Question 26
HESI RN Medical-Surgical Exam 2026. A client with acute kidney injury (AKI) weighs 110 lb (50 kg) and has potassium level of 6.7 mEq/L (6.7 mmol/L) is admitted to the hospital. Which prescribed medication should the nurse administer first?
Reference Range: Potassium [3.5 to 5 mEq/L (3.5 to 5 mmol/L)]
- A. Epoetin alfa recombinant 2,500 units subcutaneous.
- B. Sodium polystyrene sulfonate 15 grams PO.
- C. Calcium acetate one tablet PO.
- D. Sevelamer one tablet PO.
Question 27
The nurse is providing discharge instructions to a client who is receiving prednisone 5 mg PO daily for a rash due to contact with poison ivy. Which symptom should the nurse tell the client to report to the healthcare provider?
- A. Rapid weight gain.
- B. Gastric irritation.
- C. Moon facies.
- D. Abdominal striae.
Question 28
The nurse is performing the preoperative assessment of a client with an abdominal aortic aneurysm. Which finding is most important for the nurse to provide in the preoperative report?
- A. S3 heart sound on auscultation.
- B. Diminished peripheral pulses.
- C. Respirations 20 breaths/minute.
- D. Hypoactive bowel sounds.
Question 29
The nurse is teaching a client with cancer about skin care for the portal site receiving external beam radiation. Which client action about skin care indicates a need for further teaching?
- A. Washes the radiation site with antibacterial soap and water.
- B. Applies prescribed lotions to the radiation site.
- C. Dries the area with patting motions after taking a shower.
- D. Wears clothing to cover the radiation site.
Question 30
The nurse is caring for a client with herpes zoster virus who reports painful, red, blisters that align from the back along the chest’s curvature to the anterior chest. Which intervention is the highest priority for the nurse?
- A. Administer narcotic analgesics.
- B. Place wet compresses to ruptured vesicles.
- C. Administer antiviral medications.
- D. Place the client on contact precautions.
Question 31
Which opportunistic cancer is commonly seen with AIDS?
- A. Extrapulmonary cryptococcosis.
- B. Metastatic lymphoma of the brain.
- C. Kaposi’s sarcoma.
- D. Oral hairy leukoplakia.
Case Study: 67-Year-Old Male with Respiratory Distress
Question 33 of 60
The nurse reviews the client data. For each finding, click to indicate if the finding is consistent with stroke, acute respiratory distress syndrome, or dementia. Each finding may support more than one disease process. Each column must have at least one response selected.
- Altered mental status
- Stroke (Correct)
- Dementia (Correct)
- Acute respiratory distress syndrome (Correct)
- Dyspnea
- Acute respiratory distress syndrome (Correct)
- Edema in bilateral lower extremities
- (None selected)
- Fine crackles in bases of lungs
- Acute respiratory distress syndrome (Correct)
- Tachycardia
- Acute respiratory distress syndrome (Correct)
Question 34 of 60
The nurse reviewed updated client data. Choose the most likely options for the information missing from the statement by selecting from the lists of options provided.
The nurse determines that the client is most at risk for [Select Response] as evidenced by [Select Response].
- Options for 1:
- Pulmonary edema
- Acute respiratory distress syndrome (Correct) HESI RN Medical-Surgical Exam 2026
- Cardiogenic shock
- Options for 2:
- Metabolic acidosis (Correct)
- Metabolic alkalosis
- Respiratory alkalosis
Question 35 of 60
The client continues to decline and is promptly transferred into the intensive care unit and is prepared for intubation and ventilation. There are no complications with the intubation and the ventilator is set up by the respiratory therapists. Additional prescriptions are placed by the healthcare provider. The nurse is preparing a plan of care for the client. For each intervention, select if it is indicated or contraindicated at this time. Each row must have one response options selected.
- Monitor urine output hourly.
- Indicated (Correct)
- Contraindicated
- Elevate head of bed 90 degrees.
- Indicated
- Contraindicated (Correct)
- Titrate sedation as needed for pain and restlessness.
- Indicated (Correct)
- Contraindicated
- Initiate norepinephrine infusion.
- Indicated (Correct)
- Contraindicated
Question 36 of 60
The client is stable on the ventilator throughout the night. The nurse is preparing for the day and is concerned that the client’s immobility places him at high risk for loss of muscle mass. Complete the following sentence by choosing from the list of options.
The nurse should request a consult from [Options for 1] to avoid [Options for 2] and prolonged ventilator days from loss of muscle mass.
