1|Page
HESI RN MED SURG EXIT EXAM, VERSION 2 WITH NGN (REAL
EXAM) ALL QUESTIONS AND VERIFIED ANSWERS 100%
CORRECT (2025/2026 REAL EXPECTED EXAM) GRADED A+
LATEST, GUARANTEED PASS
Q1. A client with COPD is admitted with dyspnea. The nurse notes O₂
saturation of 89%. What is the priority action?
A. Place client on 2 L/min nasal cannula
B. Increase O₂ to 6 L/min
C. Put in high-Fowler’s position
D. Notify provider immediately
Correct Answer: C. Put in high-Fowler’s position
Rationale: Positioning improves ventilation before increasing O₂; excessive
O₂ in COPD may depress respiratory drive.
Reference: Lewis, Medical-Surgical Nursing (2023).
Q2. A client with cirrhosis develops ascites. Which dietary modification is
most important?
A. Low-fat diet
B. High-protein diet
C. Low-sodium diet
D. High-carbohydrate diet
Correct Answer: C. Low-sodium diet
Rationale: Sodium restriction reduces fluid retention and ascites.
Reference: Brunner & Suddarth, Textbook of Medical-Surgical Nursing.
Q3. A nurse assesses a client with hypokalemia. Which finding requires
immediate action?
,2|Page
A. Muscle weakness
B. Irregular pulse
C. Fatigue
D. Constipation
Correct Answer: B. Irregular pulse
Rationale: Hypokalemia may cause dysrhythmias, life-threatening if
untreated.
Reference: HESI Comprehensive Review (2024).
Q4. A client with type 2 diabetes reports polyuria and blurred vision. Which
diagnostic test confirms diagnosis of hyperglycemia?
A. Hemoglobin A1C
B. Fasting plasma glucose
C. Oral glucose tolerance test
D. Urinalysis
Correct Answer: B. Fasting plasma glucose
Rationale: FPG ≥126 mg/dL confirms diabetes.
Reference: ADA Standards of Care (2024).
Q5. A nurse caring for a client with pneumonia notes increased respiratory
rate and confusion. What is the likely cause?
A. Fever
B. Hypoxemia
C. Electrolyte imbalance
D. Pain
Correct Answer: B. Hypoxemia
Rationale: Confusion and tachypnea signal inadequate oxygenation.
Reference: Lewis, Medical-Surgical Nursing.
,3|Page
Q6. The nurse prepares to administer digoxin to a client. Which finding
requires withholding the dose?
A. Apical pulse 56/min
B. BP 140/88
C. HR 78/min with PVCs
D. O₂ saturation 93%
Correct Answer: A. Apical pulse 56/min
Rationale: Hold digoxin if HR <60 bpm to prevent toxicity.
Reference: Brunner & Suddarth.
Q7. A client receiving NG suction develops metabolic alkalosis. Which
finding supports this diagnosis?
A. Kussmaul respirations
B. Confusion and irritability
C. Tingling in extremities
D. Decreased urine output
Correct Answer: B. Confusion and irritability
Rationale: Alkalosis alters neurologic function; NG suction removes gastric
acid.
Reference: HESI Review Guide.
Q8. The nurse cares for a client with Addison’s disease. Which medication
is expected?
A. Fludrocortisone
B. Furosemide
C. Levothyroxine
D. Metformin
Correct Answer: A. Fludrocortisone
Rationale: Addison’s requires mineralocorticoid replacement.
Reference: Lewis, Med-Surg Nursing.
, 4|Page
Q9. Which lab result is priority to report in a client with pancreatitis?
A. Amylase 120 U/L
B. Calcium 7.2 mg/dL
C. Potassium 4.0 mEq/L
D. Glucose 150 mg/dL
Correct Answer: B. Calcium 7.2 mg/dL
Rationale: Hypocalcemia is a dangerous complication of pancreatitis.
Reference: Brunner & Suddarth.
Q10. Client with heart failure is prescribed furosemide. Which finding
indicates effectiveness?
A. Weight loss of 3 lbs in 24 hrs
B. BP 160/90
C. Decreased urine output
D. JVD present
Correct Answer: A. Weight loss of 3 lbs in 24 hrs
Rationale: Weight loss indicates fluid removal and improved HF
management.
Reference: Lewis, Med-Surg Nursing.
Q11. Which intervention prevents pneumonia in a postoperative client?
A. Maintain NPO
B. Use incentive spirometer
C. Ambulate only after 48 hrs
D. Restrict fluids
Correct Answer: B. Use incentive spirometer
Rationale: Deep breathing prevents atelectasis and pneumonia.
Reference: HESI Review Guide.
