Answer: Stop the transfusion immediately and assess the patient's airway, breathing, and circulation.

14. A post-operative patient reports severe abdominal pain and distention. What assessment finding should the
nurse report to the healthcare provider?

Answer: Absent bowel sounds, which may indicate bowel obstruction.

15. A patient with diabetes presents with a blood glucose level of 250 mg/dL. What intervention should the nurse
implement?

Answer: Administer insulin as prescribed and monitor blood glucose levels frequently.

16. A patient is admitted with suspected sepsis. What interventions should the nurse implement?

Answer: Administer broad-spectrum antibiotics, provide oxygen therapy, monitor vital signs, and obtain blood cultures.

17. A patient with a history of atrial fibrillation is prescribed warfarin. What is the purpose of this medication?

Answer: To prevent blood clots and reduce the risk of stroke.

18. A patient with a history of cirrhosis presents with ascites. What dietary modifications should the nurse
recommend?

Answer: A low-sodium diet to reduce fluid retention.

 19. A patient with a history of heart disease presents with chest pain. What initial interventions should the nurse
implement?

Answer: Administer oxygen, obtain an electrocardiogram (ECG), and administer sublingual nitroglycerin.

20. A patient with a history of hypertension presents with a blood pressure of 180/110 mmHg. What intervention
should the nurse implement?

Answer: Administer antihypertensive medication as prescribed and monitor blood pressure frequently.

21. A patient with a history of chronic kidney disease presents with a potassium level of 6.5 mEq/L. What
intervention should the nurse implement?

Answer: Administer kayexalate as prescribed to lower the potassium level.

22. A patient is admitted with acute pancreatitis. What dietary modifications should the nurse recommend?

Answer: NPO (nothing by mouth) initially, followed by a low-fat diet.

23. A patient with a history of coronary artery disease presents with ST-segment elevation on the ECG. What
intervention should the nurse anticipate being prescribed?

Answer: Immediate administration of fibrinolytic therapy or percutaneous coronary intervention (PCI).

24. A patient with a history of asthma presents with wheezing and shortness of breath. What medication should the
nurse administer first?

Answer: A bronchodilator such as albuterol.

25. A patient with a history of rheumatoid arthritis is prescribed methotrexate. What instructions should the nurse
provide to the patient?

Answer: To avoid alcohol consumption and to report any signs of infection.

26. A patient is receiving a continuous heparin infusion for deep vein thrombosis (DVT). What laboratory test should
the nurse monitor?

Answer: Activated partial thromboplastin time (aPTT)

27. A patient with chronic obstructive pulmonary disease (COPD) is receiving home oxygen therapy. During a routine
follow-up, the patient’s oxygen saturation is found to be 88%. What should the nurse do first?

Answer: The nurse should increase the oxygen flow rate to improve the patient's oxygen saturation.
28. A patient with end-stage renal disease is receiving hemodialysis. During the treatment, the patient develops muscle
cramps. What intervention should the nurse provide?

Answer: The nurse should stop the dialysis and administer a prescribed antispasmodic medication to alleviate the
patient's muscle cramps.

29. A patient with diabetes has a blood glucose level of 55 mg/dL. The patient is conscious but confused. What
intervention should the nurse provide?

Answer: The nurse should administer 15-20 grams of oral glucose or a prescribed amount of intravenous glucose to
correct the patient's hypoglycemia.

30. A patient with a history of alcohol use disorder is admitted with acute pancreatitis. The patient reports severe
abdominal pain, nausea, and vomiting. What intervention should the nurse provide to address the patient’s pain?

Answer: The nurse should administer pain medication as prescribed to alleviate the patient's severe abdominal pain.

31. A patient with a history of hypertension is taking a thiazide diuretic. The patient’s blood pressure is 160/90 mmHg.
What intervention should the nurse provide?

Answer: The nurse should notify the healthcare provider to discuss the need for a medication adjustment or a different
type of antihypertensive medication.

32. A patient with a history of heart failure is prescribed furosemide. The patient reports feeling dizzy and weak. What
intervention should the nurse provide?

Answer: The nurse should assess the patient's blood pressure and electrolyte levels and notify the healthcare provider of
the patient's symptoms.

33. A patient with a history of peptic ulcer disease is prescribed sucralfate. The patient reports constipation. What
intervention should the nurse provide?

Answer: The nurse should encourage the patient to increase their fluid intake and add fiber to their diet to alleviate
constipation.

34. A patient with a history of osteoporosis is prescribed alendronate. What instruction should the nurse provide to the
patient?

Answer: The nurse should instruct the patient to take the medication with a full glass of water and remain upright for at
least 30 minutes after taking it to prevent esophageal irritation.
35. A patient with a history of asthma is prescribed salmeterol. The patient reports not feeling any relief from their
asthma symptoms. What intervention should the nurse provide?

Answer: The nurse should assess the patient's inhaler technique and consider the need for a different type of
bronchodilator medication.

36. A patient with a history of chronic kidney disease is prescribed erythropoietin. What assessment should the nurse
prioritize?

Answer: The nurse should monitor the patient's hemoglobin and hematocrit levels to evaluate the effectiveness of the
medication in stimulating red blood cell production.

37. A patient with a history of rheumatoid arthritis is prescribed methotrexate. What instruction should the nurse
provide to the patient?

Answer: The nurse should instruct the patient to report any signs of infection, monitor for mouth sores, and avoid
alcohol consumption while taking the medication.

38. A patient with a history of angina is prescribed nitroglycerin. The patient reports chest pain that is not relieved with
one sublingual tablet. What intervention should the nurse provide?

