N491 Med-Surg HESI Practice Exam Questions with Correct

EXAM ELABORATIONS Aug 28, 2025
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pg. 1 N491 Med-Surg HESI Practice Exam/ Questions with Correct Verified Answers – Latest Update 2024/ Rated A+

The nurse is assessing a client with chronic kidney disease (CKD). Which finding is most important for the nurse to respond to first?

  • Peripheral neuropathy.
  • Potassium 6.0 mEq.
  • Uremic fetor.
  • Daily urine output of 400 ml. - ANSWER - B. Potassium 6.0 mEq.

During assessment of a client with amyotrophic lateral sclerosis (ALS), which finding should the nurse identify when planning care for this client?

  • Muscle weakness.
  • A decline in cognitive function.
  • Abnormal involuntary movements.
  • Urinary frequency. - ANSWER - A. Muscle weakness.

A client with multiple sclerosis has experienced an exacerbation of symptoms, including paresthesias, diplopia, and nystagmus. Which instruction should the nurse provide?

  • Restrict intake of high protein foods.
  • Schedule extra rest periods.
  • Stay out of direct sunlight.
  • Go to the emergency room immediately. - ANSWER - B. Schedule extra rest periods.

The nurse is assessing a client's laboratory values following administration of chemotherapy. Which lab value leads the nurse to suspect that the client is experiencing tumor lysis syndrome (TLS)? 1 / 4

pg. 2

  • Oxygen saturation of 90%.
  • Serum calcium of 5 mg/dL.
  • Hemoglobin of 10 g/dL.
  • Serum PTT of 10 seconds. - ANSWER - B. Serum calcium of 5 mg/dL

TLS results in hyperkalemia, hypocalcemia, hyperuricemia, and hyperphosphatemia.

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?

  • Purulent sputum.
  • Excessive hunger.
  • White blood count of 10,000 mm3.
  • Serum glucose of 115 mg/dl. - ANSWER - A. Purulent sputum.

Which description of pain is consistent with a diagnosis of rheumatoid arthritis?

  • Joint pain is worse in the morning and involves symmetric joints.
  • Joint pain is worse during the day and involves unilateral joints.
  • Joint pain is better in the morning and worsens throughout the day.
  • Joint pain is consistent throughout the day and is relieved by pain medication. - ANSWER - A. Joint
  • pain is worse in the morning and involves symmetric joints.

A 46-year-old female client is admitted for acute renal failure secondary to diabetes and hypertension.Which test is the best indicator of adequate glomerular filtration?

  • Sedimentation rate.
  • Urine specific gravity.
  • Blood Urea Nitrogen (BUN).
  • Serum creatinine. - ANSWER - D. Serum creatinine.

BUN is also an indicator of renal activity, but it can be affected by non-renal factors such as hypovolemia and increased protein intake. 2 / 4

pg. 3

What types of medications should the nurse expect to administer to a client during an acute respiratory distress episode?

  • Anticoagulants and expectorants.
  • Vasodilators and hormones.
  • Bronchodilators and steroids.
  • Analgesics and sedatives. - ANSWER - C. Bronchodilators and steroids.

A client who was in a motor vehicle collision was admitted to the hospital and the right knee was placed in skeletal traction. The nurse has documented this nursing diagnosis in the client's medical record: "Potential for impairment of skin integrity related to immobility from traction." Which nursing intervention is indicated based on this diagnosis statement?

  • Release the traction q4h to provide skin care.
  • Give back care after the client is released from traction.
  • Provide back and skin care while maintaining the traction.
  • Turn the client for back care while suspending traction. - ANSWER - C. Provide back and skin care
  • while maintaining the traction.

Which postmenopausal client's complaint should the nurse refer to the healthcare provider?

  • Episodes of vaginal bleeding.
  • Breasts feel lumpy when palpated.
  • Excessive diaphoresis occurs at night.
  • History of white nipple discharge. - ANSWER - A. Episodes of vaginal bleeding.

A 20-year-old female client calls the nurse to report a lump she found in her breast. Which response is the best for the nurse to provide?

  • "If you are in your menstrual period it is not a good time to check for lumps."
  • "Check it again in one month, and if it is still there schedule an appointment."
  • "Most lumps are benign, but it is always best to come in for an examination."
  • "Try not to worry too much about it, because usually, most lumps are benign." - ANSWER - C. "Most
  • lumps are benign, but it is always best to come in for an examination." 3 / 4

pg. 4

The nurse is preparing a teaching plan for a client who is newly diagnosed with Type 1 diabetes mellitus.Which clinical cues should the nurse describe when teaching the client about hypoglycemia?

  • Fruity breath, tachypnea, chest pain.
  • Sweating, trembling, tachycardia.
  • Nausea, vomiting, anorexia.
  • Polyuria, polydipsia, polyphagia. - ANSWER - B. Sweating, trembling, tachycardia.

The nurse working in a postoperative surgical clinic is assessing a woman who had a left radical mastectomy for breast cancer. Which factor puts this client at greatest risk for developing lymphedema?

  • She sustained an insect bite to her left arm yesterday.
  • Her healthcare provider now prescribes a calcium channel blocker for hypertension.
  • She has lost twenty pounds since the surgery.
  • Her hobby is playing classical music on the piano. - ANSWER - A. She sustained an insect bite to her
  • left arm yesterday.

The nurse is teaching a female client about the best time to plan sexual intercourse in order to conceive.Which information should the nurse provide?

  • Two weeks before menstruation.
  • Low basal temperature.
  • First thing in the morning.
  • Vaginal mucous discharge is thick. - ANSWER - A. Two weeks before menstruation.

A 58-year-old client who has been post-menopausal for five years is concerned about the risk for osteoporosis because her mother has the condition. Which information should the nurse offer?

  • Osteoporosis is a progressive genetic disease with no effective treatment.
  • Low-dose corticosteroid treatment effectively halts the course of osteoporosis.
  • Estrogen replacement therapy should be started to prevent the progression osteoporosis.
  • Calcium loss from bones can be slowed by increasing calcium intake and exercise. - ANSWER - D.
  • Calcium loss from bones can be slowed by increasing calcium intake and exercise.

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Category: EXAM ELABORATIONS
Added: Aug 28, 2025
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pg. 1 N491 Med-Surg HESI Practice Exam/ Questions with Correct Verified Answers – Latest Update 2024/ Rated A+ The nurse is assessing a client with chronic kidney disease (CKD). Which finding is ...

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