- Options for 1:
- Pharmacist
- Speech therapy
- Dietitian (Correct)
- Options for 2:
- Nephrotoxicity
- Aspiration
- Nutritional depletion (Correct)
Question 38
The nurse is assessing a client for signs and symptoms of hyperthyroidism. Which finding should the nurse expect?
- A. Diarrhea stools. HESI RN Medical-Surgical Exam 2026
- B. Increased heart rate.
- C. Periorbital edema.
- D. Atrophied thyroid gland.
Question 39
A client who had a biliopancreatic diversion (BPD) 3 years ago is now admitted with severe dehydration. Which finding is most important for the nurse to report to the healthcare provider?
- A. Report of poor night vision.
- B. Loose bowel movements.
- C. Strong foul smelling flatus.
- D. Occult positive emesis.
Question 40
The nurse is assessing a client with a leg cast and notes the client’s limb is blue and blanched and the client reports severe pain. Which action should the nurse take?
- A. Record observations and check the client’s limb every 15 minutes.
- B. Release the traction on the client’s limb.
- C. Notify the healthcare provider of the assessment findings.
- D. Administer PRN pain medication.
Question 41
A client with AIDS and a CD4 count of 200 cells/μL (0.2 x 109/L) is diagnosed with Pneumocystis jirovecii pneumonia. Which statement best describes the relationship between these two conditions?
- A. Inadequate numbers of neutrophils are available to ingest and destroy the fungus.
- B. Prolonged exposure to environmental agents has resulted in an atypical infection.
- C. Bone marrow suppression has occurred, resulting in inadequate white blood cells.
- D. Inadequate numbers of T-lymphocytes are available to initiate cellular immunity and macrophages.
Question 44
A client is admitted to the hospital with heart failure. Which intervention should the nurse implement to improve ventilation and reduce venous return?
- A. Increase the client’s activity level.
- B. Place the client in high Fowler position.
- C. Administer oxygen.
- D. Perform passive range of motion.
Question 45
The nurse is caring for a client with hepatic encephalopathy who has a serum ammonia level of 220 mcg/dL (129 \mumol/L). The client is confused and has 2 to 3 loose stools per day while receiving lactulose. Which action should the nurse take?
- A. Continue the prescribed dose of lactulose.
- B. Report the number of diarrhea stools.
- C. Hold the next dose of lactulose.
- D. Replace total volume voided with normal saline.
Question 46
A nurse is preparing to administer a unit of blood to a client and is checking for signs of ABO incompatibility. Which finding should the nurse recognize as a positive sign of ABO incompatibility?
- A. Lower back pain and hypotension.
- B. Arthritic joint changes and chronic pain.
- C. Delayed painful rash with urticaria.
- D. Acute rhinitis and nasal stuffiness.
Question 47
A client is being evaluated for rheumatoid arthritis. Which interpretation should the nurse provide to the client regarding an elevated rheumatoid factor?
- A. Representative of a decline in the client’s condition.
- B. Indication of the onset of joint degeneration.
- C. Confirmation of the autoimmune disease process.
- D. Evidence of spread of the disease to the kidneys.
Question 48
A client with a history of malignant melanoma is being seen in the clinic for a follow-up. Which finding is most important for the nurse to report to the healthcare provider? HESI RN Medical-Surgical Exam 2026
- A. Presence of skin tags.
- B. Slow-healing skin abrasions.
- C. Appearance of any moles.
- D. History of sunburns.
Question 49
A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which laboratory result is most important for the nurse to monitor daily?
- A. Serum protein level.
- B. Serum glucose level.
- C. 24-hour urine for calories.
- D. Peripheral IV site appearance.
Question 49
A client is receiving combination chemotherapy for treatment of metastatic carcinoma. When monitoring the client for systemic side effects, which assessment finding warrants intervention by the nurse?
- A Ascites.
- B Nystagmus.
- C Polycythemia.
- D Leukopenia.
Question 50
Which laboratory test result is most important for the nurse to report to the surgeon prior to a client’s scheduled abdominal surgery?
Reference Range: Fasting Blood Glucose [70 to 110 mg/dL (3.9 to 6.1 mmol/L)] Creatinine [0.5 to 1.1 mg/dL (44 to 97 μmol/L)] Potassium [3.5 to 5 mEq/L (3.5 to 5 mmol/L)] Hemoglobin [14 to 18 g/dL (140 to 180 g/L)]
- A Hemoglobin level of 13 g/dL (130 g/L).
- B Serum creatinine of 5 mg/dL (442 μmol/L).
- C Fasting blood glucose of 90 mg/dL (5 mmol/L).
