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HESI MED-SURG EXIT EXAM 2025/2026 | 140 PRACTICE
QUESTIONS WITH ANSWERS & RATIONALES,
VERIFID,100% CORRECT ALREADY GRADED A+
1. A patient with chronic obstructive pulmonary disease (COPD) is receiving
oxygen at 6 L/min via nasal cannula. The nurse should take which action?
A. Continue oxygen therapy as prescribed
B. Lower the oxygen flow rate
C. Place the patient on a non-rebreather mask
D. Encourage deep breathing and coughing
Answer: B. Lower the oxygen flow rate
Rationale: COPD patients rely on hypoxic drive; high O₂ may suppress
respiration. Low-flow oxygen (1–3 L/min) is preferred.
2. A client with heart failure reports sudden weight gain of 3 pounds in 2 days.
What should the nurse do?
A. Document as expected
B. Encourage fluid intake
C. Notify the healthcare provider
D. Recheck weight next week
Answer: C. Notify the healthcare provider
Rationale: Rapid weight gain suggests fluid retention and worsening heart failure.
3. A patient with type 1 diabetes has fruity breath, Kussmaul respirations, and
blood glucose of 450 mg/dL. What is the priority intervention?
A. Administer IV insulin
B. Encourage oral fluids
C. Give glucagon
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D. Provide carbohydrate snack
Answer: A. Administer IV insulin
Rationale: Findings indicate diabetic ketoacidosis (DKA), which requires IV
insulin.
4. Which ECG change is most concerning in a patient with hypokalemia?
A. Peaked T waves
B. U waves
C. Prolonged PR interval
D. Wide QRS complex
Answer: B. U waves
Rationale: U waves are classic in hypokalemia, increasing risk of dysrhythmias.
5. A patient with cirrhosis has ascites and shortness of breath. Which nursing
intervention is most appropriate?
A. Place patient in Fowler’s position
B. Restrict protein intake
C. Encourage fluid intake
D. Ambulate frequently
Answer: A. Place patient in Fowler’s position
Rationale: Upright positioning relieves pressure from ascites and improves
breathing.
6. A patient with a tracheostomy suddenly develops respiratory distress. What is
the nurse’s first action?
A. Call a rapid response team
B. Suction the airway
C. Remove the tracheostomy
D. Check oxygen saturation
Answer: B. Suction the airway
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Rationale: Secretions are the most common cause of sudden distress in
tracheostomy patients.
7. A client with a history of deep vein thrombosis reports sudden chest pain and
dyspnea. What should the nurse suspect?
A. Myocardial infarction
B. Pulmonary embolism
C. Pneumonia
D. Pleural effusion
Answer: B. Pulmonary embolism
Rationale: Sudden chest pain and dyspnea in DVT history suggest embolus.
8. Which lab value is most important to monitor in a patient receiving heparin
infusion?
A. INR
B. aPTT
C. Hemoglobin
D. Platelets
Answer: B. aPTT
Rationale: aPTT monitors heparin therapy effectiveness and safety.
9. Which symptom indicates early hypoglycemia?
A. Fruity breath
B. Sweating and tremors
C. Polyuria and polydipsia
D. Slow wound healing
Answer: B. Sweating and tremors
Rationale: Early signs of hypoglycemia include sweating, shakiness, and
irritability.
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10. A client with pneumonia is receiving IV antibiotics. Which finding suggests
the treatment is effective?
A. O₂ saturation increases from 88% to 94%
B. Fever rises to 102°F
C. Productive cough increases
D. WBC count rises
Answer: A. O₂ saturation increases from 88% to 94%
Rationale: Improvement in oxygenation indicates antibiotic effectiveness.
11. Which diet is appropriate for a patient with chronic kidney disease?
A. High protein, high sodium
B. Low protein, low sodium
C. High calcium, high potassium
D. Low carbohydrate, high fat
Answer: B. Low protein, low sodium
Rationale: Low protein reduces nitrogenous waste; sodium restriction prevents
fluid retention.
12. Which clinical sign indicates left-sided heart failure?
A. Jugular vein distension
B. Ascites
C. Pulmonary crackles
D. Peripheral edema
Answer: C. Pulmonary crackles
Rationale: Left-sided HF leads to pulmonary congestion and fluid buildup in
lungs.
