HESI PATHOPHYSIOLOGY PRACTICE QUESTIONS NEWEST 2026 COMPLETE 300
QUESTIONS AND CORRECT DETAILED/NEWEST UPDATE!!!
Question 1
A male patient asks the nurse why his Prostatic Surface Antigen (PSA) levels are elevated.
Which pathophysiological mechanism should the nurse explain?
A) Increased levels are caused by a decrease in prostate gland volume.
B) PSA is a hormone that increases only during urinary tract infections.
C) As the prostate gland enlarges, its cells contribute more PSA to the circulating blood.
D) PSA is produced by the kidneys in response to bladder obstruction.
E) PSA levels fluctuate based on the patient's daily intake of dietary protein.
Correct Answer: C) As the prostate gland enlarges, its cells contribute more PSA in the
circulating blood
Rationale: PSA is a glycoprotein found in prostatic epithelial cells. Elevations are used as
specific tumor markers because PSA levels are related to gland volume. Conditions such as
Benign Prostatic Hyperplasia (BPH), prostatitis, and prostate cancer increase the tumor
cell load, thereby increasing PSA in the blood.
Question 2
A 26-year-old male client with Hodgkin’s disease is scheduled for radiation therapy and
expresses concern about his ability to have children. What information should the nurse provide?
A) Radiation therapy has no effect on male fertility.
B) Sperm motility improves following the completion of radiation.
C) Temporary sterility occurs for approximately 6 months post-treatment.
D) Permanent sterility occurs in male clients who receive radiation for Hodgkin's.
E) High sperm counts are typical in Hodgkin's disease prior to therapy.
Correct Answer: D) Permanent sterility occurs in the male client who receive radiation
Rationale: Low sperm count and loss of motility are often seen in males with Hodgkin’s
disease even before therapy begins. Radiotherapy typically results in permanent aspermia
or sterility in males.
Question 3
While auscultating a client’s lungs, the nurse hears short, high-pitched sounds just before the end
of inspiration in the lower lobes. How should this finding be documented?
A) Wheezes in the lower lobes.
B) Rhonchi in the lower lobes.
C) Crackles in the right and left lower lobes.
D) Stridor in the right and left lower lobes.
E) Pleural friction rub in the lower lobes.
Correct Answer: C) Crackles in the right and left lower lobes
Rationale: Fine crackles are short, high-pitched sounds heard just before the end of
inspiration. They are the result of rapid equalization of pressure when collapsed alveoli or
terminal bronchioles suddenly snap open.
, 2
Question 4
A client is admitted to the Emergency Department with a tension pneumothorax. Which
assessment finding should the nurse expect to identify?
A) Deviation of the trachea toward the side of the pneumothorax.
B) Deviation of the trachea toward the side opposite of the pneumothorax.
C) Flattening of the chest wall on the affected side.
D) Increased breath sounds on the affected side.
E) Brisk capillary refill and hypertension.
Correct Answer: B) A deviation of the trachea toward the side opposite of the pneumothorax
Rationale: Tension pneumothorax is caused by a rapid accumulation of air in the pleural
space, causing severely high intrapleural pressure. This results in the collapse of the lung
and a mediastinal shift toward the unaffected side, which subsequently compresses the
remaining functional lung.
Question 5
A client receiving a whole blood transfusion develops chills, fever, and a headache 30 minutes
after the transfusion starts. The nurse should recognize these as characteristic of which reaction?
A) An allergic transfusion reaction.
B) An acute hemolytic reaction.
C) A circulatory overload reaction.
D) A febrile non-hemolytic reaction.
E) An anaphylactic reaction.
Correct Answer: D) A febrile transfusion reaction
Rationale: Symptoms of a febrile reaction include sudden chills, fever, headache, flushing,
and muscle pain. It is the most common reaction and is usually caused by recipient
antibodies reacting to donor white blood cells.
Question 6
The nurse is analyzing a client’s ECG. Which finding indicates a disturbance in electrical
conduction in the ventricles?
A) PR interval of 0.16 second.
B) QRS interval of 0.14 second.
C) QT interval of 0.34 second.
D) T wave height of 2 mm.
E) P wave duration of 0.10 second.
