1
Med Surge HESI Exam 2026/2027 Actual Exam | Real Exam
1 & 2 Versions with All 200 Questions & Correct Answers
with Detailed Rationales | Medical Surgical HESI Test Bank
| Pass Guaranteed - A+ Graded
Version 1: Med Surge HESI Exam 1
Q1: A patient with heart failure has an ejection fraction of 35%. This indicates:
A. Diastolic heart failure
B. Systolic heart failure [CORRECT]
C. Normal cardiac function
D. Hypertrophic cardiomyopathy
Correct Answer: B
Rationale: Ejection fraction (EF) measures the percentage of blood leaving the heart each time it
contracts. An EF below 40% indicates systolic heart failure (HFrEF), where the heart muscle
does not contract effectively. Diastolic heart failure (HFpEF) typically has an EF of 50% or
higher. Normal EF is 55-70%.
Q2: The nurse is caring for a patient with chronic obstructive pulmonary disease (COPD) who is
receiving oxygen via nasal cannula at 2 L/min. The patient's spouse asks why the oxygen flow is
set so low. What is the nurse's best response?
A. "Higher oxygen concentrations will cause the patient to stop breathing."
B. "Low oxygen levels stimulate the hypoxic drive to breathe in these patients." [CORRECT]
C. "Higher oxygen concentrations are toxic to the lung tissue."
D. "We are trying to prevent the patient from developing oxygen dependence."
Correct Answer: B
Rationale: In patients with chronic COPD, the chemoreceptors in the brain become insensitive to
high CO2 levels (hypercapnia). Instead, the hypoxic drive (low O2) becomes the primary
stimulus for respiration. Administering high concentrations of oxygen can suppress this hypoxic
,2
drive, leading to hypoventilation, respiratory failure, and even apnea. The goal is to maintain
SpO2 between 88-92%.
Q3: A patient is admitted with a diagnosis of syndrome of inappropriate antidiuretic hormone
(SIADH). Which clinical manifestation should the nurse expect to find?
A. Polyuria and polydipsia
B. Hypernatremia and dry mucous membranes
C. Hyponatremia and concentrated urine [CORRECT]
D. Hypotension and tachycardia
Correct Answer: C
Rationale: SIADH involves the excessive release of antidiuretic hormone (ADH), leading to
water retention and dilutional hyponatremia (low sodium). The urine becomes concentrated due
to water reabsorption. Polyuria and polydipsia (A) are signs of Diabetes Insipidus.
Hypernatremia (B) suggests dehydration. Hypotension (D) is less common as the patient retains
fluid (euvolemic hyponatremia).
Q4: The nurse is teaching a patient with a new ileostomy about diet. Which food should the
nurse instruct the patient to avoid to prevent obstruction?
A. Bananas
B. Popcorn [CORRECT]
C. Yogurt
D. White rice
Correct Answer: B
Rationale: An ileostomy has a narrow lumen. High-fiber, hard-to-digest foods like popcorn, nuts,
corn, and seeds can cause an obstruction at the stoma site. Bananas, yogurt, and white rice are
generally low residue and easier to digest.
,3
Q5: A patient with acute pancreatitis is complaining of severe abdominal pain. Which
intervention should the nurse implement first?
A. Administer morphine sulfate IV
B. Place the patient in a semi-Fowler's position
C. Assess vital signs
D. Maintain NPO status [CORRECT]
Correct Answer: D
Rationale: The priority intervention for acute pancreatitis is to "rest the pancreas." The nurse
should immediately ensure the patient is NPO (nothing by mouth) to stop pancreatic enzyme
secretion, which exacerbates pain and autodigestion. While pain medication (A) and positioning
(B) are important, stopping oral intake addresses the physiological cause of the pain. Assessing
vital signs (C) is standard but not the intervention for pain relief.
Q6: A patient is admitted with suspected bacterial meningitis. Which finding is characteristic of
this condition?
