HESI RN Medical-Surgical (Med surg) Exam
2026/2027 | Newly Released
Actual 60 questions with Correct Answers and Expert
Explanations
Q1: A patient scheduled for a hernia repair tells the nurse, "I took my aspirin this morning
because I have a headache." What is the nurse’s priority action?
A. Administer the preoperative medication as ordered.
B. Notify the surgeon and anesthesiologist immediately. [CORRECT]
C. Document the statement in the patient’s chart.
D. Explain that aspirin can increase bleeding risk.
Correct Answer: B
Rationale: Aspirin inhibits platelet aggregation and significantly increases the risk of bleeding
during surgery, so the surgical team must be notified immediately to determine if the procedure
needs to be postponed.
Q2: During the admission assessment for a patient scheduled for a cholecystectomy, the nurse
notes the patient has a history of latex allergy. Which intervention is most important to include in
the plan of care?
A. Place a "latex allergy" bracelet on the patient.
B. Ensure all equipment used in the operating room is latex-free. [CORRECT]
C. Administer an antihistamine prophylactically before surgery.
D. Keep a latex-safe cart in the patient’s room for post-op care.
Correct Answer: B
Rationale: The most critical intervention is preventing exposure during surgery, where mucosal
membranes are open and the risk of anaphylaxis is highest, by ensuring the entire OR
environment is latex-free.
,Q3: A patient in the post-anesthesia care unit (PACU) is restless and agitated. The nurse assesses
the patient and finds an oxygen saturation of 88% on 2 L nasal cannula. What is the nurse’s first
action?
A. Increase the oxygen flow to 4 L.
B. Check the patient’s oxygen saturation with a different probe. [CORRECT]
C. Administer a prescribed sedative medication.
D. Raise the head of the bed.
Correct Answer: B
Rationale: Before assuming hypoxia or administering medications, the nurse should verify the
accuracy of the reading by checking the probe connection or trying a different finger to rule out a
technical error, although hypoxia is indeed a high priority.
Q4: The nurse is caring for a patient 24 hours after a total hip replacement. The patient suddenly
reports sharp chest pain and difficulty breathing. What assessment finding would best confirm
the suspicion of a pulmonary embolism?
A. Positive Homans’ sign.
B. Hemoptysis and pleuritic chest pain. [CORRECT]
C. Redness and swelling in the operative leg.
D. Crackles audible in the lower lung bases.
Correct Answer: B
Rationale: While leg swelling (DVT) is the source, the classic presentation of a pulmonary
embolism includes sudden onset of dyspnea, pleuritic chest pain, and hemoptysis (coughing up
blood).
Q5: A patient with cancer is prescribed a transdermal fentanyl patch for chronic pain. Which
instruction is essential for the nurse to include in the teaching plan?
A. Apply the patch to the same site each time.
B. Apply heat over the patch to increase absorption.
C. Remove the old patch before applying a new one. [CORRECT]
D. Change the patch every 72 hours for breakthrough pain.
, Correct Answer: C
Rationale: Applying a new patch without removing the old one can lead to fatal fentanyl
accumulation and overdose; patches are typically changed every 72 hours, not for breakthrough
pain.
Q6: When assessing a patient’s postoperative wound, the nurse notes the edges are approximated
(closed) and there is no drainage. This type of wound healing is known as:
A. Healing by secondary intention.
B. Healing by tertiary intention.
C. Healing by primary intention. [CORRECT]
D. Dehiscence.
Correct Answer: C
Rationale: Primary intention occurs when the wound edges are surgically closed (sutures,
staples) and heal with minimal scarring, whereas secondary intention involves the wound being
left open to heal from the bottom up.
Q7: The nurse is preparing to discharge a patient with a new prescription for ibuprofen for
chronic pain. What potential adverse effect should the nurse warn the patient about?
A. Drowsiness and dizziness.
B. Gastrointestinal bleeding. [CORRECT]
C. Constipation.
D. Respiratory depression.
Correct Answer: B
Rationale: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen inhibit prostaglandins
that protect the stomach lining, increasing the risk of gastrointestinal irritation and bleeding.
