HESI-PN Exit Medical Surgical

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Sample questions from HESI-PN Exit Medical Surgical

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.Refer to the client's chart. Which findings require prompt reporting to the RN or provider? Select all that apply.

   • A.New diaphoresis and nausea
   • B.Troponin I above the laboratory reference range
   • C.Heart rate decreasing from 104/min to 88/min
   • D.SpO2 of 96% on room air
   • E.New chest pressure with pain radiating to the jaw

   Rationale: New radiating chest pressure, an elevated troponin, and new diaphoresis with nausea are concerning for acute myocardial injury and require prompt reporting. The SpO2 of 96% is within an expected range, and the heart rate has improved rather than worsened. In suspected acute coronary syndrome, report changes promptly and continue close monitoring.

2. 2.During a home visit, a client taking furosemide for heart failure reports gaining 2.3 kg (5 lb) in 3 days. Which response is most appropriate?

   • A.Recommend increasing fluid intake for 24 hours
   • B.Report the rapid weight gain to the RN or provider
   • C.Reassure the client that weight changes are expected
   • D.Advise the client to skip the next dose of furosemide

   Rationale: A rapid weight increase can indicate fluid retention and worsening heart failure, so it should be reported promptly. Reassurance could delay evaluation, and skipping or changing a prescribed diuretic dose is not appropriate. Increasing fluids could worsen congestion; daily weights taken consistently help detect fluid changes.

3. 3.Which instruction should be reinforced for a client prescribed sublingual nitroglycerin for angina?

   • A.Swallow the tablet with a full glass of water
   • B.Take a dose every hour until the pain stops
   • C.Store the tablets in a weekly pill organizer
   • D.Sit down before taking a dose because dizziness may occur

   Rationale: Nitroglycerin can cause vasodilation and a sudden drop in blood pressure, so sitting or lying down helps reduce injury from dizziness or fainting. The tablets should remain in their original tightly closed container, not a pill organizer. The client should follow the prescribed emergency plan rather than take doses hourly, and the tablet is placed under the tongue to dissolve.

4. 4.A client taking warfarin asks which over-the-counter medication to use for a mild headache. Which response is safest?

   • A.Ask the RN or provider before taking any nonprescription pain medication
   • B.Take ibuprofen with food to prevent an interaction
   • C.Use naproxen for only one dose without checking
   • D.Take aspirin because it does not affect bleeding

   Answer and rationale are in the full material.

5. 5.Which pulse finding should be reported for a client receiving digoxin?

   • A.Radial pulse of 76/min after walking
   • B.Apical pulse of 82/min with regular rhythm
   • C.Apical pulse of 54/min before the scheduled dose
   • D.Apical pulse of 88/min after a meal

   Answer and rationale are in the full material.