HESI MED-SURG –QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES
2026 Q&A | INSTANT DOWNLOAD PDF.
CORE DOMAINS
Fluid and Electrolyte BalanceCardiovascular AlterationsRespiratory Function and Gas ExchangeNeurological
and Sensory DisordersGastrointestinal and Metabolic HealthRenal and Genitourinary SystemsIntegumentary
and Immune ResponsePerioperative Nursing CareEndocrine and Musculoskeletal Disorders
INTRODUCTION
The HESI Medical-Surgical exam is a comprehensive assessment designed to evaluate a student's proficiency
in managing complex adult health conditions. This examination focuses on the synthesis of foundational
pathophysiology, pharmacology, and nursing process application. By utilizing a mix of knowledge-based and
high-level clinical scenarios, the assessment measures critical thinking skills and the ability to make safe,
evidence-based clinical decisions. Students are expected to demonstrate mastery in prioritizing care,
recognizing life-threatening complications, and applying legal and ethical standards in professional practice.
This document serves as a rigorous preparatory tool to ensure readiness for real-world clinical challenges and
licensure success.
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 experiencing mild
dyspnea. Which action should the nurse take first?
A. Increase the oxygen flow rate to 4 L/min.
B. Assist the client to a high-Fowler's position.
C. Administer a PRN dose of albuterol.
D. Notify the healthcare provider immediately.
🟢 Correct answer: B. Assist the client to a high-Fowler's position.
🔴 RATIONALE: Upright positioning improves diaphragmatic excursion and maximizes lung expansion, which
is the most immediate and least invasive intervention for dyspnea in a COPD client.
, 2. A nurse is caring for a client who is 24 hours postoperative following a subtotal thyroidectomy. Which
assessment finding is most critical for the nurse to report?
A. Client reports a sore throat when swallowing.
B. Pain at the incision site rated 4 on a scale of 10.
C. Occasional tingling in the fingers and around the mouth.
D. Small amount of serosanguinous drainage on the dressing.
🟢 Correct answer: C. Occasional tingling in the fingers and around the mouth.
🔴 RATIONALE: Tingling (paresthesia) is a sign of hypocalcemia, which can occur if the parathyroid glands are
accidentally damaged or removed during thyroidectomy, potentially leading to tetany and laryngospasm.
3. The nurse is teaching a client with newly diagnosed type 1 diabetes mellitus about insulin site rotation.
Which statement by the client indicates an understanding of the teaching?
A. I should use the same spot for one week before moving to a new area.
B. Rotating sites within one anatomical area helps prevent lipodystrophy.
C. I will inject insulin into my arm before I go for my morning jog.
D. Each injection should be at least three inches apart from the previous one.
🟢 Correct answer: B. Rotating sites within one anatomical area helps prevent lipodystrophy.
🔴 RATIONALE: Systematic rotation within one anatomical region (e.g., the abdomen) ensures consistent
insulin absorption rates while preventing the development of fibrous tissue or localized fat deposits.
4. A client is admitted with a diagnosis of acute pancreatitis. Which laboratory result should the nurse expect
to find?
A. Decreased serum amylase.
B. Increased serum calcium.
C. Increased serum lipase.
D. Decreased white blood cell count.
,🟢 Correct answer: C. Increased serum lipase.
🔴 RATIONALE: Serum lipase and amylase levels increase significantly in acute pancreatitis due to the
release of pancreatic enzymes into the bloodstream during organ inflammation.
5. Which intervention is a priority for a nurse caring for a client with a deep vein thrombosis (DVT) in the left
leg?
A. Apply ice packs to the affected calf to reduce swelling.
B. Massage the affected area to improve circulation.
C. Maintain the client on strict bed rest with the leg dependent.
D. Assess the client’s breath sounds and chest pain status.
🟢 Correct answer: D. Assess the client’s breath sounds and chest pain status.
🔴 RATIONALE: The most life-threatening complication of DVT is a pulmonary embolism; the nurse must
monitor for signs of respiratory distress or sudden pleuritic pain.