Answer: The nurse should assess the patient's blood pressure and provide an additional dose of nitroglycerin as
prescribed, up to a maximum of three doses within a 15-minute period.

39. Mr. Jones, a 67-year-old man, is admitted to the hospital with dehydration and electrolyte imbalances. He has a
history of hypertension, heart failure, and diabetes mellitus. The nurse notes that he has a urine output of less than 30
ml/hour. Which intervention would be appropriate for this patient?

Answer: Administer IV fluids as prescribed by the healthcare provider.

40. Mrs. Smith, a 72-year-old woman, has undergone a total hip replacement. The nurse notes that she is experiencing
pain and discomfort. Which intervention would be appropriate for this patient?

Answer: Administer pain medications as prescribed by the healthcare provider.

41. Mr. Johnson, a 55-year-old man, is admitted to the hospital with chest pain. He has a history of hypertension and
hyperlipidemia. The nurse notes that he has an elevated troponin level. Which intervention would be appropriate for this
patient?

Answer: Administer nitroglycerin and aspirin as prescribed by the healthcare provider.

42. Mrs. Garcia, a 62-year-old woman, has a diagnosis of acute cholecystitis. The nurse notes that she is experiencing
abdominal pain, nausea, and vomiting. Which intervention would be appropriate for this patient?

Answer: Administer antiemetic medications as prescribed by the healthcare provider.

43. Mr. Kim, a 45-year-old man, is admitted to the hospital with acute pancreatitis. The nurse notes that he has a history
of alcohol abuse. Which intervention would be appropriate for this patient?

Answer: Provide emotional support and counseling to address his alcohol use disorder.

44. Mrs. Brown, a 58-year-old woman, is admitted to the hospital with a diagnosis of diverticulitis. The nurse notes that
she is experiencing abdominal pain and constipation. Which intervention would be appropriate for this patient?

Answer: Administer stool softeners and laxatives as prescribed by the healthcare provider.

45. Mr. White, a 70-year-old man, is admitted to the hospital with a diagnosis of community-acquired pneumonia. The
nurse notes that he has a fever and productive cough. Which intervention would be appropriate for this patient?

Answer: Administer antibiotics as prescribed by the healthcare provider.

46. Mrs. Lee, a 64-year-old woman, is admitted to the hospital with a diagnosis of deep vein thrombosis. The nurse notes
that she is experiencing leg swelling and pain. Which intervention would be appropriate for this patient?

Answer: Administer anticoagulant medications as prescribed by the healthcare provider.

47. Mr. Jackson, a 52-year-old man, is admitted to the hospital with a diagnosis of acute renal failure. The nurse notes
that he has a decreased urine output and elevated creatinine level. Which intervention would be appropriate for this
patient?

Answer: Administer diuretic medications as prescribed by the healthcare provider.

48. Mrs. Davis, a 60-year-old woman, is admitted to the hospital with a diagnosis of acute myocardial infarction. The
nurse notes that she is experiencing chest pain and shortness of breath. Which intervention would be appropriate for
this patient?

Answer: Administer oxygen and nitroglycerin as prescribed by the healthcare provider.

49. Mr. Wilson, a 75-year-old man, is admitted to the hospital with a diagnosis of congestive heart failure. The nurse
notes that he is experiencing edema and shortness of breath. Which intervention would be appropriate for this patient?

Answer: Administer diuretic medications as prescribed by the healthcare provider.

50. A 68-year-old male client has undergone a left hemicolectomy. During post-operative assessment, the nurse notes
the presence of absent bowel sounds. Which action should the nurse take?

Answer: The nurse should notify the healthcare provider of the absent bowel sounds as it could indicate a postoperative
complication such as paralytic ileus.
 51. A 35-year-old female client has been diagnosed with acute pancreatitis. What is the priority nursing intervention for
this client?

Answer: The priority nursing intervention for a client with acute pancreatitis is to manage pain. The nurse should
administer analgesics as prescribed and monitor for pain relief.

52. A 52-year-old male client with a history of hypertension has been diagnosed with heart failure. The healthcare
provider has prescribed furosemide (Lasix) 40 mg IV push. What should the nurse monitor for during and after
administration of the medication?

Answer: The nurse should monitor the client's blood pressure, heart rate, and urine output during and after
administration of furosemide. The medication can cause hypotension and dehydration, so the nurse should also monitor
the client's electrolyte levels.

53. A 62-year-old female client has been diagnosed with diverticulitis. Which diet should the nurse recommend to the
client?

Answer: The nurse should recommend a low-fiber diet to the client with diverticulitis. This helps to rest the bowel and
prevent further inflammation. As symptoms improve, the client can gradually increase fiber intake.

54. A 40-year-old male client with a history of alcohol abuse has been admitted to the hospital with acute pancreatitis.
The healthcare provider has ordered a serum amylase level to be drawn. What does this lab test assess?

Answer: A serum amylase level assesses pancreatic function. Elevated levels may indicate pancreatitis, but other
conditions such as mumps, salivary gland disorders, and renal failure can also cause elevated levels.

55.. A 65-year-old male patient is admitted to the hospital with a history of myocardial infarction. The patient's blood
pressure is 150/90 mmHg, heart rate is 95 beats per minute, and oxygen saturation is 93% on room air. The patient is
complaining of chest pain and shortness of breath. What intervention should the nurse prioritize?

Answer: The nurse should prioritize administering oxygen to the patient to improve oxygen saturation and relieve
shortness of breath. The nurse should also assess the patient's chest pain and administer appropriate pain medication.
The patient's blood pressure should be monitored closely, and antihypertensive medication may be administered as
needed. A 12-lead electrocardiogram should be obtained to evaluate the patient's cardiac status.

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