Correct Answer: B) QRS interval of 0.14 second
Rationale: The normal duration of the QRS complex is 0.04 to 0.12 seconds. A QRS interval
of 0.14 seconds indicates a delay or disturbance in the electrical conduction through the
ventricles.
, 3
Question 7
Several hours after surgical repair of an Abdominal Aortic Aneurysm (AAA), the client develops
left flank pain and a urinary output of 20 mL/hr. These findings support which complication?
A) Hypovolemic shock.
B) Intestinal infarction.
C) Renal artery embolization.
D) Paralytic ileus.
E) Deep vein thrombosis.
Correct Answer: C) Renal artery embolization
Rationale: Embolization of a fragment of thrombus or plaque from the aorta into a renal
artery can compromise blood flow. This results in renal ischemia, which precipitates
unilateral flank pain and decreased urinary output.
Question 8
A client with a markedly distended bladder and a residual urine volume of 1650 mL is diagnosed
with hydronephrosis. This supports which pathophysiological cause?
A) Obstruction at the urinary bladder neck.
B) Acute glomerulonephritis.
C) Excessive intake of oral fluids.
D) Nephrotic syndrome.
E) Primary hyperaldosteronism.
Correct Answer: A) Obstruction at the urinary bladder neck
Rationale: Hydroureter and hydronephrosis (dilation of the renal pelvis and calyces) result
from post-renal obstruction. If the bladder neck is obstructed, the high pressure during
bladder filling leads to ascending urinary reflux.
Question 9
The nurse is planning care for a client who has a right hemispheric stroke. Which nursing
diagnosis is most important to include?
A) Impaired verbal communication related to aphasia.
B) Risk for injury related to denial of deficits and impulsiveness.
C) Ineffective breathing pattern related to brainstem compression.
D) Risk for fluid volume excess related to SIADH.
E) Deficient knowledge related to left-sided neglect.
Correct Answer: B) Risk for injury r/t denial of deficits and impulsiveness
Rationale: Right-brain damage often results in difficulty with judgment and spatial
perception. These clients are more likely to be impulsive and deny their physical
limitations, placing them at a high risk for falls and injury.
Question 10
The nurse is teaching a client with Maple Syrup Urine Disease (an autosomal recessive disorder).
QUESTIONS AND CORRECT DETAILED/NEWEST UPDATE!!!
Question 1
A male patient asks the nurse why his Prostatic Surface Antigen (PSA) levels are elevated.
Which pathophysiological mechanism should the nurse explain?
A) Increased levels are caused by a decrease in prostate gland volume.
B) PSA is a hormone that increases only during urinary tract infections.
C) As the prostate gland enlarges, its cells contribute more PSA to the circulating blood.
D) PSA is produced by the kidneys in response to bladder obstruction.
E) PSA levels fluctuate based on the patient's daily intake of dietary protein.
Correct Answer: C) As the prostate gland enlarges, its cells contribute more PSA in the
circulating blood
Rationale: PSA is a glycoprotein found in prostatic epithelial cells. Elevations are used as
specific tumor markers because PSA levels are related to gland volume. Conditions such as
Benign Prostatic Hyperplasia (BPH), prostatitis, and prostate cancer increase the tumor
cell load, thereby increasing PSA in the blood.
Question 2
A 26-year-old male client with Hodgkin’s disease is scheduled for radiation therapy and
expresses concern about his ability to have children. What information should the nurse provide?
A) Radiation therapy has no effect on male fertility.
B) Sperm motility improves following the completion of radiation.
C) Temporary sterility occurs for approximately 6 months post-treatment.
D) Permanent sterility occurs in male clients who receive radiation for Hodgkin's.
E) High sperm counts are typical in Hodgkin's disease prior to therapy.
Correct Answer: D) Permanent sterility occurs in the male client who receive radiation
Rationale: Low sperm count and loss of motility are often seen in males with Hodgkin’s
disease even before therapy begins. Radiotherapy typically results in permanent aspermia
or sterility in males.
Question 3
While auscultating a client’s lungs, the nurse hears short, high-pitched sounds just before the end
of inspiration in the lower lobes. How should this finding be documented?
A) Wheezes in the lower lobes.
B) Rhonchi in the lower lobes.
C) Crackles in the right and left lower lobes.
D) Stridor in the right and left lower lobes.
