HESI PN Medical-Surgical (Med surg) Exam
2026/2027 | Newly Released
Actual 70 questions with Correct Answers and Expert
Explanations
Q1: You are preparing a patient for abdominal surgery. Which statement indicates the patient
understands the preoperative teaching regarding deep breathing and coughing?
A. "I will take shallow breaths so it doesn't hurt."
B. "I will use my incentive spirometer every hour while I am awake." [CORRECT]
C. "I will hold a pillo w against my incision only if I cough."
D. "I don't need to do those exercises because I will be on a PCA pump."
Correct Answer: B
Rationale: Using the incentive spirometer regularly helps prevent atelectasis and pneumonia;
shallow breathing increases pneumonia risk, and splinting is needed for both coughing and deep
breathing to reduce pain.
Q2: During the admission assessment for a surgical patient, you note the patient takes St. John's
Wort daily. Why is this herbal supplement significant?
A. It increases the risk of postoperative bleeding. [CORRECT]
B. It causes severe drowsiness.
C. It decreases the effectiveness of local anesthesia.
D. It increases blood pressure during surgery.
Correct Answer: A
Rationale: St. John's Wort has serotonergic properties that can increase the risk of bleeding,
especially when combined with NSAIDs or anticoagulants, which is critical to know before
surgery.
,Q3: You are caring for a patient who is 2 hours post-op following a total hip replacement. The
nurse reports the patient's surgical leg is shorter than the other leg and externally rotated. What is
your immediate action?
A. Check the patient's circulation with a Doppler.
B. Notify the surgeon of possible dislocation. [CORRECT]
C. Remind the patient to keep an abduction pillow between their legs.
D. Medicate the patient for pain.
Correct Answer: B
Rationale: Shortening and external rotation are classic signs of hip prosthesis dislocation, which
is a medical emergency requiring immediate notification of the surgeon to prevent neurovascular
compromise.
Q4: A patient is being discharged home with a new Jackson-Pratt drain (JP drain). Which
instruction is most important to include in the teaching?
A. "You may remove the drain when the drainage stops."
B. "Stripping the drain tubing will help it drain faster."
C. "You must milk or strip the drain tubing every 4 hours to ensure patency." [CORRECT]
D. "Keep the drain clamped at all times except when emptying."
Correct Answer: C
Rationale: Milking or stripping the drain tubing prevents clots from obstructing the flow, which
is essential for proper wound drainage and healing; stripping helps maintain the vacuum and
patency of the system.
Q5: While changing a dressing on a postoperative patient, you note the incision is approximated
and the staples are intact, but there is a small amount of serosanguineous drainage. How should
you document this?
A. Clean, dry, and intact.
B. Serous drainage present; possible dehiscence.
C. Incision well-approximated with scant serosanguineous drainage. [CORRECT]
D. Erythema and purulent drainage noted.
, Correct Answer: C
Rationale: "Serosanguineous" describes the pinkish fluid (serum and blood), and "scant" means
a small amount; documenting approximated and intact staples confirms the wound is currently
healing well.
Q6: Your patient is day 2 post-op bowel surgery and has not passed flatus. You auscultate the
abdomen and note high-pitched, tinkling bowel sounds in all four quadrants. What is your best
action?
A. Prepare to insert a nasogastric tube.
B. Encourage ambulation and offer coffee or hot tea. [CORRECT]
C. Administer a soap suds enema.
D. Notify the physician of a paralytic ileus.
Correct Answer: B
Rationale: Hyperactive bowel sounds in a patient who hasn't passed flatus often indicate gas
cramps rather than ileus; ambulation and warm fluids stimulate peristalsis and help pass gas,
avoiding unnecessary invasive interventions.
Q7: You are performing a sterile dressing change. You accidentally touch the edge of the sterile
field with your forearm. What is the correct action?
A. Continue, as your forearm is considered clean.
B. Consider that part of the field contaminated and restart with new supplies. [CORRECT]
C. Quickly apply sterile tape to cover the area.
D. Apply a non-sterile dressing instead.
Correct Answer: B
Rationale: Any break in the sterile field compromises the entire field; the safest action is to
consider the field contaminated and restart the procedure with fresh sterile supplies to prevent
wound infection.