6. A client with a history of heart failure presents with a potassium level of 6.2 mEq/L. Which medication
should the nurse anticipate administering?
A. Spironolactone
B. Sodium polystyrene sulfonate
C. Furosemide
D. Digoxin
🟢 Correct answer: B. Sodium polystyrene sulfonate
🔴 RATIONALE: Sodium polystyrene sulfonate is a cation-exchange resin that removes potassium from the
body via the gastrointestinal tract, addressing hyperkalemia.
7. The nurse is evaluating a client's understanding of a low-purine diet for the management of gout. Which
food choice by the client suggests a need for further teaching?
, A. Steamed broccoli
B. Whole grain bread
C. Grilled liver and onions
D. Fresh apple slices
🟢 Correct answer: C. Grilled liver and onions
🔴 RATIONALE: Organ meats like liver are high in purines, which break down into uric acid and can trigger
gout flares.
8. When assessing a client with a suspected tension pneumothorax, which finding should the nurse identify
as a hallmark sign?
A. Tracheal deviation to the unaffected side.
B. Presence of bilateral breath sounds.
C. Brisk capillary refill.
D. Increased tactile fremitus.
🟢 Correct answer: A. Tracheal deviation to the unaffected side.
🔴 RATIONALE: As pressure builds in the pleural space on the affected side, it shifts the mediastinum and
trachea toward the opposite, unaffected side.
9. A nurse is preparing to administer a blood transfusion. Which action is essential to perform before starting
the infusion?
A. Warm the blood in a microwave for 30 seconds.
B. Verify the client’s identity and blood product with another RN.
C. Use a 24-gauge IV catheter for administration.
D. Run the blood through a line primed with 5% Dextrose.
🟢 Correct answer: B. Verify the client’s identity and blood product with another RN.
🔴 RATIONALE: Dual verification is a critical safety standard to prevent transfusion reactions caused by blood
incompatibility or administrative errors.
2026 Q&A | INSTANT DOWNLOAD PDF.
CORE DOMAINS
Fluid and Electrolyte BalanceCardiovascular AlterationsRespiratory Function and Gas ExchangeNeurological
and Sensory DisordersGastrointestinal and Metabolic HealthRenal and Genitourinary SystemsIntegumentary
and Immune ResponsePerioperative Nursing CareEndocrine and Musculoskeletal Disorders
INTRODUCTION
The HESI Medical-Surgical exam is a comprehensive assessment designed to evaluate a student's proficiency
in managing complex adult health conditions. This examination focuses on the synthesis of foundational
pathophysiology, pharmacology, and nursing process application. By utilizing a mix of knowledge-based and
high-level clinical scenarios, the assessment measures critical thinking skills and the ability to make safe,
evidence-based clinical decisions. Students are expected to demonstrate mastery in prioritizing care,
recognizing life-threatening complications, and applying legal and ethical standards in professional practice.
This document serves as a rigorous preparatory tool to ensure readiness for real-world clinical challenges and
licensure success.
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 experiencing mild
dyspnea. Which action should the nurse take first?
A. Increase the oxygen flow rate to 4 L/min.
B. Assist the client to a high-Fowler's position.
C. Administer a PRN dose of albuterol.
D. Notify the healthcare provider immediately.
🟢 Correct answer: B. Assist the client to a high-Fowler's position.
🔴 RATIONALE: Upright positioning improves diaphragmatic excursion and maximizes lung expansion, which
is the most immediate and least invasive intervention for dyspnea in a COPD client.
, 2. A nurse is caring for a client who is 24 hours postoperative following a subtotal thyroidectomy. Which
assessment finding is most critical for the nurse to report?
A. Client reports a sore throat when swallowing.
B. Pain at the incision site rated 4 on a scale of 10.
C. Occasional tingling in the fingers and around the mouth.
D. Small amount of serosanguinous drainage on the dressing.
🟢 Correct answer: C. Occasional tingling in the fingers and around the mouth.