A. Hypotension and bradycardia
B. Nuchal rigidity and photophobia [CORRECT]
C. Hypoglycemia and warm skin
D. Positive Trousseau’s sign
Correct Answer: B
Rationale: Meningitis involves inflammation of the meninges. Classic symptoms include nuchal
rigidity (stiff neck), photophobia (light sensitivity), and a severe headache. Hypotension (A) is
typical of septic shock but not the characteristic meningeal sign. Trousseau's sign (D) is
associated with hypocalcemia.
Q7: The nurse is caring for a patient with a chest tube connected to a closed drainage system.
The nurse notes continuous bubbling in the water seal chamber. What is the most appropriate
action?
A. Clamp the chest tube close to the insertion site.
, 4
B. Check the system for an air leak. [CORRECT]
C. Add more water to the suction control chamber.
D. Document the finding as expected.
Correct Answer: B
Rationale: Continuous bubbling in the water seal chamber indicates an air leak in the system
(tubing, connection, or insertion site). Intermittent bubbling is normal. The nurse should first
assess the connection and the insertion site. Clamping (A) is controversial and generally avoided
as it can cause a tension pneumothorax if the leak is on the patient side.
Q8: A patient with chronic kidney disease (CKD) is prescribed epoetin alfa (Epogen). What is
the primary reason for this medication?
A. To lower potassium levels
B. To prevent bone demineralization
C. To treat anemia associated with CKD [CORRECT]
D. To reduce fluid retention
Correct Answer: C
Rationale: In CKD, the kidneys fail to produce enough erythropoietin, leading to anemia.
Epoetin alfa is a synthetic form of erythropoietin that stimulates red blood cell production. It
does not directly affect potassium (A), bones (B - that is the role of phosphorus binders or
calcitriol), or fluid (D - diuretics).
Q9: The nurse is assessing a patient with a suspected fractured hip. Which clinical manifestation
supports this diagnosis?
A. Abduction of the affected leg
B. Shortening and external rotation of the affected leg [CORRECT]
C. Internal rotation and lengthening of the affected leg
D. Symmetrical alignment of the lower extremities
Med Surge HESI Exam 2026/2027 Actual Exam | Real Exam
1 & 2 Versions with All 200 Questions & Correct Answers
with Detailed Rationales | Medical Surgical HESI Test Bank
| Pass Guaranteed - A+ Graded
Version 1: Med Surge HESI Exam 1
Q1: A patient with heart failure has an ejection fraction of 35%. This indicates:
A. Diastolic heart failure
B. Systolic heart failure [CORRECT]
C. Normal cardiac function
D. Hypertrophic cardiomyopathy
Correct Answer: B
Rationale: Ejection fraction (EF) measures the percentage of blood leaving the heart each time it
contracts. An EF below 40% indicates systolic heart failure (HFrEF), where the heart muscle
does not contract effectively. Diastolic heart failure (HFpEF) typically has an EF of 50% or
higher. Normal EF is 55-70%.
Q2: The nurse is caring for a patient with chronic obstructive pulmonary disease (COPD) who is
receiving oxygen via nasal cannula at 2 L/min. The patient's spouse asks why the oxygen flow is
set so low. What is the nurse's best response?
A. "Higher oxygen concentrations will cause the patient to stop breathing."
B. "Low oxygen levels stimulate the hypoxic drive to breathe in these patients." [CORRECT]
C. "Higher oxygen concentrations are toxic to the lung tissue."
D. "We are trying to prevent the patient from developing oxygen dependence."
Correct Answer: B
Rationale: In patients with chronic COPD, the chemoreceptors in the brain become insensitive to
high CO2 levels (hypercapnia). Instead, the hypoxic drive (low O2) becomes the primary
stimulus for respiration. Administering high concentrations of oxygen can suppress this hypoxic
,2
drive, leading to hypoventilation, respiratory failure, and even apnea. The goal is to maintain
SpO2 between 88-92%.
Q3: A patient is admitted with a diagnosis of syndrome of inappropriate antidiuretic hormone
(SIADH). Which clinical manifestation should the nurse expect to find?
