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HESI Med-Surg Test Bank 2025/2026 – 180 Questions with
Correct Answers & Rationales (Latest Updated)
1. A nurse is caring for a client with heart failure who is prescribed furosemide. Which
assessment finding indicates the medication is effective?
A. Blood pressure 150/90 mmHg
B. Decreased peripheral edema
C. Weight gain of 2 kg in 2 days
D. Serum potassium 3.0 mEq/L
Answer: B. Decreased peripheral edema
Rationale: Furosemide, a loop diuretic, reduces fluid overload; decreased edema indicates
effectiveness. Weight gain indicates worsening HF, low potassium is an adverse effect, and
elevated BP shows poor control.
2. A client with COPD is receiving oxygen at 6 L/min via nasal cannula. Which action should the
nurse take?
A. Maintain oxygen flow at 6 L/min
B. Reduce oxygen flow to 1–2 L/min
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C. Discontinue oxygen
D. Switch to non-rebreather mask
Answer: B. Reduce oxygen flow to 1–2 L/min
Rationale: COPD patients rely on hypoxic drive. Oxygen should be administered at low flow
(1–2 L/min). High oxygen flow can suppress their respiratory drive.
3. A nurse is teaching a client with type 1 diabetes about hypoglycemia management. Which
statement indicates correct understanding?
A. "If my glucose is low, I’ll inject insulin."
B. "If I feel shaky, I’ll drink orange juice."
C. "If my glucose is low, I’ll eat protein only."
D. "If I feel dizzy, I’ll wait until my next meal."
Answer: B. If I feel shaky, I’ll drink orange juice.
Rationale: Simple carbohydrates like juice or glucose tabs are first-line treatment for
hypoglycemia. Insulin worsens hypoglycemia, protein is not effective for quick glucose
elevation, and waiting until the next meal delays treatment.
4. A client with cirrhosis has ascites. Which dietary instruction should the nurse provide?
A. Increase sodium intake
B. Restrict protein intake
C. Restrict sodium intake
D. Increase fluid intake
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Answer: C. Restrict sodium intake
Rationale: Sodium restriction helps control fluid retention and ascites. Increasing sodium or
fluids worsens ascites. Protein restriction is not indicated unless hepatic encephalopathy
develops.
5. A client with a history of hypertension suddenly develops slurred speech and right-sided
weakness. What is the priority nursing action?
A. Check blood pressure
B. Notify the rapid response team
C. Elevate the head of bed to 90 degrees
D. Assess glucose level
Answer: B. Notify the rapid response team
Rationale: Sudden neurological changes suggest stroke. Rapid activation of emergency response
ensures timely evaluation for thrombolytic therapy.
6. A nurse is preparing to administer digoxin to a client. Which assessment finding indicates the
medication should be withheld?
A. Heart rate 58 beats/min
B. Blood pressure 120/80 mmHg
C. Potassium level 4.0 mEq/L
D. Respiratory rate 18 breaths/min
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Answer: A. Heart rate 58 beats/min
Rationale: Digoxin should be held if HR <60 bpm due to risk of bradycardia and toxicity. Other
findings are within normal limits.
7. A client is admitted with diabetic ketoacidosis (DKA). Which order should the nurse
implement first?
A. Administer IV insulin
B. Monitor potassium levels
C. Begin IV normal saline infusion
D. Provide sodium bicarbonate
Answer: C. Begin IV normal saline infusion
Rationale: Fluid replacement is the priority to correct dehydration in DKA. Insulin and
electrolytes follow after volume status is stabilized.
8. A nurse is caring for a client with a chest tube following thoracic surgery. Which finding
requires immediate intervention?
A. Continuous bubbling in the water seal chamber
B. Intermittent bubbling with coughing
C. 40 mL drainage over 2 hours
D. Chest tube is below chest level
HESI Med-Surg Test Bank 2025/2026 – 180 Questions with
Correct Answers & Rationales (Latest Updated)
1. A nurse is caring for a client with heart failure who is prescribed furosemide. Which
assessment finding indicates the medication is effective?
A. Blood pressure 150/90 mmHg
B. Decreased peripheral edema
C. Weight gain of 2 kg in 2 days
D. Serum potassium 3.0 mEq/L
Answer: B. Decreased peripheral edema
Rationale: Furosemide, a loop diuretic, reduces fluid overload; decreased edema indicates
effectiveness. Weight gain indicates worsening HF, low potassium is an adverse effect, and
elevated BP shows poor control.
2. A client with COPD is receiving oxygen at 6 L/min via nasal cannula. Which action should the
nurse take?
A. Maintain oxygen flow at 6 L/min
B. Reduce oxygen flow to 1–2 L/min
,2 | Page
C. Discontinue oxygen
D. Switch to non-rebreather mask
Answer: B. Reduce oxygen flow to 1–2 L/min
Rationale: COPD patients rely on hypoxic drive. Oxygen should be administered at low flow
(1–2 L/min). High oxygen flow can suppress their respiratory drive.
3. A nurse is teaching a client with type 1 diabetes about hypoglycemia management. Which
statement indicates correct understanding?
A. "If my glucose is low, I’ll inject insulin."
B. "If I feel shaky, I’ll drink orange juice."
C. "If my glucose is low, I’ll eat protein only."
D. "If I feel dizzy, I’ll wait until my next meal."
Answer: B. If I feel shaky, I’ll drink orange juice.
Rationale: Simple carbohydrates like juice or glucose tabs are first-line treatment for
hypoglycemia. Insulin worsens hypoglycemia, protein is not effective for quick glucose
elevation, and waiting until the next meal delays treatment.
4. A client with cirrhosis has ascites. Which dietary instruction should the nurse provide?
A. Increase sodium intake
B. Restrict protein intake
C. Restrict sodium intake
D. Increase fluid intake
,3 | Page
Answer: C. Restrict sodium intake
Rationale: Sodium restriction helps control fluid retention and ascites. Increasing sodium or
fluids worsens ascites. Protein restriction is not indicated unless hepatic encephalopathy
develops.
5. A client with a history of hypertension suddenly develops slurred speech and right-sided
weakness. What is the priority nursing action?
A. Check blood pressure
B. Notify the rapid response team
C. Elevate the head of bed to 90 degrees
D. Assess glucose level
Answer: B. Notify the rapid response team
Rationale: Sudden neurological changes suggest stroke. Rapid activation of emergency response
ensures timely evaluation for thrombolytic therapy.
6. A nurse is preparing to administer digoxin to a client. Which assessment finding indicates the
medication should be withheld?
A. Heart rate 58 beats/min
B. Blood pressure 120/80 mmHg
C. Potassium level 4.0 mEq/L
D. Respiratory rate 18 breaths/min
, 4 | Page
Answer: A. Heart rate 58 beats/min
Rationale: Digoxin should be held if HR <60 bpm due to risk of bradycardia and toxicity. Other
findings are within normal limits.
7. A client is admitted with diabetic ketoacidosis (DKA). Which order should the nurse
implement first?
A. Administer IV insulin
B. Monitor potassium levels
C. Begin IV normal saline infusion
D. Provide sodium bicarbonate
Answer: C. Begin IV normal saline infusion
Rationale: Fluid replacement is the priority to correct dehydration in DKA. Insulin and
electrolytes follow after volume status is stabilized.
8. A nurse is caring for a client with a chest tube following thoracic surgery. Which finding
requires immediate intervention?
A. Continuous bubbling in the water seal chamber
B. Intermittent bubbling with coughing
C. 40 mL drainage over 2 hours
D. Chest tube is below chest level
