HESI MED-SURG 3 EXAM NEWEST 2026 COMPLETE
500 REAL EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS
1. Which sign suggests increased intracranial pressure?
A. Tachycardia
B. Hypotension
C. Widening pulse pressure
D. Warm skin Correct Answer: C
Rationale:
Cushing’s triad includes widening pulse pressure, bradycardia,
and irregular respirations.
1. A patient with heart failure has crackles, JVD, and weight
gain. Which order should the nurse question?
A. IV furosemide
B. Daily weights
C. Encourage oral fluids
D. Monitor potassium
Correct Answer: C
,Rationale:
Heart failure involves fluid overload. Encouraging oral fluids
worsens pulmonary congestion. Diuretics, weights, and
potassium monitoring are appropriate.
2. A COPD patient is receiving oxygen at 6 L/min via nasal
cannula. Which finding requires intervention?
A. RR 18
B. O₂ sat 88%
C. Drowsiness
D. Barrel chest
Correct Answer: C
Rationale:
High oxygen flow in COPD can suppress the hypoxic drive,
leading to CO₂ retention and decreased LOC. An O₂ sat of
~88–92% is often acceptable in COPD.
3. The priority assessment for a patient with suspected
pulmonary embolism is:
A. Lung sounds
B. Blood pressure
C. Oxygen saturation
D. Temperature Correct Answer: C
Rationale:
,PE causes impaired oxygenation. Airway and breathing come
before circulation (ABCs).
4. Which lab value is most important to monitor in a patient on
heparin infusion?
A. INR
B. aPTT
C. Platelets
only
D. Hemoglobin Correct Answer: B
Rationale:
aPTT measures heparin effectiveness. INR is for warfarin.
5. A patient on warfarin has an INR of 5.2. What is the nurse’s
priority?
A. Givenext dose
B. Encourage vitamin K foods
C. Hold warfarin and notify provider
D. Recheck in 1 week
Correct Answer: C
Rationale:
An INR >4 increases bleeding risk. The medication must be
held and the provider notified immediately.
, 6. A patient with acute kidney injury has potassium 6.1 mEq/L.
What is the priority action?
A. Encourage fluids
B. Administer calcium gluconate
C. Place on telemetry
D. Restrict protein Correct Answer: C
Rationale:
Hyperkalemia causes life-threatening arrhythmias. Continuous
cardiac monitoring is the immediate priority.
7. Which finding indicates digoxin toxicity?
A. Bradycardia
B. Green-yellow halos
C. Hypokalemia
D. All of the above
Correct Answer: D
Rationale:
Classic digoxin toxicity signs include visual changes, bradycardia,
and low potassium, which increases toxicity risk.
500 REAL EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS
1. Which sign suggests increased intracranial pressure?
A. Tachycardia
B. Hypotension
C. Widening pulse pressure
D. Warm skin Correct Answer: C
Rationale:
Cushing’s triad includes widening pulse pressure, bradycardia,
and irregular respirations.
1. A patient with heart failure has crackles, JVD, and weight
gain. Which order should the nurse question?
A. IV furosemide
B. Daily weights
C. Encourage oral fluids
D. Monitor potassium
Correct Answer: C
,Rationale:
Heart failure involves fluid overload. Encouraging oral fluids
worsens pulmonary congestion. Diuretics, weights, and
potassium monitoring are appropriate.
2. A COPD patient is receiving oxygen at 6 L/min via nasal
cannula. Which finding requires intervention?
A. RR 18
B. O₂ sat 88%
C. Drowsiness
D. Barrel chest
Correct Answer: C
Rationale:
High oxygen flow in COPD can suppress the hypoxic drive,
leading to CO₂ retention and decreased LOC. An O₂ sat of
~88–92% is often acceptable in COPD.
3. The priority assessment for a patient with suspected
pulmonary embolism is:
A. Lung sounds
B. Blood pressure
C. Oxygen saturation
D. Temperature Correct Answer: C
Rationale:
,PE causes impaired oxygenation. Airway and breathing come
before circulation (ABCs).
4. Which lab value is most important to monitor in a patient on
heparin infusion?
A. INR
B. aPTT
C. Platelets
only
D. Hemoglobin Correct Answer: B
Rationale:
aPTT measures heparin effectiveness. INR is for warfarin.
5. A patient on warfarin has an INR of 5.2. What is the nurse’s
priority?
A. Givenext dose
B. Encourage vitamin K foods
C. Hold warfarin and notify provider
D. Recheck in 1 week
Correct Answer: C
Rationale:
An INR >4 increases bleeding risk. The medication must be
held and the provider notified immediately.
, 6. A patient with acute kidney injury has potassium 6.1 mEq/L.
What is the priority action?
A. Encourage fluids
B. Administer calcium gluconate
C. Place on telemetry
D. Restrict protein Correct Answer: C
Rationale:
Hyperkalemia causes life-threatening arrhythmias. Continuous
cardiac monitoring is the immediate priority.
7. Which finding indicates digoxin toxicity?
A. Bradycardia
B. Green-yellow halos
C. Hypokalemia
D. All of the above
Correct Answer: D
Rationale:
Classic digoxin toxicity signs include visual changes, bradycardia,
and low potassium, which increases toxicity risk.
