SN HESI MED SURG EXAM – ACTUAL EXAM PRACTICE
B
QUESTIONS AND 100% VERIFIED CORRECT ANSWERS | COMPLETE
EXAM PREP TESTBANK | GUARANTEED PASS | INSTANT
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ore Domains: Cardiovascular Alterations, Respiratory Management, Fluid and
C
Electrolyte Balance, Gastrointestinal Disorders, Neurological Care, Endocrine and
Metabolic Health, Perioperative Nursing, and Renal Function.
he BSN HESI Med Surg Exam is a comprehensive assessment designed to
T
evaluate the clinical judgment and nursing knowledge of baccalaureate-level
students. This examination focuses on the physiological and psychosocial needs of
adult clients experiencing complex health alterations. By utilizing a mix of
foundational theory and scenario-based questions, the test measures the student's
ability to apply the nursing process, ensure patient safety, and make sound
professional decisions in a fast-paced acute care environment. Success requires a
deep understanding of pathophysiology, pharmacology, and the regulatory
standards governing medical-surgical nursing practice.
SECTION 1: QUESTIONS
1. A client with chronic obstructive pulmonary disease (COPD) is receiving
oxygen via nasal cannula at 2 L/min. The nurse notes the client’s respiratory
rate has decreased from 20 to 12 breaths per minute and the client is becoming
lethargic. Which action should the nurse take first?
A. Increase the oxygen flow rate to 4 L/min.
B. Assist the client to a supine position.
🔴
C. Perform a focused respiratory assessment and check SpO2.
D. Administer a PRN dose of a sedative for anxiety.
🔵
Explanation: In COPD patients, excessive oxygen can sometimes suppress
the hypoxic drive; however, the first nursing action is always assessment to
determine the clinical status before intervention.
2. A nurse is caring for a client who is 24 hours postoperative following a total
, h ip arthroplasty. Which finding should the nurse prioritize for immediate
notification of the surgeon?
A. Pain level of 5 on a 1-10 scale after physical therapy.
B. Serosanguineous drainage on the surgical dressing.
🔴
C. Sudden shortness of breath and chest pain.
D. Restricted range of motion in the affected hip.
🔵
Explanation: Sudden dyspnea and chest pain are classic signs of a
pulmonary embolism, a life-threatening complication common after major
orthopedic surgery.
3. The nurse is preparing to administer regular insulin and NPH insulin to a client
with type 1 diabetes. Which technique is correct?
🔴
A. Draw up the regular insulin into the syringe first.
B. Draw up the NPH insulin into the syringe first.
C. Shake the NPH vial vigorously to ensure mixing.
D. Use a separate syringe for each type of insulin.
🔵
Explanation: Regular insulin (clear) should be drawn before NPH (cloudy)
to prevent contaminating the short-acting insulin vial with the long-acting
protein.
4. A client is admitted with a suspected diagnosis of acute pancreatitis. Which
laboratory result should the nurse expect to find?
A. Decreased serum bilirubin.
B. Increased serum calcium.
🔴
C. Increased serum amylase and lipase.
D. Decreased white blood cell count.
🔵
Explanation: Amylase and lipase are digestive enzymes released by the
pancreas; their levels rise significantly during an acute inflammatory process
of the organ.
5. A nurse is assessing a client with a chest tube connected to a water-seal
drainage system. Which observation indicates a potential problem that requires
intervention?
A. Fluctuations in the water-seal chamber with inspiration and expiration.
🔴
B. Continuous bubbling in the water-seal chamber.
C. 50 mL of serosanguineous drainage in the collection chamber over 4 hours.
, . Bubbling in the suction control chamber.
D
🔵
Explanation: Continuous bubbling in the water-seal chamber suggests an
air leak in the system or at the insertion site, whereas intermittent bubbling is
expected with a pneumothorax.
6. A client with a history of heart failure presents with peripheral edema, jugular
venous distention, and weight gain. Which medication class should the nurse
anticipate administering?
A. Beta-blockers.
🔴
B. Loop diuretics.
C. Calcium channel blockers.
D. Anticoagulants.
🔵
Explanation: Loop diuretics such as furosemide are the first-line treatment
for reducing fluid volume overload in symptomatic heart failure.
7. Which dietary instruction is most important for a client diagnosed with chronic
kidney disease (CKD)?
A. Increase intake of protein to promote tissue healing.
🔴
B. Limit intake of potassium-rich foods like bananas and spinach.
C. Consume at least 3,000 mL of fluid per day.
D. Use salt substitutes to flavor food.
🔵
Explanation: In CKD, the kidneys cannot effectively excrete potassium;
salt substitutes often contain potassium chloride and should also be avoided.
