HESI PN Med-Surg Final 100/100
ELSEVIER HESI PN
MED-SURG HESI PN FINAL EXAM
2026/2027 | 100 QUESTIONS | GRADED A+ | 100% VERIFIED | LATEST VERSION
100 Questions NGN Style Clinical Judgment HESI Aligned
Cardiovascular Respiratory GI & Endocrine Neuro & MSK
HESI PN Med-Surg Overview
Exam Structure Core Domains
✓ 100 Total Questions ● Cardiovascular & Respiratory
✓ Multiple-Choice & NGN Items ● Gastrointestinal & Endocrine
✓ 3 Hour Time Limit ● Renal & Neurological
✓ Clinical Judgment Focus ● Musculoskeletal & Integumentary
✓ 75-80% Passing Score ● Perioperative & Pharmacology
Introduction: Medical-surgical nursing represents the largest content area on the HESI PN exit examination. This exam evaluates
comprehensive understanding of disease processes, nursing assessments, evidence-based interventions, and clinical judgment required for
safe practical nursing practice.
Answer Format
All questions are presented in bold text for clear distinction and readability.
All correct answers are presented in bold and lime green, followed by clearly defined, clinically focused rationales in italic
format that reinforce evidence-based medical-surgical nursing practices, patient safety principles, pathophysiology connections,
pharmacological reasoning, and clinical judgment required for HESI PN final exam success.
Cardiovascular (Questions 1-15)
Cardiovascular
1
A client with heart failure reports sudden weight gain of 3 lbs in 2 days. What is the priority
nursing action?
A) Encourage oral fluids
B) Notify the healthcare provider
C) Administer a diuretic
, D) Document the finding
Correct Answer: B) Notify the healthcare provider
Rationale: Sudden weight gain indicates fluid retention and worsening heart failure. The provider should be notified
for potential medication adjustment.
Cardiovascular
2
A client is prescribed enalapril (Vasotec). Which side effect should the nurse monitor for?
A) Hypokalemia
B) Dry cough
C) Tachycardia
D) Hyperglycemia
Correct Answer: B) Dry cough
Rationale: ACE inhibitors like enalapril commonly cause a persistent dry cough due to bradykinin accumulation.
Cardiovascular
3
A client with MI experiences chest pain. What is the priority intervention?
A) Administer morphine
B) Obtain 12-lead ECG
C) Notify provider
D) Start IV
Correct Answer: B) Obtain 12-lead ECG
Rationale: Obtaining an ECG is priority to diagnose STEMI and initiate reperfusion therapy within the golden hour.
Cardiovascular
4
A client with DVT is on heparin. Which lab value is monitored?
A) PT/INR
B) aPTT
C) CBC
D) BMP
Correct Answer: B) aPTT
Rationale: aPTT monitors heparin therapy. PT/INR monitors warfarin.
Cardiovascular
5
, A client with hypertension is prescribed metoprolol. Which finding contraindicates
administration?
A) BP 140/90
B) HR 50 bpm
C) RR 18
D) Temp 98.6
Correct Answer: B) HR 50 bpm
Rationale: Beta-blockers lower heart rate. Holding the dose is necessary if HR is <60 bpm (or per protocol).
Cardiovascular
6
A client with PAD reports leg pain. What assessment finding is expected?
A) Warm, red legs
B) Cool, pale extremities
C) Bilateral edema
D) Bounding pulses
Correct Answer: B) Cool, pale extremities
Rationale: PAD causes decreased blood flow, resulting in cool, pale skin and diminished pulses.
Cardiovascular
7
A client with HF is prescribed digoxin. Which finding requires holding the dose?
A) HR 72
B) HR 52
C) BP 130/80
D) K+ 4.0
Correct Answer: B) HR 52
Rationale: Digoxin slows HR. Hold if HR <60 bpm in adults.
Cardiovascular
8
A client post-CABG has chest tube drainage of 200 mL/hr. What is the action?
