2026/2027 HESI PN EXIT MED SURG
EXAM
V1,V2, V3, V4, V5, V6, & V7
,HESI PN EXIT MED SURG EXAM V1 – Questions 1-50
1. A post-cholecystectomy client reports dyspnea, tachycardia, and chest pain. Lung
sounds reveal absent breath sounds on the right. What is the priority action?
A. Administer oxygen via nasal cannula.
B. Prepare for chest tube insertion.
C. Encourage deep breathing exercises.
D. Elevate the head of the bed.
Answer: B
2. The PN delegates morning care to UAP for four clients. Which client is appropriate?
A. New admission with chest pain.
B. Stable hypertension client on oral meds.
C. Postoperative client with IV fluids.
D. Diabetic with new foot ulcer.
Answer: B
3. A client with new-onset atrial fibrillation receives diltiazem IV. Which parameter requires
immediate reporting?
A. Heart rate 65 bpm.
B. Blood pressure 88/50 mmHg.
C. Respiratory rate 16 breaths/min.
D. Oxygen saturation 95%.
Answer: B
4. During blood transfusion, the client reports low back pain and chills. What is the first
action?
A. Slow the infusion rate.
B. Stop the transfusion and run normal saline.
C. Administer diphenhydramine.
D. Increase the primary IV fluid rate.
Answer: B
5. A client with 30% TBSA full-thickness burns to the torso and arms arrives via EMS. What
initial fluid resuscitation rate does the PN anticipate?
A. 2 mL/kg/%TBSA.
B. 4 mL/kg/%TBSA.
C. 6 mL/kg/%TBSA.
D. 8 mL/kg/%TBSA.
Answer: B
6. Post-op day 1 after hip replacement, the client has calf tenderness and Homan's
positive. What does the PN suspect?
A. Muscle strain.
B. Deep vein thrombosis.
C. Compartment syndrome.
, D. Arterial occlusion.
Answer: B
7. A client on NPO status with NG tube to suction has 800 mL output in 8 hours. What
electrolyte imbalance is priority?
A. Hyperkalemia.
B. Hypokalemia.
C. Hypernatremia.
D. Hypocalcemia.
Answer: B
8. The PN assesses a client with emphysema using pursed-lip breathing. Which position
optimizes breathing?
A. Supine.
B. Trendelenburg.
C. High Fowler's.
D. Prone.
Answer: C
9. A diabetic client has blood glucose 450 mg/dL, polyuria, and dry mucous membranes.
What is the priority intervention?
A. Administer subcutaneous insulin.
B. Start IV fluids with insulin drip.
C. Encourage oral fluids.
D. Check urine ketones.
Answer: B
10.For a client at high fall risk receiving PCA morphine, what safety measure is essential?
A. Bedrails up and locked.
B. Place bed in low position with alarm.
C. Administer antiemetic routinely.
D. Encourage frequent ambulation alone.
Answer: B
11.A client post-CABG has sternal incision with purulent drainage and fever. What nursing
diagnosis is priority?
A. Impaired gas exchange.
B. Risk for infection.
C. Acute pain.
D. Activity intolerance.
Answer: B
12.The PN notes peaked T waves on telemetry for a client with serum K+ 6.5 mEq/L. What
is the initial action?
A. Administer kayexalate.
B. Hold potassium supplement.
C. Prepare for dialysis.
D. Increase oral intake.
Answer: B
, 13.Which task can the PN delegate to LPN for a stable post-op client?
A. Initial postoperative assessment.
B. Irrigate Jackson-Pratt drain.
C. Discharge teaching.
D. IV antibiotic administration.
Answer: B
14.A client with pneumonia on droplet precautions coughs without covering mouth. What
does the PN do first?
A. Provide mask and tissues.
B. Isolate the client.
C. Administer antibiotics.
D. Educate on hand hygiene.
Answer: A
15.Post-abdominal surgery, the client has absent bowel sounds and distended abdomen.
What is the likely complication?
A. Paralytic ileus.
B. Bowel perforation.
C. Hypovolemia.
D. Electrolyte imbalance.
Answer: A
16.A client with continuous bladder irrigation post-TURP has bright red output. Priority
action?
A. Continue monitoring.
B. Clamp irrigation and notify provider.
C. Increase irrigation rate.
D. Administer analgesic.
Answer: B
17.For hypovolemic shock with UO 15 mL/hr, what fluid does the PN anticipate?
A. D5W.
B. Lactated Ringer's.
C. 0.45% saline.
D. Albumin.
Answer: B
18.A client with stage III sacral pressure ulcer requires dressing change. Who performs it?
A. UAP.
B. LPN under supervision.
C. PN only.
D. Family member.
Answer: B
19.During tube feeding, the client reports nausea and residual 250 mL. What action?