8. A nurse is caring for a client in the oliguric phase of acute kidney injury
(AKI). Which finding is the nurse most likely to observe?
A. Urine output of 2,000 mL/day.
B. Hypotension.
🔴
C. Hyperkalemia.
D. Hypophosphatemia.
🔵
Explanation: During the oliguric phase, decreased excretion of metabolic
waste leads to electrolyte imbalances, specifically elevated potassium levels.
9. An older adult client is admitted with a hip fracture. The nurse notes the client
is confused and agitated. What is the priority nursing action?
🔴
A. Assess oxygen saturation and respiratory status.
B. Apply bilateral wrist restraints.
, . Administer a sedative as prescribed.
C
D. Close the door to the room to reduce stimuli.
🔵
Explanation: In older adults, new-onset confusion (delirium) is often a
physiological red flag for hypoxia, infection, or electrolyte imbalance.
10. A client is prescribed levothyroxine for hypothyroidism. Which statement
by the client indicates a need for further teaching?
A. "I will take this medication on an empty stomach every morning."
🔴
B. "I can stop taking this medication once my energy levels return to
normal."
C. "I will report any tremors or heart palpitations to my doctor."
D. "I will wait 30 to 60 minutes after taking the pill before eating breakfast."
🔵
Explanation: Levothyroxine is typically a lifelong replacement therapy;
stopping it abruptly can lead to a return of symptoms or myxedema coma.
11. Which clinical manifestation should the nurse expect to find in a client with
Graves' disease?
A. Bradycardia.
B. Weight gain.
🔴
C. Exophthalmos.
D. Cold intolerance.
🔵
Explanation: Exophthalmos (protruding eyeballs) is a hallmark sign of
hyperthyroidism, specifically Graves' disease, due to tissue edema in the orbit.
12. A nurse is caring for a client with a Glascow Coma Scale (GCS) score of 7.
Which action is the priority?
🔴
A. Ensuring a patent airway and preparing for intubation.
B. Assessing the client’s pupillary response.
C. Monitoring the client's temperature.
D. Checking the client's blood glucose level.
🔵
Explanation: A GCS score of 8 or less generally indicates a need for
airway protection as the client may not be able to maintain their own
respiratory effort.
13. A client is receiving a blood transfusion and starts to complain of low back
pain and chills. What is the nurse's first action?
A. Slow the infusion rate.
B
QUESTIONS AND 100% VERIFIED CORRECT ANSWERS | COMPLETE
EXAM PREP TESTBANK | GUARANTEED PASS | INSTANT
DOWNLOAD PDF
ore Domains: Cardiovascular Alterations, Respiratory Management, Fluid and
C
Electrolyte Balance, Gastrointestinal Disorders, Neurological Care, Endocrine and
Metabolic Health, Perioperative Nursing, and Renal Function.
he BSN HESI Med Surg Exam is a comprehensive assessment designed to
T
evaluate the clinical judgment and nursing knowledge of baccalaureate-level
students. This examination focuses on the physiological and psychosocial needs of
adult clients experiencing complex health alterations. By utilizing a mix of
foundational theory and scenario-based questions, the test measures the student's
ability to apply the nursing process, ensure patient safety, and make sound
professional decisions in a fast-paced acute care environment. Success requires a
deep understanding of pathophysiology, pharmacology, and the regulatory
standards governing medical-surgical nursing practice.
SECTION 1: QUESTIONS
1. A client with chronic obstructive pulmonary disease (COPD) is receiving
oxygen via nasal cannula at 2 L/min. The nurse notes the client’s respiratory
rate has decreased from 20 to 12 breaths per minute and the client is becoming
lethargic. Which action should the nurse take first?
A. Increase the oxygen flow rate to 4 L/min.
B. Assist the client to a supine position.
🔴
C. Perform a focused respiratory assessment and check SpO2.
D. Administer a PRN dose of a sedative for anxiety.
🔵
Explanation: In COPD patients, excessive oxygen can sometimes suppress
the hypoxic drive; however, the first nursing action is always assessment to
determine the clinical status before intervention.
2. A nurse is caring for a client who is 24 hours postoperative following a total
, h ip arthroplasty. Which finding should the nurse prioritize for immediate
notification of the surgeon?
A. Pain level of 5 on a 1-10 scale after physical therapy.
B. Serosanguineous drainage on the surgical dressing.
🔴
C. Sudden shortness of breath and chest pain.
D. Restricted range of motion in the affected hip.
🔵
Explanation: Sudden dyspnea and chest pain are classic signs of a
pulmonary embolism, a life-threatening complication common after major
orthopedic surgery.
