MED SURG HESI V2 EXAM PRACTICE
QUESTIONS & VERIFIED ANSWERS |
Medical-Surgical Nursing HESI V2 Test Bank
with Detailed Rationales | 2026 Updated
Study Guide | Instant PDF Download
• This study guide contains 200 comprehensive Medical-Surgical Nursing HESI
V2 practice questions covering all major body systems, disease processes,
pharmacology, and nursing interventions tested on the exam.
• Each question includes five vertically arranged answer choices, a clearly
marked correct answer, and a detailed EXPERT RATIONALE to reinforce
clinical reasoning — work through them in blocks of 25–30, review EXPERT
RATIONALE carefully, and re-test missed items before moving forward.
1. A nurse is caring for a client with chronic obstructive pulmonary disease
(COPD). Which finding should the nurse expect to assess?
A. Barrel-shaped chest
B. Increased oxygen saturation at rest
C. Decreased anteroposterior chest diameter
D. Hyperresonance only on the left side
E. Bradypnea with deep respirations
Correct Answer: A. Barrel-shaped chest
EXPERT RATIONALE: Clients with COPD develop a barrel-shaped chest due to
chronic air trapping and hyperinflation of the lungs, which increases the
anteroposterior diameter of the thorax. Over time, the diaphragm flattens and the
accessory muscles of respiration become more active. Oxygen saturation is typically
decreased, not increased, due to impaired gas exchange. Tachypnea, not
bradypnea, is more common as the body compensates for hypoxia.
,2. A client is admitted with heart failure and reports shortness of breath
when lying flat. The nurse documents this as which condition?
A. Dyspnea on exertion
B. Orthopnea
C. Paroxysmal nocturnal dyspnea
D. Kussmaul respirations
E. Cheyne-Stokes respirations
Correct Answer: B. Orthopnea
EXPERT RATIONALE: Orthopnea is shortness of breath that occurs when lying flat
and is relieved by sitting or standing upright. It occurs because fluid redistributes
from the lower extremities to the lungs when supine, worsening pulmonary
congestion in heart failure. Paroxysmal nocturnal dyspnea refers to sudden
breathlessness that awakens the client from sleep, which is a different but related
symptom of left-sided heart failure.
3. The nurse is reviewing laboratory results for a client with suspected
myocardial infarction. Which cardiac biomarker is most specific for
myocardial injury?
A. Creatine kinase (CK)
B. C-reactive protein (CRP)
C. Troponin I
D. Myoglobin
E. Lactate dehydrogenase (LDH)
Correct Answer: C. Troponin I
EXPERT RATIONALE: Troponin I is the most cardiac-specific biomarker because it is
found almost exclusively in cardiac muscle tissue and remains elevated for 7–10
days after myocardial injury, making it valuable for both early and late diagnosis.
,Myoglobin rises quickly but is not cardiac-specific. CK and LDH are less specific
because they are also found in skeletal muscle and other tissues.
4. A nurse is teaching a client about a low-sodium diet for hypertension
management. Which food choice indicates the client understood the
teaching?
A. Canned soup
B. Fresh grilled chicken with steamed vegetables
C. Processed deli meat sandwich
D. Frozen dinner entrée
E. Salted pretzels
Correct Answer: B. Fresh grilled chicken with steamed vegetables
EXPERT RATIONALE: Fresh, unprocessed foods naturally contain less sodium than
canned, processed, or frozen foods, which often contain added sodium as a
preservative. Canned soups, deli meats, frozen dinners, and salty snacks are all
high in sodium and should be limited in a client managing hypertension. Choosing
fresh proteins and vegetables demonstrates an accurate understanding of dietary
sodium restriction.
5. A client with type 1 diabetes mellitus is brought to the emergency
department with confusion, fruity breath odor, and Kussmaul respirations.
The nurse suspects which condition?
A. Hypoglycemia
B. Diabetic ketoacidosis (DKA)
C. Hyperosmolar hyperglycemic state (HHS)
D. Somogyi effect
E. Dawn phenomenon
, Correct Answer: B. Diabetic ketoacidosis (DKA)
EXPERT RATIONALE: DKA is characterized by hyperglycemia, ketosis, metabolic
acidosis, fruity (acetone) breath odor, and Kussmaul respirations as the body
attempts to compensate for acidosis by blowing off carbon dioxide. It occurs
primarily in type 1 diabetes due to absolute insulin deficiency. HHS occurs in type 2
diabetes without significant ketosis, and hypoglycemia presents with shakiness,
diaphoresis, and confusion without fruity breath.
6. The nurse is caring for a client following a thyroidectomy. Which
assessment finding requires immediate intervention?
A. Mild hoarseness
B. Positive Chvostek's sign
C. Pain rated 3/10 at the incision site
D. Serosanguineous drainage on the dressing
E. Temperature of 99.1°F (37.3°C)
Correct Answer: B. Positive Chvostek's sign
EXPERT RATIONALE: A positive Chvostek's sign (facial twitching when tapping the
facial nerve) indicates hypocalcemia, which can occur after thyroidectomy if the
parathyroid glands are inadvertently damaged or removed. This can progress to
life-threatening tetany and laryngospasm, requiring immediate calcium
replacement. Mild hoarseness, minimal drainage, low-grade temperature, and mild
pain are expected postoperative findings.
7. A nurse is assessing a client with suspected appendicitis. Which finding is
most consistent with this diagnosis?