13. A client with Addison’s disease is at highest risk for which complication?
A. Hyperkalemia
B. Hypokalemia
C. Fluid overload
D. Hypertension
HESI MED-SURG EXIT EXAM 2025/2026 | 140 PRACTICE
QUESTIONS WITH ANSWERS & RATIONALES,
VERIFID,100% CORRECT ALREADY GRADED A+
1. A patient with chronic obstructive pulmonary disease (COPD) is receiving
oxygen at 6 L/min via nasal cannula. The nurse should take which action?
A. Continue oxygen therapy as prescribed
B. Lower the oxygen flow rate
C. Place the patient on a non-rebreather mask
D. Encourage deep breathing and coughing
Answer: B. Lower the oxygen flow rate
Rationale: COPD patients rely on hypoxic drive; high O₂ may suppress
respiration. Low-flow oxygen (1–3 L/min) is preferred.
2. A client with heart failure reports sudden weight gain of 3 pounds in 2 days.
What should the nurse do?
A. Document as expected
B. Encourage fluid intake
C. Notify the healthcare provider
D. Recheck weight next week
Answer: C. Notify the healthcare provider
Rationale: Rapid weight gain suggests fluid retention and worsening heart failure.
3. A patient with type 1 diabetes has fruity breath, Kussmaul respirations, and
blood glucose of 450 mg/dL. What is the priority intervention?
A. Administer IV insulin
B. Encourage oral fluids
C. Give glucagon
,2|Page
D. Provide carbohydrate snack
Answer: A. Administer IV insulin
Rationale: Findings indicate diabetic ketoacidosis (DKA), which requires IV
insulin.
4. Which ECG change is most concerning in a patient with hypokalemia?
A. Peaked T waves
B. U waves
C. Prolonged PR interval
D. Wide QRS complex
Answer: B. U waves
Rationale: U waves are classic in hypokalemia, increasing risk of dysrhythmias.
5. A patient with cirrhosis has ascites and shortness of breath. Which nursing
intervention is most appropriate?
A. Place patient in Fowler’s position
B. Restrict protein intake
C. Encourage fluid intake
D. Ambulate frequently
Answer: A. Place patient in Fowler’s position
Rationale: Upright positioning relieves pressure from ascites and improves
breathing.
6. A patient with a tracheostomy suddenly develops respiratory distress. What is
the nurse’s first action?
A. Call a rapid response team
B. Suction the airway
C. Remove the tracheostomy
D. Check oxygen saturation
Answer: B. Suction the airway
,3|Page
Rationale: Secretions are the most common cause of sudden distress in
tracheostomy patients.
7. A client with a history of deep vein thrombosis reports sudden chest pain and
dyspnea. What should the nurse suspect?
A. Myocardial infarction
B. Pulmonary embolism
C. Pneumonia
D. Pleural effusion
Answer: B. Pulmonary embolism
Rationale: Sudden chest pain and dyspnea in DVT history suggest embolus.
8. Which lab value is most important to monitor in a patient receiving heparin
infusion?
A. INR
B. aPTT
C. Hemoglobin
D. Platelets
Answer: B. aPTT
Rationale: aPTT monitors heparin therapy effectiveness and safety.
9. Which symptom indicates early hypoglycemia?
A. Fruity breath
B. Sweating and tremors
C. Polyuria and polydipsia
D. Slow wound healing
Answer: B. Sweating and tremors
Rationale: Early signs of hypoglycemia include sweating, shakiness, and
irritability.
, 4|Page
10. A client with pneumonia is receiving IV antibiotics. Which finding suggests
the treatment is effective?
A. O₂ saturation increases from 88% to 94%
B. Fever rises to 102°F
C. Productive cough increases
D. WBC count rises
Answer: A. O₂ saturation increases from 88% to 94%
Rationale: Improvement in oxygenation indicates antibiotic effectiveness.
11. Which diet is appropriate for a patient with chronic kidney disease?
A. High protein, high sodium
B. Low protein, low sodium
C. High calcium, high potassium
D. Low carbohydrate, high fat
Answer: B. Low protein, low sodium
Rationale: Low protein reduces nitrogenous waste; sodium restriction prevents
fluid retention.
12. Which clinical sign indicates left-sided heart failure?
A. Jugular vein distension
B. Ascites
C. Pulmonary crackles
D. Peripheral edema
Answer: C. Pulmonary crackles
Rationale: Left-sided HF leads to pulmonary congestion and fluid buildup in
lungs.
13. A client with Addison’s disease is at highest risk for which complication?
A. Hyperkalemia
B. Hypokalemia
C. Fluid overload
D. Hypertension
