MEDICAL-SURGICAL HESI MASTERY EXAM 2026 | 100 HIGH-YIELD NCLEX-STYLE
QUESTIONS WITH DETAILED RATIONALES (A+ GUARANTEED PASS GUIDE)
MED-SURG HESI-STYLE PRACTICE EXAM (ORIGINAL)
Set 1: Questions 1–20 (With Answers & Rationales)
1. A patient with COPD is receiving oxygen therapy. Which oxygen delivery method is most
appropriate to prevent CO₂ retention?
,A. non-rebreather mask
B. Nasal cannula at 6 L/min
C. Venturi mask
D. Simple face mask at 10 L/min
Correct Answer: C. Venturi mask
Rationale:
COPD patients require controlled oxygen delivery. The Venturi mask provides precise oxygen
concentrations, preventing oxygen-induced hypoventilation and CO₂ retention.
2. Which symptom is most indicative of left-sided heart failure?
A. Peripheral edema
B. Jugular vein distention
C. Crackles in lungs
D. Ascites
Correct Answer: C. Crackles in lungs
Rationale:
Left-sided heart failure causes pulmonary congestion, leading to crackles, dyspnea, and
orthopnea.
3. A post-op patient suddenly develops chest pain and dyspnea. What is the nurse’s priority
action?
A. Administer oxygen
B. Encourage coughing
C. Elevate legs
D. Give pain medication
Correct Answer: A. Administer oxygen
Rationale:
Sudden chest pain and dyspnea suggest possible pulmonary embolism or MI. Oxygen is the
priority to support perfusion.
4. Which lab value indicates kidney dysfunction?
,A. BUN 12 mg/dL
B. Creatinine 0.8 mg/dL
C. Creatinine 3.2 mg/dL
D. Potassium 4.0 me/L
Correct Answer: C. Creatinine 3.2 mg/dL
Rationale:
Elevated creatinine reflects impaired renal filtration and kidney dysfunction.
5. A patient with hyperkalemia is at risk for which complication?
A. Bradycardia
B. Hypertension
C. Hyperactivity
D. Polyuria
Correct Answer: A. Bradycardia
Rationale:
Hyperkalemia disrupts cardiac conduction, leading to dangerous dysrhythmias and bradycardia.
6. Which finding is most concerning in a patient with diabetes mellitus?
A. Blood glucose 120 mg/dL
B. Blood glucose 250 mg/dL
C. Blood glucose 70 mg/dL
D. Blood glucose 90 mg/dL
Correct Answer: B. Blood glucose 250 mg/dL
Rationale:
Hyperglycemia increases risk of DKA and complications if persistent.
7. What is the priority intervention for a patient experiencing an asthma attack?
A. Encourage fluids
B. Administer bronchodilator
C. Take vital signs
D. Place in supine position
, Correct Answer: B. Administer bronchodilator
Rationale:
Bronchodilators quickly open airways and relieve bronchospasm.
8. Which sign indicates hypoglycemia?
A. Warm, dry skin
B. Fruity breath
C. Sweating and confusion
D. Hypertension
Correct Answer: C. Sweating and confusion
Rationale:
Hypoglycemia stimulates sympathetic response causing diaphoresis and neuro symptoms.
9. A patient is receiving heparin therapy. Which lab should be monitored?
A. INR
B. aPTT
C. Platelet count only
D. Hemoglobin
Correct Answer: B. aPTT
Rationale:
Heparin therapy is monitored using aPTT to assess anticoagulation levels.
10. Which condition increases risk for deep vein thrombosis (DVT)?
A. Early ambulation
B. Dehydration
C. High fiber diet
D. Hypotension
Correct Answer: B. Dehydration
Rationale:
Dehydration increases blood viscosity, promoting clot formation.
QUESTIONS WITH DETAILED RATIONALES (A+ GUARANTEED PASS GUIDE)
MED-SURG HESI-STYLE PRACTICE EXAM (ORIGINAL)
Set 1: Questions 1–20 (With Answers & Rationales)
1. A patient with COPD is receiving oxygen therapy. Which oxygen delivery method is most
appropriate to prevent CO₂ retention?
,A. non-rebreather mask
B. Nasal cannula at 6 L/min
C. Venturi mask
D. Simple face mask at 10 L/min
Correct Answer: C. Venturi mask
Rationale:
COPD patients require controlled oxygen delivery. The Venturi mask provides precise oxygen
concentrations, preventing oxygen-induced hypoventilation and CO₂ retention.
2. Which symptom is most indicative of left-sided heart failure?
A. Peripheral edema
B. Jugular vein distention
C. Crackles in lungs
D. Ascites
Correct Answer: C. Crackles in lungs
Rationale:
Left-sided heart failure causes pulmonary congestion, leading to crackles, dyspnea, and
orthopnea.
3. A post-op patient suddenly develops chest pain and dyspnea. What is the nurse’s priority
action?
A. Administer oxygen
B. Encourage coughing
C. Elevate legs
D. Give pain medication
Correct Answer: A. Administer oxygen
Rationale:
Sudden chest pain and dyspnea suggest possible pulmonary embolism or MI. Oxygen is the
priority to support perfusion.
4. Which lab value indicates kidney dysfunction?
,A. BUN 12 mg/dL
B. Creatinine 0.8 mg/dL
C. Creatinine 3.2 mg/dL
D. Potassium 4.0 me/L
Correct Answer: C. Creatinine 3.2 mg/dL
Rationale:
Elevated creatinine reflects impaired renal filtration and kidney dysfunction.
5. A patient with hyperkalemia is at risk for which complication?
A. Bradycardia
B. Hypertension
C. Hyperactivity
D. Polyuria
Correct Answer: A. Bradycardia
Rationale:
Hyperkalemia disrupts cardiac conduction, leading to dangerous dysrhythmias and bradycardia.
6. Which finding is most concerning in a patient with diabetes mellitus?
A. Blood glucose 120 mg/dL
B. Blood glucose 250 mg/dL
C. Blood glucose 70 mg/dL
D. Blood glucose 90 mg/dL
Correct Answer: B. Blood glucose 250 mg/dL
Rationale:
Hyperglycemia increases risk of DKA and complications if persistent.
7. What is the priority intervention for a patient experiencing an asthma attack?
A. Encourage fluids
B. Administer bronchodilator
C. Take vital signs
D. Place in supine position
, Correct Answer: B. Administer bronchodilator
Rationale:
Bronchodilators quickly open airways and relieve bronchospasm.
8. Which sign indicates hypoglycemia?
A. Warm, dry skin
B. Fruity breath
C. Sweating and confusion
D. Hypertension
Correct Answer: C. Sweating and confusion
Rationale:
Hypoglycemia stimulates sympathetic response causing diaphoresis and neuro symptoms.
9. A patient is receiving heparin therapy. Which lab should be monitored?
A. INR
B. aPTT
C. Platelet count only
D. Hemoglobin
Correct Answer: B. aPTT
Rationale:
Heparin therapy is monitored using aPTT to assess anticoagulation levels.
10. Which condition increases risk for deep vein thrombosis (DVT)?
A. Early ambulation
B. Dehydration
C. High fiber diet
D. Hypotension
Correct Answer: B. Dehydration
Rationale:
Dehydration increases blood viscosity, promoting clot formation.