- D Potassium level of 4 mEq/L (4 mmol/L).
Question 51
After performing a head-to-toe assessment for a client with Addison’s disease, the nurse reports assessment findings to the healthcare provider. The findings include moist mucous membranes, strong palpable peripheral pulses, and a blood pressure 132/88 mm Hg. The client verbalizes understanding of the illness and importance of taking medications every day. Which action should the nurse implement?
- A Make a referral for social services at home.
- B Recommend strict intake and output monitoring.
- C Begin preparing the client for discharge home.
- D Continue to limit daily fluid intake to 500 mL.
Question 52
Complete the diagram by dragging from the choices area to specify which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client’s progress.
- Potential Condition: Meningitis
- Actions to Take: Administer pain and other prescriptions; Minimize environmental stimuli
- Parameters to Monitor: Intracranial pressure; Medication effectiveness
Question 53
A client is admitted with acute diabetes insipidus (DI) and related hypernatremia. In planning care, which client data is most important for the nurse to obtain during the hourly nursing assessment?
- A Bowel sounds.
- B Mental status. HESI RN Medical-Surgical Exam 2026.
- C Pain level.
- D Capillary glucose.
Question 54
A client who reports a sudden visual change is being evaluated for an ischemic cerebrovascular accident (CVA). After obtaining vital signs, the nurse should implement which intervention?
- A Raise the head of the bed to 45 degrees keeping head and neck in neutral alignment.
- B Document observed transient episodes of neurologic dysfunction.
- C Start two large bore IV catheters and review inclusion criteria for IV fibrinolytic therapy.
- D Initiate bilateral intermittent sequential pneumatic compression devices.
Question 55
An adult client who was recently diagnosed with glaucoma tells the nurse, “It feels like I am driving through a tunnel.” The client expresses great concern about going blind. Which nursing instruction is most important for the nurse to provide this client?
- A Eat a diet high in carotene.
- B Maintain prescribed eye drop regimen.
- C Wear prescription glasses.
- D Avoid frequent eye pressure measurements.
Question 56
While assessing a client following lithotripsy with stent insertion, which data indicates to the nurse that the procedure was successful?
- A Client denies urinary frequency, urgency, or dysuria.
- B Serum creatinine and blood urea nitrogen (BUN) levels are within normal limits.
- C Stone fragments are collected when straining the client’s urine.
- D Urine is pale pink with no observable blood clots.
Question 57
The nurse is interviewing a client who comes to the clinic and reports experiencing erectile dysfunction (ED). The client asks if the healthcare provider (HCP) will give him a prescription for sildenafil. Which finding in the client’s electronic medical record (EMR) indicates that this treatment may be contraindicated?
- A Has a history of recurrent angina pectoris.
- B Uses a bronchodilator for chronic obstructive pulmonary disease (COPD).
- C Previous laboratory values indicate renal insufficiency.
- D Takes an oral hypoglycemic agent for type 2 diabetes mellitus.
Question 58
The nurse is developing a plan of care for a client with type 2 diabetes mellitus (DM). When providing teaching on lowering blood glucose levels and increasing serum high-density lipoprotein (HDL) levels, which instruction should the nurse include? HESI RN Medical-Surgical Exam 2026.
- A Monthly appointments with the dietitian.
- B Regular exercise with medical approval.
- C Limit calories on days unable to exercise.
- D Monitor blood glucose levels daily.
Question 59
After several days of coughing and taking acetaminophen to treat temperatures of 101°F (38.3°C), a client with diabetes mellitus (DM) is admitted to the hospital with an upper respiratory infection (URI). Several hours after admission, the client reports having a severe headache and feeling dizzy. Which intervention should the nurse implement first?
- A Obtain sputum for culture.
- B Reassess vital signs.
- C Obtain a fingerstick glucose.
- D Administer an antipyretic.
Question 60
When explaining dietary guidelines to a client with acute glomerulonephritis (AGN), which instruction should the nurse include in the dietary teaching?
- A Restrict sodium intake.
- B Eat foods high in potassium.
- C Select a protein rich food daily.
- D Avoid foods high in carbohydrates.
Question 60 of 60
After four days of treatment, the healthcare provider prescribes an arterial blood gas and decides to remove the client’s endotracheal tube. Which findings indicate that the client is responding well to treatment? Select all that apply.
- A Swallowing status (Correct)
- B Heart rate (Correct)
- C Arterial pH (Correct)
- D Generalized edema
- E PaO2/FiO2 ratio (Correct)
- F Orientation (Correct)