E) Pleural friction rub in the lower lobes.
Correct Answer: C) Crackles in the right and left lower lobes
Rationale: Fine crackles are short, high-pitched sounds heard just before the end of
inspiration. They are the result of rapid equalization of pressure when collapsed alveoli or
terminal bronchioles suddenly snap open.
, 2
Question 4
A client is admitted to the Emergency Department with a tension pneumothorax. Which
assessment finding should the nurse expect to identify?
A) Deviation of the trachea toward the side of the pneumothorax.
B) Deviation of the trachea toward the side opposite of the pneumothorax.
C) Flattening of the chest wall on the affected side.
D) Increased breath sounds on the affected side.
E) Brisk capillary refill and hypertension.
Correct Answer: B) A deviation of the trachea toward the side opposite of the pneumothorax
Rationale: Tension pneumothorax is caused by a rapid accumulation of air in the pleural
space, causing severely high intrapleural pressure. This results in the collapse of the lung
and a mediastinal shift toward the unaffected side, which subsequently compresses the
remaining functional lung.
Question 5
A client receiving a whole blood transfusion develops chills, fever, and a headache 30 minutes
after the transfusion starts. The nurse should recognize these as characteristic of which reaction?
A) An allergic transfusion reaction.
B) An acute hemolytic reaction.
C) A circulatory overload reaction.
D) A febrile non-hemolytic reaction.
E) An anaphylactic reaction.
Correct Answer: D) A febrile transfusion reaction
Rationale: Symptoms of a febrile reaction include sudden chills, fever, headache, flushing,
and muscle pain. It is the most common reaction and is usually caused by recipient
antibodies reacting to donor white blood cells.
Question 6
The nurse is analyzing a client’s ECG. Which finding indicates a disturbance in electrical
conduction in the ventricles?
A) PR interval of 0.16 second.
B) QRS interval of 0.14 second.
C) QT interval of 0.34 second.
D) T wave height of 2 mm.
E) P wave duration of 0.10 second.
Correct Answer: B) QRS interval of 0.14 second
Rationale: The normal duration of the QRS complex is 0.04 to 0.12 seconds. A QRS interval
of 0.14 seconds indicates a delay or disturbance in the electrical conduction through the
ventricles.
, 3
Question 7
Several hours after surgical repair of an Abdominal Aortic Aneurysm (AAA), the client develops
left flank pain and a urinary output of 20 mL/hr. These findings support which complication?
A) Hypovolemic shock.
B) Intestinal infarction.
C) Renal artery embolization.
D) Paralytic ileus.
E) Deep vein thrombosis.
Correct Answer: C) Renal artery embolization
Rationale: Embolization of a fragment of thrombus or plaque from the aorta into a renal
artery can compromise blood flow. This results in renal ischemia, which precipitates
unilateral flank pain and decreased urinary output.
Question 8
A client with a markedly distended bladder and a residual urine volume of 1650 mL is diagnosed
with hydronephrosis. This supports which pathophysiological cause?
A) Obstruction at the urinary bladder neck.
B) Acute glomerulonephritis.
C) Excessive intake of oral fluids.
D) Nephrotic syndrome.
E) Primary hyperaldosteronism.
Correct Answer: A) Obstruction at the urinary bladder neck
Rationale: Hydroureter and hydronephrosis (dilation of the renal pelvis and calyces) result
from post-renal obstruction. If the bladder neck is obstructed, the high pressure during
bladder filling leads to ascending urinary reflux.
Question 9
The nurse is planning care for a client who has a right hemispheric stroke. Which nursing
diagnosis is most important to include?
A) Impaired verbal communication related to aphasia.
B) Risk for injury related to denial of deficits and impulsiveness.
C) Ineffective breathing pattern related to brainstem compression.
D) Risk for fluid volume excess related to SIADH.
E) Deficient knowledge related to left-sided neglect.
Correct Answer: B) Risk for injury r/t denial of deficits and impulsiveness
Rationale: Right-brain damage often results in difficulty with judgment and spatial
perception. These clients are more likely to be impulsive and deny their physical
limitations, placing them at a high risk for falls and injury.
Question 10
The nurse is teaching a client with Maple Syrup Urine Disease (an autosomal recessive disorder).
