Elsevier Health Sciences
GRUS/DEM • ISEH
ELSEVIER HESI Examination Division
EMPOWERING KNOWLEDGE
EST. 1880
HESI MED/SURG
CO M P R E H E N S I V E R E V I E W — F U N D A M E N TA LS , P H A R M A CO LO G Y, E T H I CS & G E R O N TO LO G Y
INSTITUTION Elsevier / HESI Testing EXAM TYPE HESI Medical-Surgical Nursing
PROGRAM Nursing — HESI Exam Preparation ACADEMIC YEAR
EXAM TITLE HESI MED/SURG — Comprehensive TOTAL QUESTIONS 50 Questions
Review
COURSE TITLE Medical-Surgical Nursing — HESI FORMAT Multiple Choice — Select the Single Best
Preparation Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question unless otherwise specified.
▸ This comprehensive review covers end-of-life care, genetics, pharmacology, rehabilitation, gerontology, pain assessment,
ethics, religious considerations, and medical-surgical nursing concepts.
▸ Correct answers and detailed rationales appear below each question.
▸ All content is derived from HESI Medical-Surgical Nursing core concepts.
HESI MED/SURG COMPREHENSIVE EXAMINATION Questions 1 – 50
1. Which clinical sign would the nurse expect in a patient approaching death?
A. Increased sleeping
B. Increased restlessness
C. Decreased temperature of the extremities
CORRECT ANSWER A — Increased sleeping
RATIONALE As death approaches, metabolic demands decrease and patients spend more time sleeping or in unconscious
states. This is a natural part of the dying process. Decreased extremity temperature occurs due to circulatory
decline but is a later sign. Restlessness may occur earlier but increased sleeping is the more consistent
hallmark.
2. Which statement about sex chromosomes is correct?
A. Women have both X and Y chromosomes.
B. Men have both X and Y chromosomes.
C. Men have two X chromosomes.
D. Women have one X chromosome.
CORRECT ANSWER B — Men have both X and Y chromosomes.
RATIONALE Male chromosomal pattern is XY—one X chromosome (from mother) and one Y chromosome (from father).
Female pattern is XX. The Y chromosome contains the SRY gene that triggers male development.
, 3. Which statement about the immunoglobulin A (IgA) antibody is correct?
A. It is the most abundant antibody in the blood.
B. It exists in mucous membranes and intestinal mucosa.
C. It is the first antibody produced in an immune response.
D. It crosses the placenta to protect the fetus.
CORRECT ANSWER B — It exists in mucous membranes and intestinal mucosa.
RATIONALE IgA is found primarily in mucosal surfaces (respiratory tract, GI tract, genitourinary tract) and secretions
(saliva, tears, breast milk), providing localized protection against pathogens. IgG is the most abundant in
blood (A) and crosses the placenta (D). IgM is the first antibody produced (C).
4. A caregiver is modifying an older patient's home to incorporate hand rails near the toilet and install side rails on the
bed. Which suggestion would the nurse make?
A. Keep the side rails on the bed.
B. Remove the side rails from the bed.
C. Add more side rails for safety.
D. Use restraints with side rails.
CORRECT ANSWER B — Remove the side rails from the bed.
RATIONALE Bed side rails are considered restraints and increase the risk of serious injury if the patient attempts to climb
over them. Older adults with confusion or mobility issues may fall from a greater height. Hand rails near the
toilet are appropriate safety modifications; bed rails are not.
5. Which intervention may help minimize relocation stress syndrome in an older adult?
A. Limit visiting hours.
B. Encourage family to visit often.
C. Keep the patient isolated for rest.
D. Change the room assignment frequently.
CORRECT ANSWER B — Encourage family to visit often.
RATIONALE Relocation stress syndrome causes anxiety, confusion, and depression when an older adult moves to a new
environment. Familiar faces and frequent family visits provide continuity, emotional support, and orientation,
reducing stress.
6. Which intervention would the hospice nurse perform for the patient who is unable to cough secretions effectively?
A. Position the patient on the side.
B. Perform deep tracheal suctioning.
C. Administer a cough suppressant.
D. Encourage deep breathing exercises.
CORRECT ANSWER A — Position the patient on the side.
RATIONALE Positioning the patient on the side (lateral position) allows gravity to drain secretions from the mouth and
prevents aspiration—a gentle, comfort-focused intervention appropriate for end-of-life care. Deep suctioning
(B) is invasive and uncomfortable for a dying patient.