HESI RN MED SURG EXIT EXAM, VERSION 2 WITH NGN (REAL
EXAM) ALL QUESTIONS AND VERIFIED ANSWERS 100%
CORRECT (2025/2026 REAL EXPECTED EXAM) GRADED A+
LATEST, GUARANTEED PASS
Q1. A client with COPD is admitted with dyspnea. The nurse notes O₂
saturation of 89%. What is the priority action?
A. Place client on 2 L/min nasal cannula
B. Increase O₂ to 6 L/min
C. Put in high-Fowler’s position
D. Notify provider immediately
Correct Answer: C. Put in high-Fowler’s position
Rationale: Positioning improves ventilation before increasing O₂; excessive
O₂ in COPD may depress respiratory drive.
Reference: Lewis, Medical-Surgical Nursing (2023).
Q2. A client with cirrhosis develops ascites. Which dietary modification is
most important?
A. Low-fat diet
B. High-protein diet
C. Low-sodium diet
D. High-carbohydrate diet
Correct Answer: C. Low-sodium diet
Rationale: Sodium restriction reduces fluid retention and ascites.
Reference: Brunner & Suddarth, Textbook of Medical-Surgical Nursing.
Q3. A nurse assesses a client with hypokalemia. Which finding requires
immediate action?
,2|Page
A. Muscle weakness
B. Irregular pulse
C. Fatigue
D. Constipation
Correct Answer: B. Irregular pulse
Rationale: Hypokalemia may cause dysrhythmias, life-threatening if
untreated.
Reference: HESI Comprehensive Review (2024).
Q4. A client with type 2 diabetes reports polyuria and blurred vision. Which
diagnostic test confirms diagnosis of hyperglycemia?
A. Hemoglobin A1C
B. Fasting plasma glucose
C. Oral glucose tolerance test
D. Urinalysis
Correct Answer: B. Fasting plasma glucose
Rationale: FPG ≥126 mg/dL confirms diabetes.
Reference: ADA Standards of Care (2024).
Q5. A nurse caring for a client with pneumonia notes increased respiratory
rate and confusion. What is the likely cause?
A. Fever
B. Hypoxemia
C. Electrolyte imbalance
D. Pain
Correct Answer: B. Hypoxemia
Rationale: Confusion and tachypnea signal inadequate oxygenation.
Reference: Lewis, Medical-Surgical Nursing.
,3|Page
Q6. The nurse prepares to administer digoxin to a client. Which finding
requires withholding the dose?
A. Apical pulse 56/min
B. BP 140/88
C. HR 78/min with PVCs
D. O₂ saturation 93%
Correct Answer: A. Apical pulse 56/min
Rationale: Hold digoxin if HR <60 bpm to prevent toxicity.
Reference: Brunner & Suddarth.
Q7. A client receiving NG suction develops metabolic alkalosis. Which
finding supports this diagnosis?
A. Kussmaul respirations
B. Confusion and irritability
C. Tingling in extremities
D. Decreased urine output
Correct Answer: B. Confusion and irritability
Rationale: Alkalosis alters neurologic function; NG suction removes gastric
acid.
Reference: HESI Review Guide.
Q8. The nurse cares for a client with Addison’s disease. Which medication
is expected?
A. Fludrocortisone
B. Furosemide
C. Levothyroxine
D. Metformin
Correct Answer: A. Fludrocortisone
Rationale: Addison’s requires mineralocorticoid replacement.
Reference: Lewis, Med-Surg Nursing.
, 4|Page
Q9. Which lab result is priority to report in a client with pancreatitis?
A. Amylase 120 U/L
B. Calcium 7.2 mg/dL
C. Potassium 4.0 mEq/L
D. Glucose 150 mg/dL
Correct Answer: B. Calcium 7.2 mg/dL
Rationale: Hypocalcemia is a dangerous complication of pancreatitis.
Reference: Brunner & Suddarth.
Q10. Client with heart failure is prescribed furosemide. Which finding
indicates effectiveness?
A. Weight loss of 3 lbs in 24 hrs
B. BP 160/90
C. Decreased urine output
D. JVD present
Correct Answer: A. Weight loss of 3 lbs in 24 hrs
Rationale: Weight loss indicates fluid removal and improved HF
management.
Reference: Lewis, Med-Surg Nursing.
Q11. Which intervention prevents pneumonia in a postoperative client?
A. Maintain NPO
B. Use incentive spirometer
C. Ambulate only after 48 hrs
D. Restrict fluids
Correct Answer: B. Use incentive spirometer
Rationale: Deep breathing prevents atelectasis and pneumonia.
Reference: HESI Review Guide.
