HESI RN MedSurg V1 (PDF) | (2026) Nursing Exam
Questions | Medical Surgical
1. A client with COPD has an oxygen saturation of 88%.
Which action should the nurse take first?
A. Increase oxygen to 4 L/min via nasal cannula
B. Encourage deep breathing and coughing
C. Apply a non-rebreather mask at 100% oxygen
D. Auscultate lung sounds
Answer: D
Rationale: Auscultation provides immediate assessment of
breath sounds and guides further intervention. Increasing
oxygen without assessment could suppress hypoxic drive
in COPD.
2. A nurse is caring for a client with a chest tube after
thoracotomy. Which finding requires immediate
intervention?
A. Intermittent bubbling in the suction control chamber
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,B. Tidaling in the water seal chamber
C. Continuous bubbling in the water seal chamber
D. Drainage of 50 mL in the first hour
Answer: C
Rationale: Continuous bubbling in the water seal chamber
indicates an air leak, which can lead to pneumothorax or
loss of negative pressure. Tidaling is normal; intermittent
bubbling in suction control is expected.
3. Which position is most appropriate for a client with
severe dyspnea from pulmonary edema?
A. Supine
B. Prone
C. High-Fowler’s with legs dependent
D. Trendelenburg
Answer: C
Rationale: High-Fowler’s reduces venous return and allows
2
,gravity to aid lung expansion; legs dependent decreases
preload by pooling blood in lower extremities.
4. A client on mechanical ventilation has a sudden drop in
SpO2 to 82% and high-pressure alarm. What should the
nurse do first?
A. Suction the client
B. Disconnect the client from the ventilator
C. Manually ventilate with a bag-valve mask
D. Increase the FiO2
Answer: C
Rationale: Manual ventilation ensures oxygenation while
troubleshooting the cause (e.g., mucus plug, kinked tube,
or pneumothorax).
5. A client with pneumonia has a fever, productive cough,
and pleuritic chest pain. Which nursing intervention is most
effective to mobilize secretions?
3
, A. Maintain bed rest
B. Administer PRN antitussives
C. Encourage fluid intake to 2–3 L/day
D. Apply oxygen at 2 L/min
Answer: C
Rationale: Adequate hydration thins secretions, making
them easier to expectorate. Antitussives suppress cough
and are avoided when mobilization is needed.
6. A client with tuberculosis is started on isoniazid and
rifampin. Which instruction is most important?
A. Take medications with antacids to prevent GI upset
B. Expect orange discoloration of urine and tears
C. Stop medications when symptoms resolve
D. Avoid foods containing tyramine
Answer: B
Rationale: Rifampin causes harmless orange-red
discoloration of body fluids; clients must be warned to
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Questions | Medical Surgical
1. A client with COPD has an oxygen saturation of 88%.
Which action should the nurse take first?
A. Increase oxygen to 4 L/min via nasal cannula
B. Encourage deep breathing and coughing
C. Apply a non-rebreather mask at 100% oxygen
D. Auscultate lung sounds
Answer: D
Rationale: Auscultation provides immediate assessment of
breath sounds and guides further intervention. Increasing
oxygen without assessment could suppress hypoxic drive
in COPD.
2. A nurse is caring for a client with a chest tube after
thoracotomy. Which finding requires immediate
intervention?
A. Intermittent bubbling in the suction control chamber
1
,B. Tidaling in the water seal chamber
C. Continuous bubbling in the water seal chamber
D. Drainage of 50 mL in the first hour
Answer: C
Rationale: Continuous bubbling in the water seal chamber
indicates an air leak, which can lead to pneumothorax or
loss of negative pressure. Tidaling is normal; intermittent
bubbling in suction control is expected.
3. Which position is most appropriate for a client with
severe dyspnea from pulmonary edema?
A. Supine
B. Prone
C. High-Fowler’s with legs dependent
D. Trendelenburg
Answer: C
Rationale: High-Fowler’s reduces venous return and allows
2
,gravity to aid lung expansion; legs dependent decreases
preload by pooling blood in lower extremities.
4. A client on mechanical ventilation has a sudden drop in
SpO2 to 82% and high-pressure alarm. What should the
nurse do first?
A. Suction the client
B. Disconnect the client from the ventilator
C. Manually ventilate with a bag-valve mask
D. Increase the FiO2
Answer: C
Rationale: Manual ventilation ensures oxygenation while
troubleshooting the cause (e.g., mucus plug, kinked tube,
or pneumothorax).
5. A client with pneumonia has a fever, productive cough,
and pleuritic chest pain. Which nursing intervention is most
effective to mobilize secretions?
3
, A. Maintain bed rest
B. Administer PRN antitussives
C. Encourage fluid intake to 2–3 L/day
D. Apply oxygen at 2 L/min
Answer: C
Rationale: Adequate hydration thins secretions, making
them easier to expectorate. Antitussives suppress cough
and are avoided when mobilization is needed.
6. A client with tuberculosis is started on isoniazid and
rifampin. Which instruction is most important?
A. Take medications with antacids to prevent GI upset
B. Expect orange discoloration of urine and tears
C. Stop medications when symptoms resolve
D. Avoid foods containing tyramine
Answer: B
Rationale: Rifampin causes harmless orange-red
discoloration of body fluids; clients must be warned to
4