2026/2027 | Newly Released
Actual 70 questions with Correct Answers and Expert
Explanations
Q1: You are preparing a patient for abdominal surgery. Which statement indicates the patient
understands the preoperative teaching regarding deep breathing and coughing?
A. "I will take shallow breaths so it doesn't hurt."
B. "I will use my incentive spirometer every hour while I am awake." [CORRECT]
C. "I will hold a pillo w against my incision only if I cough."
D. "I don't need to do those exercises because I will be on a PCA pump."
Correct Answer: B
Rationale: Using the incentive spirometer regularly helps prevent atelectasis and pneumonia;
shallow breathing increases pneumonia risk, and splinting is needed for both coughing and deep
breathing to reduce pain.
Q2: During the admission assessment for a surgical patient, you note the patient takes St. John's
Wort daily. Why is this herbal supplement significant?
A. It increases the risk of postoperative bleeding. [CORRECT]
B. It causes severe drowsiness.
C. It decreases the effectiveness of local anesthesia.
D. It increases blood pressure during surgery.
Correct Answer: A
Rationale: St. John's Wort has serotonergic properties that can increase the risk of bleeding,
especially when combined with NSAIDs or anticoagulants, which is critical to know before
surgery.
,Q3: You are caring for a patient who is 2 hours post-op following a total hip replacement. The
nurse reports the patient's surgical leg is shorter than the other leg and externally rotated. What is
your immediate action?
A. Check the patient's circulation with a Doppler.
B. Notify the surgeon of possible dislocation. [CORRECT]
C. Remind the patient to keep an abduction pillow between their legs.
D. Medicate the patient for pain.
Correct Answer: B
Rationale: Shortening and external rotation are classic signs of hip prosthesis dislocation, which
is a medical emergency requiring immediate notification of the surgeon to prevent neurovascular
compromise.
Q4: A patient is being discharged home with a new Jackson-Pratt drain (JP drain). Which
instruction is most important to include in the teaching?
A. "You may remove the drain when the drainage stops."
B. "Stripping the drain tubing will help it drain faster."
C. "You must milk or strip the drain tubing every 4 hours to ensure patency." [CORRECT]
D. "Keep the drain clamped at all times except when emptying."
Correct Answer: C
Rationale: Milking or stripping the drain tubing prevents clots from obstructing the flow, which
is essential for proper wound drainage and healing; stripping helps maintain the vacuum and
patency of the system.
Q5: While changing a dressing on a postoperative patient, you note the incision is approximated
and the staples are intact, but there is a small amount of serosanguineous drainage. How should
you document this?
A. Clean, dry, and intact.
B. Serous drainage present; possible dehiscence.
C. Incision well-approximated with scant serosanguineous drainage. [CORRECT]
D. Erythema and purulent drainage noted.
, Correct Answer: C
Rationale: "Serosanguineous" describes the pinkish fluid (serum and blood), and "scant" means
a small amount; documenting approximated and intact staples confirms the wound is currently
healing well.
Q6: Your patient is day 2 post-op bowel surgery and has not passed flatus. You auscultate the
abdomen and note high-pitched, tinkling bowel sounds in all four quadrants. What is your best
action?
A. Prepare to insert a nasogastric tube.
B. Encourage ambulation and offer coffee or hot tea. [CORRECT]
C. Administer a soap suds enema.
D. Notify the physician of a paralytic ileus.
Correct Answer: B
Rationale: Hyperactive bowel sounds in a patient who hasn't passed flatus often indicate gas
cramps rather than ileus; ambulation and warm fluids stimulate peristalsis and help pass gas,
avoiding unnecessary invasive interventions.
Q7: You are performing a sterile dressing change. You accidentally touch the edge of the sterile
field with your forearm. What is the correct action?
A. Continue, as your forearm is considered clean.
B. Consider that part of the field contaminated and restart with new supplies. [CORRECT]
C. Quickly apply sterile tape to cover the area.
D. Apply a non-sterile dressing instead.
Correct Answer: B
Rationale: Any break in the sterile field compromises the entire field; the safest action is to
consider the field contaminated and restart the procedure with fresh sterile supplies to prevent
wound infection.
