HESI Medical Surgical Nursing Exam Prep
HESI MEDICAL SURGICAL NURSING EXAM PREP NEWEST 2026/2027
ACTUAL EXAM COMPLETE 230 QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) WITH DETAILED RATIONALES
|ALREADY GRADED A+||BRAND NEW VERSION!!
The nurse is providing dietary instructions to a 68-year-old client who is at high
risk for development of coronary heart disease (CHD). Which information should
the nurse include?
A) Limit dietary selection of cholesterol to 300 mg per day
B) Increase intake of soluble fiber to 10 to 25 grams per day.
C) Decrease plant stanols and sterols to less than 2 grams/day.
D) Ensure saturated fat is less than 30% of total caloric intake. - Correct Answer-B)
Increase intake of soluble fiber to 10 to 25 grams per day.
Rationale: To reduce risk factors associated with coronary heart disease, the daily
intake of soluble fiber (B) should be increased to between 10 and 25 gm.
Cholesterol intake (A) should be limited to 180 mg/day or less. Intake of plant
stanols and sterols is recommended at 2 g/day (C). Saturated fat (D) intake should
be limited to 7% of total daily calories.
A splint is prescribed for nighttime use by a client with rheumatoid arthritis.
Which statement by the nurse provides the most accurate explanation for use of
the splints?
1|Page
, HESI Medical Surgical Nursing Exam Prep
A) Prevention of deformities.
B) Avoidance of joint trauma.
C) Relief of joint inflammation.
D) Improvement in joint strength. - Correct Answer-A) Prevention of deformities.
Rationale: Splints may be used at night by clients with rheumatoid arthritis to
prevent deformities (A) caused by muscle spasms and contractures. Splints are not
used for (B). (C) is usually treated with medications, particularly those classified as
non-steroidal antiinflammatory drugs (NSAIDs). For (D), a prescribed exercise
program is indicated.
A 32-year-old female client complains of severe abdominal pain each month
before her menstrual period, painful intercourse, and painful defecation. Which
additional history should the nurse obtain that is consistent with the client's
complaints?
A) Frequent urinary tract infections.
B) Inability to get pregnant.
C) Premenstrual syndrome.
D) Chronic use of laxatives. - Correct Answer-B) Inability to get pregnant.
Rationale: Dysmenorrhea, dyspareunia, and difficulty or painful defecation are
common symptoms of endometriosis, which is the abnormal displacement of
endometrial tissue in the dependent areas of the pelvic peritoneum. A history of
infertility (B) is another common finding associated with endometriosis. Although
(A, C, and D) are common, nonspecific gynecological complaints, the most
common complaints of the client with endometriosis are pain and infertility.
2|Page
, HESI Medical Surgical Nursing Exam Prep
A client with a 16-year history of diabetes mellitus is having renal function tests
because of recent fatigue, weakness, elevated blood urea nitrogen, and serum
creatinine levels. Which finding should the nurse conclude as an early symptom of
renal insufficiency?
A) Dyspnea.
B) Nocturia.
C) Confusion.
D) Stomatitis. - Correct Answer-B) Nocturia.
Rationale: As the glomerular filtration rate decreases in early renal insufficiency,
metabolic waste products, including urea, creatinine, and other substances, such
phenols, hormones, electrolytes, accumulate in the blood. In the early stage of
renal insufficiency, polyuria results from the inability of the kidneys to concentrate
urine and contribute to nocturia (B). (A, C, and D) are more common in the later
stages of renal failure.
A client with heart disease is on a continuous telemetry monitor and has
developed sinus bradycardia. In determining the possible cause of the
bradycardia, the nurse assesses the client's medication record. Which medication
is most likely the cause of the bradycardia?
A) Propanolol (Inderal).
B) Captopril (Capoten).
C) Furosemide (Lasix).
3|Page
, HESI Medical Surgical Nursing Exam Prep
D) Dobutamine (Dobutrex). - Correct Answer-A) Propanolol (Inderal).
Rationale: Inderal (A) is a beta adrenergic blocking agent, which causes decreased
heart rate and decreased contractility. Neither (B), an ACE inhibitor, nor (C), a loop
diuretic, causes bradycardia. (D) is a sympathomimetic, direct acting cardiac
stimulant, which would increase the heart rate.
A client has been taking oral corticosteroids for the past five days because of
seasonal allergies. Which assessment finding is of most concern to the nurse?
A) White blood count of 10,000 mm3.
B) Serum glucose of 115 mg/dl.
C) Purulent sputum.
D) Excessive hunger. - Correct Answer-C) Purulent sputum.
Rationale: Steroids cause immunosuppression, and a purulent sputum (C) is an
indication of infection, so this symptom is of greatest concern. Oral steroids may
increase (A) and often cause (D). (B) may remain normal, borderline, or increase
while taking oral steroids.
A female client receiving IV vasopressin (Pitressin) for esophageal varice rupture
reports to the nurse that she feels substernal tightness and pressure across her
chest. Which PRN protocol should the nurse initiate?
A) Start an IV nitroglycerin infusion.
B) Nasogastric lavage with cool saline.
