MED SURG 2 HESI TEST BANK PRACTICE
QUESTIONS AND ANSWERS | 200+ VERIFIED
QUESTIONS WITH RATIONALES | UPDATED
2026 STUDY GUIDE
• This practice test contains 200 verified Med-Surg 2 HESI-style questions with
answers and EXPERT RATIONALE to help you master high-yield clinical concepts.
• Use this material by attempting each question independently before checking the
correct answer and EXPERT RATIONALE for deep understanding and retention.
1. A client with chronic kidney disease (CKD) has a serum potassium of 6.2
mEq/L. Which finding requires the nurse's most immediate intervention?
A. Serum creatinine of 4.5 mg/dL
B. Urine output of 30 mL/hour
C. Peaked T-waves on the ECG
D. Blood pressure of 158/96 mmHg
E. Peripheral edema in bilateral lower extremities
C. Peaked T-waves on the ECG
EXPERT RATIONALE: Peaked T-waves are an early sign of hyperkalemia-induced
cardiac toxicity. Hyperkalemia alters myocardial conduction and can rapidly
progress to fatal dysrhythmias. This is the priority finding requiring immediate
intervention.
2. A nurse is caring for a client post-myocardial infarction who suddenly
develops a heart rate of 180 bpm with a narrow QRS complex. Which action
should the nurse take first?
A. Administer IV amiodarone as ordered
B. Prepare the client for synchronized cardioversion
C. Perform vagal maneuvers such as carotid massage
,D. Obtain a 12-lead ECG immediately
E. Administer oxygen via non-rebreather mask
D. Obtain a 12-lead ECG immediately
EXPERT RATIONALE: Before any intervention, the nurse must first identify the
specific dysrhythmia via 12-lead ECG. Accurate identification guides appropriate
treatment, whether pharmacologic or electrical.
3. A client with heart failure is receiving furosemide (Lasix). Which laboratory
finding should the nurse report to the provider immediately?
A. Sodium 138 mEq/L
B. Potassium 2.8 mEq/L
C. Chloride 100 mEq/L
D. BUN 18 mg/dL
E. Creatinine 1.0 mg/dL
B. Potassium 2.8 mEq/L
EXPERT RATIONALE: Furosemide is a loop diuretic that causes potassium wasting.
A potassium level of 2.8 mEq/L indicates hypokalemia, which increases the risk of
life-threatening cardiac dysrhythmias, especially in heart failure clients who may be
on digoxin.
4. A client with COPD is admitted with acute exacerbation. Which oxygen
delivery method is most appropriate?
A. Non-rebreather mask at 15 L/min
B. Simple face mask at 8 L/min
C. Venturi mask at 24–28% FiO2
D. Nasal cannula at 6 L/min
,E. Bag-valve mask with 100% oxygen
C. Venturi mask at 24–28% FiO2
EXPERT RATIONALE: COPD clients rely on hypoxic drive to breathe. The Venturi
mask delivers precise, controlled low-flow oxygen, preventing hypercapnic
respiratory failure from excessive oxygen administration.
5. A nurse assesses a client with cirrhosis who has asterixis. Which
intervention is the priority?
A. Administer lactulose as prescribed
B. Restrict dietary sodium to 2g/day
C. Insert a urinary catheter to monitor output
D. Place the client in Trendelenburg position
E. Administer albumin infusion
A. Administer lactulose as prescribed
EXPERT RATIONALE: Asterixis (flapping tremor) is a sign of hepatic encephalopathy
caused by elevated ammonia levels. Lactulose reduces ammonia absorption from
the gut by trapping ammonia in the colon and promoting its excretion.
6. A client is admitted with diabetic ketoacidosis (DKA). Which finding is most
consistent with this diagnosis?
A. pH 7.48, HCO3 28, PaCO2 48
B. pH 7.30, HCO3 14, PaCO2 30
C. pH 7.35, HCO3 24, PaCO2 40
D. pH 7.50, HCO3 30, PaCO2 44
E. pH 7.32, HCO3 26, PaCO2 50
B. pH 7.30, HCO3 14, PaCO2 30
, EXPERT RATIONALE: DKA presents with metabolic acidosis — low pH, low
bicarbonate. The low PaCO2 represents compensatory respiratory alkalosis
(Kussmaul breathing), where the body tries to blow off CO2 to raise the pH.
7. A client with pneumonia has a SpO2 of 88% on room air. After applying 2
L/min nasal cannula oxygen, SpO2 rises to 94%. Which action should the nurse
take next?
A. Increase oxygen to 4 L/min immediately
B. Notify the provider of persistent hypoxemia
C. Document the finding and continue to monitor
D. Place client in supine position to improve ventilation
E. Prepare for intubation
C. Document the finding and continue to monitor
EXPERT RATIONALE: An SpO2 of 94% after oxygen application is an acceptable
therapeutic response. The nurse should document the intervention and continue
monitoring. There is no immediate need to escalate unless the client deteriorates.
8. A client receiving total parenteral nutrition (TPN) develops sudden onset
chest pain and dyspnea. The nurse suspects air embolism. What is the priority
action?