🔴 RATIONALE: Tingling (paresthesia) is a sign of hypocalcemia, which can occur if the parathyroid glands are
accidentally damaged or removed during thyroidectomy, potentially leading to tetany and laryngospasm.
3. The nurse is teaching a client with newly diagnosed type 1 diabetes mellitus about insulin site rotation.
Which statement by the client indicates an understanding of the teaching?
A. I should use the same spot for one week before moving to a new area.
B. Rotating sites within one anatomical area helps prevent lipodystrophy.
C. I will inject insulin into my arm before I go for my morning jog.
D. Each injection should be at least three inches apart from the previous one.
🟢 Correct answer: B. Rotating sites within one anatomical area helps prevent lipodystrophy.
🔴 RATIONALE: Systematic rotation within one anatomical region (e.g., the abdomen) ensures consistent
insulin absorption rates while preventing the development of fibrous tissue or localized fat deposits.
4. A client is admitted with a diagnosis of acute pancreatitis. Which laboratory result should the nurse expect
to find?
A. Decreased serum amylase.
B. Increased serum calcium.
C. Increased serum lipase.
D. Decreased white blood cell count.
,🟢 Correct answer: C. Increased serum lipase.
🔴 RATIONALE: Serum lipase and amylase levels increase significantly in acute pancreatitis due to the
release of pancreatic enzymes into the bloodstream during organ inflammation.
5. Which intervention is a priority for a nurse caring for a client with a deep vein thrombosis (DVT) in the left
leg?
A. Apply ice packs to the affected calf to reduce swelling.
B. Massage the affected area to improve circulation.
C. Maintain the client on strict bed rest with the leg dependent.
D. Assess the client’s breath sounds and chest pain status.
🟢 Correct answer: D. Assess the client’s breath sounds and chest pain status.
🔴 RATIONALE: The most life-threatening complication of DVT is a pulmonary embolism; the nurse must
monitor for signs of respiratory distress or sudden pleuritic pain.
6. A client with a history of heart failure presents with a potassium level of 6.2 mEq/L. Which medication
should the nurse anticipate administering?
A. Spironolactone
B. Sodium polystyrene sulfonate
C. Furosemide
D. Digoxin
🟢 Correct answer: B. Sodium polystyrene sulfonate
🔴 RATIONALE: Sodium polystyrene sulfonate is a cation-exchange resin that removes potassium from the
body via the gastrointestinal tract, addressing hyperkalemia.
7. The nurse is evaluating a client's understanding of a low-purine diet for the management of gout. Which
food choice by the client suggests a need for further teaching?
, A. Steamed broccoli
B. Whole grain bread
C. Grilled liver and onions
D. Fresh apple slices
🟢 Correct answer: C. Grilled liver and onions
🔴 RATIONALE: Organ meats like liver are high in purines, which break down into uric acid and can trigger
gout flares.
8. When assessing a client with a suspected tension pneumothorax, which finding should the nurse identify
as a hallmark sign?
A. Tracheal deviation to the unaffected side.
B. Presence of bilateral breath sounds.
C. Brisk capillary refill.
D. Increased tactile fremitus.
🟢 Correct answer: A. Tracheal deviation to the unaffected side.
🔴 RATIONALE: As pressure builds in the pleural space on the affected side, it shifts the mediastinum and
trachea toward the opposite, unaffected side.
9. A nurse is preparing to administer a blood transfusion. Which action is essential to perform before starting
the infusion?
A. Warm the blood in a microwave for 30 seconds.
B. Verify the client’s identity and blood product with another RN.
C. Use a 24-gauge IV catheter for administration.
D. Run the blood through a line primed with 5% Dextrose.
🟢 Correct answer: B. Verify the client’s identity and blood product with another RN.
🔴 RATIONALE: Dual verification is a critical safety standard to prevent transfusion reactions caused by blood
incompatibility or administrative errors.