A) Document
B) Notify provider
C) Strip the tube
D) Clamp the tube
Correct Answer: B) Notify provider
ELSEVIER HESI PN
MED-SURG HESI PN FINAL EXAM
2026/2027 | 100 QUESTIONS | GRADED A+ | 100% VERIFIED | LATEST VERSION
100 Questions NGN Style Clinical Judgment HESI Aligned
Cardiovascular Respiratory GI & Endocrine Neuro & MSK
HESI PN Med-Surg Overview
Exam Structure Core Domains
✓ 100 Total Questions ● Cardiovascular & Respiratory
✓ Multiple-Choice & NGN Items ● Gastrointestinal & Endocrine
✓ 3 Hour Time Limit ● Renal & Neurological
✓ Clinical Judgment Focus ● Musculoskeletal & Integumentary
✓ 75-80% Passing Score ● Perioperative & Pharmacology
Introduction: Medical-surgical nursing represents the largest content area on the HESI PN exit examination. This exam evaluates
comprehensive understanding of disease processes, nursing assessments, evidence-based interventions, and clinical judgment required for
safe practical nursing practice.
Answer Format
All questions are presented in bold text for clear distinction and readability.
All correct answers are presented in bold and lime green, followed by clearly defined, clinically focused rationales in italic
format that reinforce evidence-based medical-surgical nursing practices, patient safety principles, pathophysiology connections,
pharmacological reasoning, and clinical judgment required for HESI PN final exam success.
Cardiovascular (Questions 1-15)
Cardiovascular
1
A client with heart failure reports sudden weight gain of 3 lbs in 2 days. What is the priority
nursing action?
A) Encourage oral fluids
B) Notify the healthcare provider
C) Administer a diuretic
, D) Document the finding
Correct Answer: B) Notify the healthcare provider
Rationale: Sudden weight gain indicates fluid retention and worsening heart failure. The provider should be notified
for potential medication adjustment.
Cardiovascular
2
A client is prescribed enalapril (Vasotec). Which side effect should the nurse monitor for?
A) Hypokalemia
B) Dry cough
C) Tachycardia
D) Hyperglycemia
Correct Answer: B) Dry cough
Rationale: ACE inhibitors like enalapril commonly cause a persistent dry cough due to bradykinin accumulation.
Cardiovascular
3
A client with MI experiences chest pain. What is the priority intervention?
A) Administer morphine
B) Obtain 12-lead ECG
C) Notify provider
D) Start IV
Correct Answer: B) Obtain 12-lead ECG
Rationale: Obtaining an ECG is priority to diagnose STEMI and initiate reperfusion therapy within the golden hour.
Cardiovascular
4
A client with DVT is on heparin. Which lab value is monitored?
A) PT/INR
B) aPTT
C) CBC
D) BMP
Correct Answer: B) aPTT
Rationale: aPTT monitors heparin therapy. PT/INR monitors warfarin.
Cardiovascular
5
, A client with hypertension is prescribed metoprolol. Which finding contraindicates
administration?
A) BP 140/90
B) HR 50 bpm
C) RR 18
D) Temp 98.6
Correct Answer: B) HR 50 bpm
Rationale: Beta-blockers lower heart rate. Holding the dose is necessary if HR is <60 bpm (or per protocol).
Cardiovascular
6
A client with PAD reports leg pain. What assessment finding is expected?
A) Warm, red legs
B) Cool, pale extremities
C) Bilateral edema
D) Bounding pulses
Correct Answer: B) Cool, pale extremities
Rationale: PAD causes decreased blood flow, resulting in cool, pale skin and diminished pulses.
Cardiovascular
7
A client with HF is prescribed digoxin. Which finding requires holding the dose?
A) HR 72
B) HR 52
C) BP 130/80
D) K+ 4.0
Correct Answer: B) HR 52
Rationale: Digoxin slows HR. Hold if HR <60 bpm in adults.
Cardiovascular
8
A client post-CABG has chest tube drainage of 200 mL/hr. What is the action?
A) Document
B) Notify provider
C) Strip the tube
D) Clamp the tube
Correct Answer: B) Notify provider