2026/2027 | Newly Released
Actual 60 questions with Correct Answers and Expert
Explanations
Q1: A patient scheduled for a hernia repair tells the nurse, "I took my aspirin this morning
because I have a headache." What is the nurse’s priority action?
A. Administer the preoperative medication as ordered.
B. Notify the surgeon and anesthesiologist immediately. [CORRECT]
C. Document the statement in the patient’s chart.
D. Explain that aspirin can increase bleeding risk.
Correct Answer: B
Rationale: Aspirin inhibits platelet aggregation and significantly increases the risk of bleeding
during surgery, so the surgical team must be notified immediately to determine if the procedure
needs to be postponed.
Q2: During the admission assessment for a patient scheduled for a cholecystectomy, the nurse
notes the patient has a history of latex allergy. Which intervention is most important to include in
the plan of care?
A. Place a "latex allergy" bracelet on the patient.
B. Ensure all equipment used in the operating room is latex-free. [CORRECT]
C. Administer an antihistamine prophylactically before surgery.
D. Keep a latex-safe cart in the patient’s room for post-op care.
Correct Answer: B
Rationale: The most critical intervention is preventing exposure during surgery, where mucosal
membranes are open and the risk of anaphylaxis is highest, by ensuring the entire OR
environment is latex-free.
,Q3: A patient in the post-anesthesia care unit (PACU) is restless and agitated. The nurse assesses
the patient and finds an oxygen saturation of 88% on 2 L nasal cannula. What is the nurse’s first
action?
A. Increase the oxygen flow to 4 L.
B. Check the patient’s oxygen saturation with a different probe. [CORRECT]
C. Administer a prescribed sedative medication.
D. Raise the head of the bed.
Correct Answer: B
Rationale: Before assuming hypoxia or administering medications, the nurse should verify the
accuracy of the reading by checking the probe connection or trying a different finger to rule out a
technical error, although hypoxia is indeed a high priority.
Q4: The nurse is caring for a patient 24 hours after a total hip replacement. The patient suddenly
reports sharp chest pain and difficulty breathing. What assessment finding would best confirm
the suspicion of a pulmonary embolism?
A. Positive Homans’ sign.
B. Hemoptysis and pleuritic chest pain. [CORRECT]
C. Redness and swelling in the operative leg.
D. Crackles audible in the lower lung bases.
Correct Answer: B
Rationale: While leg swelling (DVT) is the source, the classic presentation of a pulmonary
embolism includes sudden onset of dyspnea, pleuritic chest pain, and hemoptysis (coughing up
blood).
Q5: A patient with cancer is prescribed a transdermal fentanyl patch for chronic pain. Which
instruction is essential for the nurse to include in the teaching plan?
A. Apply the patch to the same site each time.
B. Apply heat over the patch to increase absorption.
C. Remove the old patch before applying a new one. [CORRECT]
D. Change the patch every 72 hours for breakthrough pain.
, Correct Answer: C
Rationale: Applying a new patch without removing the old one can lead to fatal fentanyl
accumulation and overdose; patches are typically changed every 72 hours, not for breakthrough
pain.
Q6: When assessing a patient’s postoperative wound, the nurse notes the edges are approximated
(closed) and there is no drainage. This type of wound healing is known as:
A. Healing by secondary intention.
B. Healing by tertiary intention.
C. Healing by primary intention. [CORRECT]
D. Dehiscence.
Correct Answer: C
Rationale: Primary intention occurs when the wound edges are surgically closed (sutures,
staples) and heal with minimal scarring, whereas secondary intention involves the wound being
left open to heal from the bottom up.
Q7: The nurse is preparing to discharge a patient with a new prescription for ibuprofen for
chronic pain. What potential adverse effect should the nurse warn the patient about?
A. Drowsiness and dizziness.
B. Gastrointestinal bleeding. [CORRECT]
C. Constipation.
D. Respiratory depression.
Correct Answer: B
Rationale: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen inhibit prostaglandins
that protect the stomach lining, increasing the risk of gastrointestinal irritation and bleeding.