4|Page
HESI MEDICAL SURGICAL NURSING EXAM PREP NEWEST 2026/2027
ACTUAL EXAM COMPLETE 230 QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) WITH DETAILED RATIONALES
|ALREADY GRADED A+||BRAND NEW VERSION!!
The nurse is providing dietary instructions to a 68-year-old client who is at high
risk for development of coronary heart disease (CHD). Which information should
the nurse include?
A) Limit dietary selection of cholesterol to 300 mg per day
B) Increase intake of soluble fiber to 10 to 25 grams per day.
C) Decrease plant stanols and sterols to less than 2 grams/day.
D) Ensure saturated fat is less than 30% of total caloric intake. - Correct Answer-B)
Increase intake of soluble fiber to 10 to 25 grams per day.
Rationale: To reduce risk factors associated with coronary heart disease, the daily
intake of soluble fiber (B) should be increased to between 10 and 25 gm.
Cholesterol intake (A) should be limited to 180 mg/day or less. Intake of plant
stanols and sterols is recommended at 2 g/day (C). Saturated fat (D) intake should
be limited to 7% of total daily calories.
A splint is prescribed for nighttime use by a client with rheumatoid arthritis.
Which statement by the nurse provides the most accurate explanation for use of
the splints?
1|Page
, HESI Medical Surgical Nursing Exam Prep
A) Prevention of deformities.
B) Avoidance of joint trauma.
C) Relief of joint inflammation.
D) Improvement in joint strength. - Correct Answer-A) Prevention of deformities.
Rationale: Splints may be used at night by clients with rheumatoid arthritis to
prevent deformities (A) caused by muscle spasms and contractures. Splints are not
used for (B). (C) is usually treated with medications, particularly those classified as
non-steroidal antiinflammatory drugs (NSAIDs). For (D), a prescribed exercise
program is indicated.
A 32-year-old female client complains of severe abdominal pain each month
before her menstrual period, painful intercourse, and painful defecation. Which
additional history should the nurse obtain that is consistent with the client's
complaints?
A) Frequent urinary tract infections.
B) Inability to get pregnant.
C) Premenstrual syndrome.
D) Chronic use of laxatives. - Correct Answer-B) Inability to get pregnant.
Rationale: Dysmenorrhea, dyspareunia, and difficulty or painful defecation are
common symptoms of endometriosis, which is the abnormal displacement of
endometrial tissue in the dependent areas of the pelvic peritoneum. A history of
infertility (B) is another common finding associated with endometriosis. Although
(A, C, and D) are common, nonspecific gynecological complaints, the most
common complaints of the client with endometriosis are pain and infertility.
2|Page
, HESI Medical Surgical Nursing Exam Prep
A client with a 16-year history of diabetes mellitus is having renal function tests
because of recent fatigue, weakness, elevated blood urea nitrogen, and serum
creatinine levels. Which finding should the nurse conclude as an early symptom of
renal insufficiency?
A) Dyspnea.
B) Nocturia.
C) Confusion.
D) Stomatitis. - Correct Answer-B) Nocturia.
Rationale: As the glomerular filtration rate decreases in early renal insufficiency,
metabolic waste products, including urea, creatinine, and other substances, such
phenols, hormones, electrolytes, accumulate in the blood. In the early stage of
renal insufficiency, polyuria results from the inability of the kidneys to concentrate
urine and contribute to nocturia (B). (A, C, and D) are more common in the later
stages of renal failure.
A client with heart disease is on a continuous telemetry monitor and has
developed sinus bradycardia. In determining the possible cause of the
bradycardia, the nurse assesses the client's medication record. Which medication
is most likely the cause of the bradycardia?
A) Propanolol (Inderal).
B) Captopril (Capoten).
C) Furosemide (Lasix).
3|Page
, HESI Medical Surgical Nursing Exam Prep
D) Dobutamine (Dobutrex). - Correct Answer-A) Propanolol (Inderal).
Rationale: Inderal (A) is a beta adrenergic blocking agent, which causes decreased
heart rate and decreased contractility. Neither (B), an ACE inhibitor, nor (C), a loop
diuretic, causes bradycardia. (D) is a sympathomimetic, direct acting cardiac
stimulant, which would increase the heart rate.
A client has been taking oral corticosteroids for the past five days because of
seasonal allergies. Which assessment finding is of most concern to the nurse?
A) White blood count of 10,000 mm3.
B) Serum glucose of 115 mg/dl.
C) Purulent sputum.
D) Excessive hunger. - Correct Answer-C) Purulent sputum.
Rationale: Steroids cause immunosuppression, and a purulent sputum (C) is an
indication of infection, so this symptom is of greatest concern. Oral steroids may
increase (A) and often cause (D). (B) may remain normal, borderline, or increase
while taking oral steroids.
A female client receiving IV vasopressin (Pitressin) for esophageal varice rupture
reports to the nurse that she feels substernal tightness and pressure across her
chest. Which PRN protocol should the nurse initiate?
A) Start an IV nitroglycerin infusion.
B) Nasogastric lavage with cool saline.
4|Page
