HESI MEDICAL-SURGICAL NURSING EXAM – PRACTICE
QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF.
CORE DOMAINS
Fluid and Electrolyte Balance
Perioperative Nursing Care
Cardiovascular Disorders
Respiratory Management
Endocrine and Metabolic Disorders
Gastrointestinal and Nutritional Health
Renal and Urinary Systems
Neurological Assessment and Intervention
Musculoskeletal and Integumentary Care
INTRODUCTION
The purpose of this comprehensive practice assessment is to
prepare nursing students for the HESI Medical-Surgical Nursing
Exam. This document evaluates the essential skills and clinical
knowledge required to provide safe, effective care for adult clients
in various healthcare settings. The assessment utilizes a blend of
,foundational multiple-choice questions and complex scenario-
based items to mirror the actual exam environment. Emphasis is
placed on real-world clinical application, critical thinking, and
prioritization. By engaging with these questions, learners will
demonstrate their ability to apply pathophysiology, pharmacology,
and nursing process principles to ensure optimal patient outcomes
and sound professional decision-making.
SECTION ONE: QUESTIONS 1–100
1. A client with chronic obstructive pulmonary disease (COPD)
is receiving oxygen at 2 L/min via nasal cannula. The nurse
notes the client's oxygen saturation is 89% and the client is
slightly short of breath. Which action should the nurse take
first?
A. Increase the oxygen flow rate to 4 L/min.
B. Assist the client to a tripod position.
C. Administer a PRN dose of albuterol.
D. Notify the healthcare provider immediately.
🟢 B. Assist the client to a tripod position.
🔴 RATIONALE: The tripod position helps improve breathing
mechanics by allowing the diaphragm to drop and the lungs to
,expand more fully. In COPD patients, oxygen should be titrated
carefully to avoid suppressing the hypoxic drive; 89% is often an
acceptable baseline for this population.
2. A nurse is caring for a client who is 24 hours postoperative
following a total hip arthroplasty. Which finding requires
immediate intervention?
A. Pain level of 6 on a scale of 0 to 10.
B. Small amount of serosanguinous drainage on the dressing.
C. Sudden onset of shortness of breath and chest pain.
D. Redness and warmth in the calf of the affected leg.
🟢 C. Sudden onset of shortness of breath and chest pain.
🔴 RATIONALE: These symptoms are classic signs of a
pulmonary embolism (PE), a life-threatening complication of deep
vein thrombosis (DVT) following orthopedic surgery. While redness
in the calf is concerning for DVT, the acute respiratory distress
takes priority.
3. When assessing a client with hyperthyroidism, which clinical
manifestation should the nurse expect to find?
, A. Bradycardia
B. Weight gain
C. Constipation
D. Exophthalmos
🟢 D. Exophthalmos
🔴 RATIONALE: Exophthalmos (protruding eyeballs) is a common
finding in Graves' disease, the most frequent cause of
hyperthyroidism. Bradycardia, weight gain, and constipation are
associated with hypothyroidism.
4. A client is admitted with a diagnosis of acute pancreatitis.
Which laboratory result should the nurse anticipate?
A. Elevated serum amylase
B. Decreased serum glucose
C. Elevated serum calcium
D. Decreased white blood cell count
🟢 A. Elevated serum amylase
🔴 RATIONALE: Serum amylase and lipase levels rise
significantly in acute pancreatitis due to the autodigestion of the
QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF.
CORE DOMAINS
Fluid and Electrolyte Balance
Perioperative Nursing Care
Cardiovascular Disorders
Respiratory Management
Endocrine and Metabolic Disorders
Gastrointestinal and Nutritional Health
Renal and Urinary Systems
Neurological Assessment and Intervention
Musculoskeletal and Integumentary Care
INTRODUCTION
The purpose of this comprehensive practice assessment is to
prepare nursing students for the HESI Medical-Surgical Nursing
Exam. This document evaluates the essential skills and clinical
knowledge required to provide safe, effective care for adult clients
in various healthcare settings. The assessment utilizes a blend of
,foundational multiple-choice questions and complex scenario-
based items to mirror the actual exam environment. Emphasis is
placed on real-world clinical application, critical thinking, and
prioritization. By engaging with these questions, learners will
demonstrate their ability to apply pathophysiology, pharmacology,
and nursing process principles to ensure optimal patient outcomes
and sound professional decision-making.
SECTION ONE: QUESTIONS 1–100
1. A client with chronic obstructive pulmonary disease (COPD)
is receiving oxygen at 2 L/min via nasal cannula. The nurse
notes the client's oxygen saturation is 89% and the client is
slightly short of breath. Which action should the nurse take
first?
A. Increase the oxygen flow rate to 4 L/min.
B. Assist the client to a tripod position.
C. Administer a PRN dose of albuterol.
D. Notify the healthcare provider immediately.
🟢 B. Assist the client to a tripod position.
🔴 RATIONALE: The tripod position helps improve breathing
mechanics by allowing the diaphragm to drop and the lungs to
,expand more fully. In COPD patients, oxygen should be titrated
carefully to avoid suppressing the hypoxic drive; 89% is often an
acceptable baseline for this population.
2. A nurse is caring for a client who is 24 hours postoperative
following a total hip arthroplasty. Which finding requires
immediate intervention?
A. Pain level of 6 on a scale of 0 to 10.
B. Small amount of serosanguinous drainage on the dressing.
C. Sudden onset of shortness of breath and chest pain.
D. Redness and warmth in the calf of the affected leg.
🟢 C. Sudden onset of shortness of breath and chest pain.
🔴 RATIONALE: These symptoms are classic signs of a
pulmonary embolism (PE), a life-threatening complication of deep
vein thrombosis (DVT) following orthopedic surgery. While redness
in the calf is concerning for DVT, the acute respiratory distress
takes priority.
3. When assessing a client with hyperthyroidism, which clinical
manifestation should the nurse expect to find?
, A. Bradycardia
B. Weight gain
C. Constipation
D. Exophthalmos
🟢 D. Exophthalmos
🔴 RATIONALE: Exophthalmos (protruding eyeballs) is a common
finding in Graves' disease, the most frequent cause of
hyperthyroidism. Bradycardia, weight gain, and constipation are
associated with hypothyroidism.
4. A client is admitted with a diagnosis of acute pancreatitis.
Which laboratory result should the nurse anticipate?
A. Elevated serum amylase
B. Decreased serum glucose
C. Elevated serum calcium
D. Decreased white blood cell count
🟢 A. Elevated serum amylase
🔴 RATIONALE: Serum amylase and lipase levels rise
significantly in acute pancreatitis due to the autodigestion of the