A. Polyuria and polydipsia
B. Hypernatremia and dry mucous membranes
C. Hyponatremia and concentrated urine [CORRECT]
D. Hypotension and tachycardia
Correct Answer: C
Rationale: SIADH involves the excessive release of antidiuretic hormone (ADH), leading to
water retention and dilutional hyponatremia (low sodium). The urine becomes concentrated due
to water reabsorption. Polyuria and polydipsia (A) are signs of Diabetes Insipidus.
Hypernatremia (B) suggests dehydration. Hypotension (D) is less common as the patient retains
fluid (euvolemic hyponatremia).
Q4: The nurse is teaching a patient with a new ileostomy about diet. Which food should the
nurse instruct the patient to avoid to prevent obstruction?
A. Bananas
B. Popcorn [CORRECT]
C. Yogurt
D. White rice
Correct Answer: B
Rationale: An ileostomy has a narrow lumen. High-fiber, hard-to-digest foods like popcorn, nuts,
corn, and seeds can cause an obstruction at the stoma site. Bananas, yogurt, and white rice are
generally low residue and easier to digest.
,3
Q5: A patient with acute pancreatitis is complaining of severe abdominal pain. Which
intervention should the nurse implement first?
A. Administer morphine sulfate IV
B. Place the patient in a semi-Fowler's position
C. Assess vital signs
D. Maintain NPO status [CORRECT]
Correct Answer: D
Rationale: The priority intervention for acute pancreatitis is to "rest the pancreas." The nurse
should immediately ensure the patient is NPO (nothing by mouth) to stop pancreatic enzyme
secretion, which exacerbates pain and autodigestion. While pain medication (A) and positioning
(B) are important, stopping oral intake addresses the physiological cause of the pain. Assessing
vital signs (C) is standard but not the intervention for pain relief.
Q6: A patient is admitted with suspected bacterial meningitis. Which finding is characteristic of
this condition?
A. Hypotension and bradycardia
B. Nuchal rigidity and photophobia [CORRECT]
C. Hypoglycemia and warm skin
D. Positive Trousseau’s sign
Correct Answer: B
Rationale: Meningitis involves inflammation of the meninges. Classic symptoms include nuchal
rigidity (stiff neck), photophobia (light sensitivity), and a severe headache. Hypotension (A) is
typical of septic shock but not the characteristic meningeal sign. Trousseau's sign (D) is
associated with hypocalcemia.
Q7: The nurse is caring for a patient with a chest tube connected to a closed drainage system.
The nurse notes continuous bubbling in the water seal chamber. What is the most appropriate
action?
A. Clamp the chest tube close to the insertion site.
, 4
B. Check the system for an air leak. [CORRECT]
C. Add more water to the suction control chamber.
D. Document the finding as expected.
Correct Answer: B
Rationale: Continuous bubbling in the water seal chamber indicates an air leak in the system
(tubing, connection, or insertion site). Intermittent bubbling is normal. The nurse should first
assess the connection and the insertion site. Clamping (A) is controversial and generally avoided
as it can cause a tension pneumothorax if the leak is on the patient side.
Q8: A patient with chronic kidney disease (CKD) is prescribed epoetin alfa (Epogen). What is
the primary reason for this medication?
A. To lower potassium levels
B. To prevent bone demineralization
C. To treat anemia associated with CKD [CORRECT]
D. To reduce fluid retention
Correct Answer: C
Rationale: In CKD, the kidneys fail to produce enough erythropoietin, leading to anemia.
Epoetin alfa is a synthetic form of erythropoietin that stimulates red blood cell production. It
does not directly affect potassium (A), bones (B - that is the role of phosphorus binders or
calcitriol), or fluid (D - diuretics).
Q9: The nurse is assessing a patient with a suspected fractured hip. Which clinical manifestation
supports this diagnosis?
A. Abduction of the affected leg
B. Shortening and external rotation of the affected leg [CORRECT]
C. Internal rotation and lengthening of the affected leg
D. Symmetrical alignment of the lower extremities