3. The nurse is preparing to administer regular insulin and NPH insulin to a client
with type 1 diabetes. Which technique is correct?
🔴
A. Draw up the regular insulin into the syringe first.
B. Draw up the NPH insulin into the syringe first.
C. Shake the NPH vial vigorously to ensure mixing.
D. Use a separate syringe for each type of insulin.
🔵
Explanation: Regular insulin (clear) should be drawn before NPH (cloudy)
to prevent contaminating the short-acting insulin vial with the long-acting
protein.
4. A client is admitted with a suspected diagnosis of acute pancreatitis. Which
laboratory result should the nurse expect to find?
A. Decreased serum bilirubin.
B. Increased serum calcium.
🔴
C. Increased serum amylase and lipase.
D. Decreased white blood cell count.
🔵
Explanation: Amylase and lipase are digestive enzymes released by the
pancreas; their levels rise significantly during an acute inflammatory process
of the organ.
5. A nurse is assessing a client with a chest tube connected to a water-seal
drainage system. Which observation indicates a potential problem that requires
intervention?
A. Fluctuations in the water-seal chamber with inspiration and expiration.
🔴
B. Continuous bubbling in the water-seal chamber.
C. 50 mL of serosanguineous drainage in the collection chamber over 4 hours.
, . Bubbling in the suction control chamber.
D
🔵
Explanation: Continuous bubbling in the water-seal chamber suggests an
air leak in the system or at the insertion site, whereas intermittent bubbling is
expected with a pneumothorax.
6. A client with a history of heart failure presents with peripheral edema, jugular
venous distention, and weight gain. Which medication class should the nurse
anticipate administering?
A. Beta-blockers.
🔴
B. Loop diuretics.
C. Calcium channel blockers.
D. Anticoagulants.
🔵
Explanation: Loop diuretics such as furosemide are the first-line treatment
for reducing fluid volume overload in symptomatic heart failure.
7. Which dietary instruction is most important for a client diagnosed with chronic
kidney disease (CKD)?
A. Increase intake of protein to promote tissue healing.
🔴
B. Limit intake of potassium-rich foods like bananas and spinach.
C. Consume at least 3,000 mL of fluid per day.
D. Use salt substitutes to flavor food.
🔵
Explanation: In CKD, the kidneys cannot effectively excrete potassium;
salt substitutes often contain potassium chloride and should also be avoided.
8. A nurse is caring for a client in the oliguric phase of acute kidney injury
(AKI). Which finding is the nurse most likely to observe?
A. Urine output of 2,000 mL/day.
B. Hypotension.
🔴
C. Hyperkalemia.
D. Hypophosphatemia.
🔵
Explanation: During the oliguric phase, decreased excretion of metabolic
waste leads to electrolyte imbalances, specifically elevated potassium levels.
9. An older adult client is admitted with a hip fracture. The nurse notes the client
is confused and agitated. What is the priority nursing action?
🔴
A. Assess oxygen saturation and respiratory status.
B. Apply bilateral wrist restraints.
, . Administer a sedative as prescribed.
C
D. Close the door to the room to reduce stimuli.
🔵
Explanation: In older adults, new-onset confusion (delirium) is often a
physiological red flag for hypoxia, infection, or electrolyte imbalance.
10. A client is prescribed levothyroxine for hypothyroidism. Which statement
by the client indicates a need for further teaching?
A. "I will take this medication on an empty stomach every morning."
🔴
B. "I can stop taking this medication once my energy levels return to
normal."
C. "I will report any tremors or heart palpitations to my doctor."
D. "I will wait 30 to 60 minutes after taking the pill before eating breakfast."
🔵
Explanation: Levothyroxine is typically a lifelong replacement therapy;
stopping it abruptly can lead to a return of symptoms or myxedema coma.
11. Which clinical manifestation should the nurse expect to find in a client with
Graves' disease?
A. Bradycardia.
B. Weight gain.
🔴
C. Exophthalmos.
D. Cold intolerance.
🔵
Explanation: Exophthalmos (protruding eyeballs) is a hallmark sign of
hyperthyroidism, specifically Graves' disease, due to tissue edema in the orbit.
12. A nurse is caring for a client with a Glascow Coma Scale (GCS) score of 7.
Which action is the priority?
🔴
A. Ensuring a patent airway and preparing for intubation.
B. Assessing the client’s pupillary response.
C. Monitoring the client's temperature.
D. Checking the client's blood glucose level.
🔵
Explanation: A GCS score of 8 or less generally indicates a need for
airway protection as the client may not be able to maintain their own
respiratory effort.
13. A client is receiving a blood transfusion and starts to complain of low back
pain and chills. What is the nurse's first action?
A. Slow the infusion rate.
