HESI Med-Surg 1 Exam 1

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Sample questions from HESI Med-Surg 1 Exam 1

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

1. 1.A client scheduled for surgery tells the nurse, "I had a reaction to anesthesia during my last operation, but I do not remember what happened." What is the nurse's priority action?

   • A.Document the statement and notify the surgeon and anesthesia provider
   • B.Ask the client to sign the consent form before becoming more anxious
   • C.Reassure the client that anesthesia reactions are uncommon
   • D.Administer the prescribed preoperative sedative

   Rationale: A prior anesthesia reaction may signal a serious risk and must be clarified with the anesthesia provider before surgery. Obtaining consent or giving a sedative does not address the potential danger, and reassurance without assessment may be misleading. The exam takeaway is to report significant allergy or anesthesia history before administering preoperative medications.

2. 2.A client is scheduled for surgery and has signed the consent form. The client then says, "I still do not understand what the surgeon plans to do." What should the nurse do?

   • A.Explain the procedure using the surgeon's notes
   • B.Ask the client to describe the concerns and notify the surgeon
   • C.Witness the consent because it has already been signed
   • D.Tell the client that signing the form means the procedure is understood

   Rationale: The provider performing the procedure is responsible for explaining its nature, risks, benefits, and alternatives; the nurse should notify that provider when understanding is unclear. The nurse should not substitute for the surgeon's explanation or assume a signature proves comprehension. Consent should not be treated as complete when the client has unresolved questions.

3. 3.A client is 2 hours postoperative after abdominal surgery and has a respiratory rate of 8/min after receiving an opioid. Which action should the nurse take first?

   • A.Assess the client's level of consciousness and oxygenation
   • B.Encourage the client to use the incentive spirometer
   • C.Document the respiratory rate and reassess in 1 hour
   • D.Administer the next scheduled opioid dose

   Rationale: A respiratory rate of 8/min after an opioid suggests potentially dangerous respiratory depression, so immediate assessment of responsiveness and oxygenation is needed. Incentive spirometry is not an adequate response to a client who may be hypoventilating, and delaying reassessment or giving another opioid could worsen the condition. Prioritize airway and breathing and follow facility protocols for opioid-related respiratory depression.

4. 4.A postoperative client reports incisional pain when coughing. Which instruction best helps reduce pain while promoting effective coughing?

   • A.Hold a pillow firmly over the incision while coughing
   • B.Avoid coughing until the incision is no longer painful
   • C.Lie flat and take several shallow breaths
   • D.Request a sedative before each coughing episode

   Answer and rationale are in the full material.

5. 5.A client receiving an opioid by patient-controlled analgesia (PCA) is very drowsy but arouses to voice. The client's family member asks whether they can press the PCA button while the client sleeps. What is the nurse's best response?

   • A.The family member may press it when the client appears uncomfortable
   • B.Only the client should activate the PCA button
   • C.The nurse should increase the dose so fewer button presses are needed
   • D.The family member may press it if the client gives permission

   Answer and rationale are in the full material.