GRUS/DEM • ISEH
ELSEVIER HESI Examination Division
EMPOWERING KNOWLEDGE
EST. 1880
HESI MED/SURG
CO M P R E H E N S I V E R E V I E W — F U N D A M E N TA LS , P H A R M A CO LO G Y, E T H I CS & G E R O N TO LO G Y
INSTITUTION Elsevier / HESI Testing EXAM TYPE HESI Medical-Surgical Nursing
PROGRAM Nursing — HESI Exam Preparation ACADEMIC YEAR
EXAM TITLE HESI MED/SURG — Comprehensive TOTAL QUESTIONS 50 Questions
Review
COURSE TITLE Medical-Surgical Nursing — HESI FORMAT Multiple Choice — Select the Single Best
Preparation Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question unless otherwise specified.
▸ This comprehensive review covers end-of-life care, genetics, pharmacology, rehabilitation, gerontology, pain assessment,
ethics, religious considerations, and medical-surgical nursing concepts.
▸ Correct answers and detailed rationales appear below each question.
▸ All content is derived from HESI Medical-Surgical Nursing core concepts.
HESI MED/SURG COMPREHENSIVE EXAMINATION Questions 1 – 50
1. Which clinical sign would the nurse expect in a patient approaching death?
A. Increased sleeping
B. Increased restlessness
C. Decreased temperature of the extremities
CORRECT ANSWER A — Increased sleeping
RATIONALE As death approaches, metabolic demands decrease and patients spend more time sleeping or in unconscious
states. This is a natural part of the dying process. Decreased extremity temperature occurs due to circulatory
decline but is a later sign. Restlessness may occur earlier but increased sleeping is the more consistent
hallmark.
2. Which statement about sex chromosomes is correct?
A. Women have both X and Y chromosomes.
B. Men have both X and Y chromosomes.
C. Men have two X chromosomes.
D. Women have one X chromosome.
CORRECT ANSWER B — Men have both X and Y chromosomes.
RATIONALE Male chromosomal pattern is XY—one X chromosome (from mother) and one Y chromosome (from father).
Female pattern is XX. The Y chromosome contains the SRY gene that triggers male development.
, 3. Which statement about the immunoglobulin A (IgA) antibody is correct?
A. It is the most abundant antibody in the blood.
B. It exists in mucous membranes and intestinal mucosa.
C. It is the first antibody produced in an immune response.
D. It crosses the placenta to protect the fetus.
CORRECT ANSWER B — It exists in mucous membranes and intestinal mucosa.
RATIONALE IgA is found primarily in mucosal surfaces (respiratory tract, GI tract, genitourinary tract) and secretions
(saliva, tears, breast milk), providing localized protection against pathogens. IgG is the most abundant in
blood (A) and crosses the placenta (D). IgM is the first antibody produced (C).
4. A caregiver is modifying an older patient's home to incorporate hand rails near the toilet and install side rails on the
bed. Which suggestion would the nurse make?
A. Keep the side rails on the bed.
B. Remove the side rails from the bed.
C. Add more side rails for safety.
D. Use restraints with side rails.
CORRECT ANSWER B — Remove the side rails from the bed.
RATIONALE Bed side rails are considered restraints and increase the risk of serious injury if the patient attempts to climb
over them. Older adults with confusion or mobility issues may fall from a greater height. Hand rails near the
toilet are appropriate safety modifications; bed rails are not.
5. Which intervention may help minimize relocation stress syndrome in an older adult?
A. Limit visiting hours.
B. Encourage family to visit often.
C. Keep the patient isolated for rest.
D. Change the room assignment frequently.
CORRECT ANSWER B — Encourage family to visit often.
RATIONALE Relocation stress syndrome causes anxiety, confusion, and depression when an older adult moves to a new
environment. Familiar faces and frequent family visits provide continuity, emotional support, and orientation,
reducing stress.
6. Which intervention would the hospice nurse perform for the patient who is unable to cough secretions effectively?
A. Position the patient on the side.
B. Perform deep tracheal suctioning.
C. Administer a cough suppressant.
D. Encourage deep breathing exercises.
CORRECT ANSWER A — Position the patient on the side.
RATIONALE Positioning the patient on the side (lateral position) allows gravity to drain secretions from the mouth and
prevents aspiration—a gentle, comfort-focused intervention appropriate for end-of-life care. Deep suctioning
(B) is invasive and uncomfortable for a dying patient.