A. Advance rate.
B. Hold feeding and recheck in 1 hour.
C. Change formula.
EXAM
V1,V2, V3, V4, V5, V6, & V7
,HESI PN EXIT MED SURG EXAM V1 – Questions 1-50
1. A post-cholecystectomy client reports dyspnea, tachycardia, and chest pain. Lung
sounds reveal absent breath sounds on the right. What is the priority action?
A. Administer oxygen via nasal cannula.
B. Prepare for chest tube insertion.
C. Encourage deep breathing exercises.
D. Elevate the head of the bed.
Answer: B
2. The PN delegates morning care to UAP for four clients. Which client is appropriate?
A. New admission with chest pain.
B. Stable hypertension client on oral meds.
C. Postoperative client with IV fluids.
D. Diabetic with new foot ulcer.
Answer: B
3. A client with new-onset atrial fibrillation receives diltiazem IV. Which parameter requires
immediate reporting?
A. Heart rate 65 bpm.
B. Blood pressure 88/50 mmHg.
C. Respiratory rate 16 breaths/min.
D. Oxygen saturation 95%.
Answer: B
4. During blood transfusion, the client reports low back pain and chills. What is the first
action?
A. Slow the infusion rate.
B. Stop the transfusion and run normal saline.
C. Administer diphenhydramine.
D. Increase the primary IV fluid rate.
Answer: B
5. A client with 30% TBSA full-thickness burns to the torso and arms arrives via EMS. What
initial fluid resuscitation rate does the PN anticipate?
A. 2 mL/kg/%TBSA.
B. 4 mL/kg/%TBSA.
C. 6 mL/kg/%TBSA.
D. 8 mL/kg/%TBSA.
Answer: B
6. Post-op day 1 after hip replacement, the client has calf tenderness and Homan's
positive. What does the PN suspect?
A. Muscle strain.
B. Deep vein thrombosis.
C. Compartment syndrome.
, D. Arterial occlusion.
Answer: B
7. A client on NPO status with NG tube to suction has 800 mL output in 8 hours. What
electrolyte imbalance is priority?
A. Hyperkalemia.
B. Hypokalemia.
C. Hypernatremia.
D. Hypocalcemia.
Answer: B
8. The PN assesses a client with emphysema using pursed-lip breathing. Which position
optimizes breathing?
A. Supine.
B. Trendelenburg.
C. High Fowler's.
D. Prone.
Answer: C
9. A diabetic client has blood glucose 450 mg/dL, polyuria, and dry mucous membranes.
What is the priority intervention?
A. Administer subcutaneous insulin.
B. Start IV fluids with insulin drip.
C. Encourage oral fluids.
D. Check urine ketones.
Answer: B
10.For a client at high fall risk receiving PCA morphine, what safety measure is essential?
A. Bedrails up and locked.
B. Place bed in low position with alarm.
C. Administer antiemetic routinely.
D. Encourage frequent ambulation alone.
Answer: B
11.A client post-CABG has sternal incision with purulent drainage and fever. What nursing
diagnosis is priority?
A. Impaired gas exchange.
B. Risk for infection.
C. Acute pain.
D. Activity intolerance.
Answer: B
12.The PN notes peaked T waves on telemetry for a client with serum K+ 6.5 mEq/L. What
is the initial action?
A. Administer kayexalate.
B. Hold potassium supplement.
C. Prepare for dialysis.
D. Increase oral intake.
Answer: B
, 13.Which task can the PN delegate to LPN for a stable post-op client?
A. Initial postoperative assessment.
B. Irrigate Jackson-Pratt drain.
C. Discharge teaching.
D. IV antibiotic administration.
Answer: B
14.A client with pneumonia on droplet precautions coughs without covering mouth. What
does the PN do first?
A. Provide mask and tissues.
B. Isolate the client.
C. Administer antibiotics.
D. Educate on hand hygiene.
Answer: A
15.Post-abdominal surgery, the client has absent bowel sounds and distended abdomen.
What is the likely complication?
A. Paralytic ileus.
B. Bowel perforation.
C. Hypovolemia.
D. Electrolyte imbalance.
Answer: A
16.A client with continuous bladder irrigation post-TURP has bright red output. Priority
action?
A. Continue monitoring.
B. Clamp irrigation and notify provider.
C. Increase irrigation rate.
D. Administer analgesic.
Answer: B
17.For hypovolemic shock with UO 15 mL/hr, what fluid does the PN anticipate?
A. D5W.
B. Lactated Ringer's.
C. 0.45% saline.
D. Albumin.
Answer: B
18.A client with stage III sacral pressure ulcer requires dressing change. Who performs it?
A. UAP.
B. LPN under supervision.
C. PN only.
D. Family member.
Answer: B
19.During tube feeding, the client reports nausea and residual 250 mL. What action?
A. Advance rate.
B. Hold feeding and recheck in 1 hour.
C. Change formula.