A. Pain in the left lower quadrant that improves with movement
B. Rebound tenderness at McBurney's point
C. Diffuse abdominal pain relieved by eating
QUESTIONS & VERIFIED ANSWERS |
Medical-Surgical Nursing HESI V2 Test Bank
with Detailed Rationales | 2026 Updated
Study Guide | Instant PDF Download
• This study guide contains 200 comprehensive Medical-Surgical Nursing HESI
V2 practice questions covering all major body systems, disease processes,
pharmacology, and nursing interventions tested on the exam.
• Each question includes five vertically arranged answer choices, a clearly
marked correct answer, and a detailed EXPERT RATIONALE to reinforce
clinical reasoning — work through them in blocks of 25–30, review EXPERT
RATIONALE carefully, and re-test missed items before moving forward.
1. A nurse is caring for a client with chronic obstructive pulmonary disease
(COPD). Which finding should the nurse expect to assess?
A. Barrel-shaped chest
B. Increased oxygen saturation at rest
C. Decreased anteroposterior chest diameter
D. Hyperresonance only on the left side
E. Bradypnea with deep respirations
Correct Answer: A. Barrel-shaped chest
EXPERT RATIONALE: Clients with COPD develop a barrel-shaped chest due to
chronic air trapping and hyperinflation of the lungs, which increases the
anteroposterior diameter of the thorax. Over time, the diaphragm flattens and the
accessory muscles of respiration become more active. Oxygen saturation is typically
decreased, not increased, due to impaired gas exchange. Tachypnea, not
bradypnea, is more common as the body compensates for hypoxia.
,2. A client is admitted with heart failure and reports shortness of breath
when lying flat. The nurse documents this as which condition?
A. Dyspnea on exertion
B. Orthopnea
C. Paroxysmal nocturnal dyspnea
D. Kussmaul respirations
E. Cheyne-Stokes respirations
Correct Answer: B. Orthopnea
EXPERT RATIONALE: Orthopnea is shortness of breath that occurs when lying flat
and is relieved by sitting or standing upright. It occurs because fluid redistributes
from the lower extremities to the lungs when supine, worsening pulmonary
congestion in heart failure. Paroxysmal nocturnal dyspnea refers to sudden
breathlessness that awakens the client from sleep, which is a different but related
symptom of left-sided heart failure.
3. The nurse is reviewing laboratory results for a client with suspected
myocardial infarction. Which cardiac biomarker is most specific for
myocardial injury?
A. Creatine kinase (CK)
B. C-reactive protein (CRP)
C. Troponin I
D. Myoglobin
E. Lactate dehydrogenase (LDH)
Correct Answer: C. Troponin I
EXPERT RATIONALE: Troponin I is the most cardiac-specific biomarker because it is
found almost exclusively in cardiac muscle tissue and remains elevated for 7–10
days after myocardial injury, making it valuable for both early and late diagnosis.
,Myoglobin rises quickly but is not cardiac-specific. CK and LDH are less specific
because they are also found in skeletal muscle and other tissues.
4. A nurse is teaching a client about a low-sodium diet for hypertension
management. Which food choice indicates the client understood the
teaching?
A. Canned soup
B. Fresh grilled chicken with steamed vegetables
C. Processed deli meat sandwich
D. Frozen dinner entrée
E. Salted pretzels
Correct Answer: B. Fresh grilled chicken with steamed vegetables
EXPERT RATIONALE: Fresh, unprocessed foods naturally contain less sodium than
canned, processed, or frozen foods, which often contain added sodium as a
preservative. Canned soups, deli meats, frozen dinners, and salty snacks are all
high in sodium and should be limited in a client managing hypertension. Choosing
fresh proteins and vegetables demonstrates an accurate understanding of dietary
sodium restriction.
5. A client with type 1 diabetes mellitus is brought to the emergency
department with confusion, fruity breath odor, and Kussmaul respirations.
The nurse suspects which condition?
A. Hypoglycemia
B. Diabetic ketoacidosis (DKA)
C. Hyperosmolar hyperglycemic state (HHS)
D. Somogyi effect
E. Dawn phenomenon
, Correct Answer: B. Diabetic ketoacidosis (DKA)
EXPERT RATIONALE: DKA is characterized by hyperglycemia, ketosis, metabolic
acidosis, fruity (acetone) breath odor, and Kussmaul respirations as the body
attempts to compensate for acidosis by blowing off carbon dioxide. It occurs
primarily in type 1 diabetes due to absolute insulin deficiency. HHS occurs in type 2
diabetes without significant ketosis, and hypoglycemia presents with shakiness,
diaphoresis, and confusion without fruity breath.
6. The nurse is caring for a client following a thyroidectomy. Which
assessment finding requires immediate intervention?
A. Mild hoarseness
B. Positive Chvostek's sign
C. Pain rated 3/10 at the incision site
D. Serosanguineous drainage on the dressing
E. Temperature of 99.1°F (37.3°C)
Correct Answer: B. Positive Chvostek's sign
EXPERT RATIONALE: A positive Chvostek's sign (facial twitching when tapping the
facial nerve) indicates hypocalcemia, which can occur after thyroidectomy if the
parathyroid glands are inadvertently damaged or removed. This can progress to
life-threatening tetany and laryngospasm, requiring immediate calcium
replacement. Mild hoarseness, minimal drainage, low-grade temperature, and mild
pain are expected postoperative findings.
7. A nurse is assessing a client with suspected appendicitis. Which finding is
most consistent with this diagnosis?
A. Pain in the left lower quadrant that improves with movement
B. Rebound tenderness at McBurney's point
C. Diffuse abdominal pain relieved by eating
