HESI Medical-Surgical Nursing Practice Exam (100 Questions
with Answers and Rationales)
1. A client with COPD is receiving oxygen via nasal cannula at 4 L/min. What is the nurse’s
priority concern?
A. Oxygen toxicity
B. Respiratory depression
C. Dry mucous membranes
D. Hyperventilation
Answer: B
Rationale: COPD patients rely on hypoxic drive; high oxygen levels can suppress breathing.
2. A postoperative patient suddenly develops chest pain and dyspnea. What should the
nurse do first?
A. Obtain a chest X-ray
B. Administer pain medication
C. Apply oxygen
D. Notify the provider
Answer: C
Rationale: Airway and oxygenation come first (possible pulmonary embolism).
3. Which lab result is most concerning?
A. Sodium 138 mEq/L
B. Potassium 6.5 mEq/L
C. Hemoglobin 13 g/dL
D. Calcium 9 mg/dL
Answer: B
Rationale: Hyperkalemia can cause fatal cardiac dysrhythmias.
4. A patient with heart failure is on furosemide. What should the nurse monitor?
A. Sodium
B. Potassium
,C. Glucose
D. Calcium
Answer: B
Rationale: Loop diuretics cause potassium loss → hypokalemia risk.
5. Which sign suggests hypoglycemia?
A. Fruity breath
B. Sweating and tremors
C. Deep respirations
D. Polyuria
Answer: B
Rationale: Hypoglycemia activates sympathetic response.
6. A patient has increased intracranial pressure. What is the earliest sign?
A. Bradycardia
B. Decreased LOC
C. Widened pulse pressure
D. Fixed pupils
Answer: B
Rationale: Decreased level of consciousness is the earliest sign.
7. Which action is priority for a burn patient?
A. Pain control
B. Fluid resuscitation
C. Wound dressing
D. Infection prevention
Answer: B
Rationale: Burns cause major fluid loss → shock risk.
8. A patient has a potassium level of 2.8 mEq/L. What is expected?
A. Muscle weakness
B. Hypertension
, C. Bradycardia only
D. Hyperactivity
Answer: A
Rationale: Hypokalemia causes muscle weakness and cramps.
9. Which finding suggests infection after surgery?
A. Mild pain
B. Fever and purulent drainage
C. Slight redness
D. Fatigue
Answer: B
Rationale: Purulent drainage + fever = infection.
10. Priority action for a patient with chest pain?
A. Give antacid
B. Obtain ECG
C. Encourage rest
D. Check blood sugar
Answer: B
Rationale: Rule out myocardial infarction first.
11. A patient with diabetes has glucose 350 mg/dL. What is the priority action?
A. Give insulin
B. Encourage fluids
C. Recheck later
D. Give juice
Answer: A
Rationale: Hyperglycemia requires insulin therapy.
12. What indicates fluid overload?
A. Dry skin
B. Crackles in lungs
with Answers and Rationales)
1. A client with COPD is receiving oxygen via nasal cannula at 4 L/min. What is the nurse’s
priority concern?
A. Oxygen toxicity
B. Respiratory depression
C. Dry mucous membranes
D. Hyperventilation
Answer: B
Rationale: COPD patients rely on hypoxic drive; high oxygen levels can suppress breathing.
2. A postoperative patient suddenly develops chest pain and dyspnea. What should the
nurse do first?
A. Obtain a chest X-ray
B. Administer pain medication
C. Apply oxygen
D. Notify the provider
Answer: C
Rationale: Airway and oxygenation come first (possible pulmonary embolism).
3. Which lab result is most concerning?
A. Sodium 138 mEq/L
B. Potassium 6.5 mEq/L
C. Hemoglobin 13 g/dL
D. Calcium 9 mg/dL
Answer: B
Rationale: Hyperkalemia can cause fatal cardiac dysrhythmias.
4. A patient with heart failure is on furosemide. What should the nurse monitor?
A. Sodium
B. Potassium
,C. Glucose
D. Calcium
Answer: B
Rationale: Loop diuretics cause potassium loss → hypokalemia risk.
5. Which sign suggests hypoglycemia?
A. Fruity breath
B. Sweating and tremors
C. Deep respirations
D. Polyuria
Answer: B
Rationale: Hypoglycemia activates sympathetic response.
6. A patient has increased intracranial pressure. What is the earliest sign?
A. Bradycardia
B. Decreased LOC
C. Widened pulse pressure
D. Fixed pupils
Answer: B
Rationale: Decreased level of consciousness is the earliest sign.
7. Which action is priority for a burn patient?
A. Pain control
B. Fluid resuscitation
C. Wound dressing
D. Infection prevention
Answer: B
Rationale: Burns cause major fluid loss → shock risk.
8. A patient has a potassium level of 2.8 mEq/L. What is expected?
A. Muscle weakness
B. Hypertension
, C. Bradycardia only
D. Hyperactivity
Answer: A
Rationale: Hypokalemia causes muscle weakness and cramps.
9. Which finding suggests infection after surgery?
A. Mild pain
B. Fever and purulent drainage
C. Slight redness
D. Fatigue
Answer: B
Rationale: Purulent drainage + fever = infection.
10. Priority action for a patient with chest pain?
A. Give antacid
B. Obtain ECG
C. Encourage rest
D. Check blood sugar
Answer: B
Rationale: Rule out myocardial infarction first.
11. A patient with diabetes has glucose 350 mg/dL. What is the priority action?
A. Give insulin
B. Encourage fluids
C. Recheck later
D. Give juice
Answer: A
Rationale: Hyperglycemia requires insulin therapy.
12. What indicates fluid overload?
A. Dry skin
B. Crackles in lungs