A. Stop the TPN infusion and flush the line with normal saline
B. Place the client in left lateral Trendelenburg position
C. Administer aspirin 325 mg orally
D. Apply oxygen via nasal cannula at 2 L/min
E. Notify the pharmacy to check the TPN solution
B. Place the client in left lateral Trendelenburg position
QUESTIONS AND ANSWERS | 200+ VERIFIED
QUESTIONS WITH RATIONALES | UPDATED
2026 STUDY GUIDE
• This practice test contains 200 verified Med-Surg 2 HESI-style questions with
answers and EXPERT RATIONALE to help you master high-yield clinical concepts.
• Use this material by attempting each question independently before checking the
correct answer and EXPERT RATIONALE for deep understanding and retention.
1. A client with chronic kidney disease (CKD) has a serum potassium of 6.2
mEq/L. Which finding requires the nurse's most immediate intervention?
A. Serum creatinine of 4.5 mg/dL
B. Urine output of 30 mL/hour
C. Peaked T-waves on the ECG
D. Blood pressure of 158/96 mmHg
E. Peripheral edema in bilateral lower extremities
C. Peaked T-waves on the ECG
EXPERT RATIONALE: Peaked T-waves are an early sign of hyperkalemia-induced
cardiac toxicity. Hyperkalemia alters myocardial conduction and can rapidly
progress to fatal dysrhythmias. This is the priority finding requiring immediate
intervention.
2. A nurse is caring for a client post-myocardial infarction who suddenly
develops a heart rate of 180 bpm with a narrow QRS complex. Which action
should the nurse take first?
A. Administer IV amiodarone as ordered
B. Prepare the client for synchronized cardioversion
C. Perform vagal maneuvers such as carotid massage
,D. Obtain a 12-lead ECG immediately
E. Administer oxygen via non-rebreather mask
D. Obtain a 12-lead ECG immediately
EXPERT RATIONALE: Before any intervention, the nurse must first identify the
specific dysrhythmia via 12-lead ECG. Accurate identification guides appropriate
treatment, whether pharmacologic or electrical.
3. A client with heart failure is receiving furosemide (Lasix). Which laboratory
finding should the nurse report to the provider immediately?
A. Sodium 138 mEq/L
B. Potassium 2.8 mEq/L
C. Chloride 100 mEq/L
D. BUN 18 mg/dL
E. Creatinine 1.0 mg/dL
B. Potassium 2.8 mEq/L
EXPERT RATIONALE: Furosemide is a loop diuretic that causes potassium wasting.
A potassium level of 2.8 mEq/L indicates hypokalemia, which increases the risk of
life-threatening cardiac dysrhythmias, especially in heart failure clients who may be
on digoxin.
4. A client with COPD is admitted with acute exacerbation. Which oxygen
delivery method is most appropriate?
A. Non-rebreather mask at 15 L/min
B. Simple face mask at 8 L/min
C. Venturi mask at 24–28% FiO2
D. Nasal cannula at 6 L/min
,E. Bag-valve mask with 100% oxygen
C. Venturi mask at 24–28% FiO2
EXPERT RATIONALE: COPD clients rely on hypoxic drive to breathe. The Venturi
mask delivers precise, controlled low-flow oxygen, preventing hypercapnic
respiratory failure from excessive oxygen administration.
5. A nurse assesses a client with cirrhosis who has asterixis. Which
intervention is the priority?
A. Administer lactulose as prescribed
B. Restrict dietary sodium to 2g/day
C. Insert a urinary catheter to monitor output
D. Place the client in Trendelenburg position
E. Administer albumin infusion
A. Administer lactulose as prescribed
EXPERT RATIONALE: Asterixis (flapping tremor) is a sign of hepatic encephalopathy
caused by elevated ammonia levels. Lactulose reduces ammonia absorption from
the gut by trapping ammonia in the colon and promoting its excretion.
6. A client is admitted with diabetic ketoacidosis (DKA). Which finding is most
consistent with this diagnosis?
A. pH 7.48, HCO3 28, PaCO2 48
B. pH 7.30, HCO3 14, PaCO2 30
C. pH 7.35, HCO3 24, PaCO2 40
D. pH 7.50, HCO3 30, PaCO2 44
E. pH 7.32, HCO3 26, PaCO2 50
B. pH 7.30, HCO3 14, PaCO2 30
, EXPERT RATIONALE: DKA presents with metabolic acidosis — low pH, low
bicarbonate. The low PaCO2 represents compensatory respiratory alkalosis
(Kussmaul breathing), where the body tries to blow off CO2 to raise the pH.
7. A client with pneumonia has a SpO2 of 88% on room air. After applying 2
L/min nasal cannula oxygen, SpO2 rises to 94%. Which action should the nurse
take next?
A. Increase oxygen to 4 L/min immediately
B. Notify the provider of persistent hypoxemia
C. Document the finding and continue to monitor
D. Place client in supine position to improve ventilation
E. Prepare for intubation
C. Document the finding and continue to monitor
EXPERT RATIONALE: An SpO2 of 94% after oxygen application is an acceptable
therapeutic response. The nurse should document the intervention and continue
monitoring. There is no immediate need to escalate unless the client deteriorates.
8. A client receiving total parenteral nutrition (TPN) develops sudden onset
chest pain and dyspnea. The nurse suspects air embolism. What is the priority
action?
A. Stop the TPN infusion and flush the line with normal saline
B. Place the client in left lateral Trendelenburg position
C. Administer aspirin 325 mg orally
D. Apply oxygen via nasal cannula at 2 L/min
E. Notify the pharmacy to check the TPN solution
B. Place the client in left lateral Trendelenburg position
