pg. 1 2025 RN Hesi Med Surg Exam 2025 Test Bank With 300 Real Exam Prep Questions And Correct Answers With Detailed Rationales/ Hesi RN Med Surg Exam/ RN Hesi Medical Surgical
When assigning clients on a medical-surgical floor to an RN and a PN, it is best for the charge nurse to assign which client to the PN?
- A young adult with bacterial meningitis with recent seizures
- An older adult client with pneumonia and viral meningitis
- A female client in isolation with meningococcal meningitis
- A male client 1 day postoperative after drainage of a brain abscess
- An older adult client with pneumonia and viral meningitis
Rationale:
The most stable client is option B. Options A, C, and D are all at high risk for increased intracranial pressure and require the expertise of the RN for assessment and management of care.A practical nurse (PN) tells the charge nurse in a long-term facility that she does not want to be assigned to one particular resident. She reports that the male client keeps insisting that she is his daughter and begs her to stay in his room. What is the best managerial decision?
- Notify the family that the resident will have to be discharged if his behavior
- Reassign the PN until the resident can be assessed more completely for reality
does not improve.B.Notify administration of the PN's insubordination and need for counseling about her statements.C.Ask the PN what she has done to encourage the resident to believe that she is his daughter.D.Reassign the PN until the resident can be assessed more completely for reality orientation.
orientation. 1 / 4
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Rationale:
Temporary reassignment is the best option until the resident can be examined and his medications reviewed. He may have worsening cerebral dysfunction from an infection or electrolyte imbalance. Option A is not the best option because the family cannot control the resident's actions. The administration may need to know about the situation, but not as a case of insubordination. Implying that the PN is somehow creating the situation is inappropriate until a further evaluation has been conducted.The registered nurse (RN) is caring for a client with peptic ulcer disease (PUD).What assessment should the RN identify and document that is consistent with PUD? (Select all that apply).
Hematemesis.Gastric pain on an empty stomach.Colic-like pain with fatty food ingestion.Intolerance of spicy foods.Diarrhea and stearrhea.Hematemesis (the vomiting of blood) Gastric pain on an empty stomach.Intolerance of spicy foods.
Manifestations of PUD include hematemesis, gastric pain, and spicy food intolerance.A 55-year-old male client has been admitted to the hospital with a medical diagnosis of chronic obstructive pulmonary disease (COPD). Which risk factor is the most significant in the development of this client's COPD?A.The client's father was diagnosed with COPD in his 50s.B.A close family member contracted tuberculosis last year.C.The client smokes one to two packs of cigarettes per day.D.The client has been 40 pounds overweight for 15 years.
- The client smokes one to two packs of cigarettes per day.
Rationale:
Smoking, considered to be a modifiable risk factor, is the most significant risk factor for the development of COPD. The exact mechanism of genetic and hereditary implications for the development of COPD is still under investigation, 2 / 4
pg. 3 although exposure to similar predisposing factors (e.g., smoking or inhaling secondhand smoke) may increase the likelihood of COPD incidence among family members. Options B and D do not exceed the risks associated with cigarette smoking in the development of COPD.A client is ready for discharge following the creation of an ileostomy. Which instruction should the nurse include in discharge teaching?
- Replace the stoma appliance every day.
B.Use warm tap water to irrigate the ileostomy.C.Change the bag when the seal is broken.D.Measure and record the ileostomy output.C.Change the bag when the seal is broken.
Rationale:
A seal must be maintained to prevent leakage of irritating liquid stool onto the skin. Option A is excessive and can cause skin irritation and breakdown.Ileostomies produce liquid fecal drainage, so option B is not necessary. Option D is not needed.A client is placed on a mechanical ventilator following a cerebral hemorrhage, and vecuronium bromide, 0.04 mg/kg every 12 hours IV, is prescribed. What is the priority nursing diagnosis for this client?
A.Impaired communication related to paralysis of skeletal muscles B.High risk for infection related to increased intracranial pressure C.Potential for injury related to impaired lung expansion D.Social isolation related to inability to communicate
- Impaired communication related to paralysis of skeletal muscles
Rationale:
To increase the client's tolerance of endotracheal intubation and/or mechanical ventilation, a skeletal muscle relaxant such as vecuronium is usually prescribed.Option A is a serious outcome because the client cannot communicate his or her needs. Although this client might also experience option D, it is not a priority when compared with option A. Infection is not related to increased intracranial pressure.The respirator will ensure that the lungs are expanded, so option C is incorrect.A 63-year-old client with type 2 diabetes mellitus is admitted for treatment of an ulcer on the heel of the left foot that has not healed with wound care. The nurse 3 / 4
pg. 4 observes that the entire left foot is darker in color than the right foot. Which additional symptom should the nurse expect to find?
A.Pedal pulses will be weak or absent in the left foot.B.The client will state that the left foot is usually warm C.Flexion and extension of the left foot will be limited.D.Capillary refill of the client's left toes will be brisk.
- Pedal pulses will be weak or absent in the left foot.
Rationale:
Symptoms associated with decreased blood supply are weak or absent pedal and tibial pulses. The client with diabetes experiences vascular scarring as a result of atherosclerotic changes in the peripheral vessels. This results in compromised perfusion to the dependent extremities, which further delays wound healing in the affected foot. Although flexion and extension may be limited, depending on the degree of damage, this is not always the case. Options B and D are signs of adequate perfusion of the foot, which would not be expected in this client.Zolpidem tartrate, 1.75 mg PRN at bedtime, is prescribed for rest. The scored tablets are labeled 3.5 mg per tablet. How many tablets should the nurse plan to administer?
A.½ tablet B.1 tablet C.1½ tablets D.2 tablets
- ½ tablet
Rationale:
1.75 is ordered. 3.5 is available. 1.75/3.5 time one tab equlas 05. Or one half tablet.Options B, C, and D are incorrect.
The nurse includes frequent oral care in the plan of care for a client scheduled for an esophagogastrostomy for esophageal cancer. This intervention is included in the client's plan of care to address which nursing diagnosis?
A.Fluid volume deficit B.Self-care deficit
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