BSN 266 HESI
Med Surg Exam
(NGN-Style Presentation & Case Scenarios)
Actual Qs & Verified Ans to Pass the Exam
,This Hesi test contains:
Next Gen-style presentation of the questions with expert rationales for a BSN-level
Med-Surg exam.
Each question includes Answer Choices, the Correct Answer, and a detailed Expert
Rationale explaining the reasoning process, suitable for the 2025 HESI Med-Surg
exam standard.
1. A client with gouty arthritis is prescribed colchicine and indomethacin for ankle and great
toe inflammation. Which instruction related to medication and symptom management
should the nurse emphasize at discharge?
Answer Choices:
, a. Avoid drinking fluids to prevent uric acid dilution.
b. Limit walking to prevent joint damage.
c. Take medications only when pain worsens.
d. Drink at least 8 cups (1920 mL) of water daily.
Correct Answer:
d. Drink at least 8 cups (1920 mL) of water daily.
Expert Rationale:
Adequate hydration promotes uric acid excretion, reducing the risk of urate crystal precipitation and kidney
stone formation. Fluid restriction worsens gout. Medication adherence should be consistent, and limited
mobility is usually discouraged to prevent stiffness.
2. A client with pheochromocytoma reports a severe headache and appears diaphoretic.
Which assessment should the nurse prioritize next?
Answer Choices:
a. Heart rate
b. Respiratory rate
c. Oxygen saturation
d. Blood pressure
Correct Answer:
d. Blood pressure
Expert Rationale:
Pheochromocytoma results in episodic catecholamine surges causing severe hypertension, headache, and
diaphoresis. Rapid blood pressure assessment allows prompt intervention to prevent hypertensive
emergencies.
3. A client with cirrhosis has 4+ pitting edema and massive ascites. Which pathophysiological
mechanism primarily contributes to these findings?
Answer Choices:
a. Hypoalbuminemia resulting in decreased colloidal oncotic pressure
b. Increased aldosterone production causing sodium loss
c. Hyperalbuminemia leading to fluid retention
d. Decreased portal venous pressure reducing capillary filtration
Correct Answer:
a. Hypoalbuminemia resulting in decreased colloidal oncotic pressure
Expert Rationale:
Liver dysfunction reduces albumin synthesis, lowering plasma oncotic pressure and causing fluid to shift
into interstitial and peritoneal spaces, resulting in edema and ascites. Portal hypertension also contributes
but hypoalbuminemia is central.
4. A client with asthma reports episodes of bronchoconstriction and increased mucus
production during exercise. What is the nurse’s best initial action?
Med Surg Exam
(NGN-Style Presentation & Case Scenarios)
Actual Qs & Verified Ans to Pass the Exam
,This Hesi test contains:
Next Gen-style presentation of the questions with expert rationales for a BSN-level
Med-Surg exam.
Each question includes Answer Choices, the Correct Answer, and a detailed Expert
Rationale explaining the reasoning process, suitable for the 2025 HESI Med-Surg
exam standard.
1. A client with gouty arthritis is prescribed colchicine and indomethacin for ankle and great
toe inflammation. Which instruction related to medication and symptom management
should the nurse emphasize at discharge?
Answer Choices:
, a. Avoid drinking fluids to prevent uric acid dilution.
b. Limit walking to prevent joint damage.
c. Take medications only when pain worsens.
d. Drink at least 8 cups (1920 mL) of water daily.
Correct Answer:
d. Drink at least 8 cups (1920 mL) of water daily.
Expert Rationale:
Adequate hydration promotes uric acid excretion, reducing the risk of urate crystal precipitation and kidney
stone formation. Fluid restriction worsens gout. Medication adherence should be consistent, and limited
mobility is usually discouraged to prevent stiffness.
2. A client with pheochromocytoma reports a severe headache and appears diaphoretic.
Which assessment should the nurse prioritize next?
Answer Choices:
a. Heart rate
b. Respiratory rate
c. Oxygen saturation
d. Blood pressure
Correct Answer:
d. Blood pressure
Expert Rationale:
Pheochromocytoma results in episodic catecholamine surges causing severe hypertension, headache, and
diaphoresis. Rapid blood pressure assessment allows prompt intervention to prevent hypertensive
emergencies.
3. A client with cirrhosis has 4+ pitting edema and massive ascites. Which pathophysiological
mechanism primarily contributes to these findings?
Answer Choices:
a. Hypoalbuminemia resulting in decreased colloidal oncotic pressure
b. Increased aldosterone production causing sodium loss
c. Hyperalbuminemia leading to fluid retention
d. Decreased portal venous pressure reducing capillary filtration
Correct Answer:
a. Hypoalbuminemia resulting in decreased colloidal oncotic pressure
Expert Rationale:
Liver dysfunction reduces albumin synthesis, lowering plasma oncotic pressure and causing fluid to shift
into interstitial and peritoneal spaces, resulting in edema and ascites. Portal hypertension also contributes
but hypoalbuminemia is central.
4. A client with asthma reports episodes of bronchoconstriction and increased mucus
production during exercise. What is the nurse’s best initial action?
