HESI MED -SURG EXAM
HESI Medical-Surgical Nursing 2026 Test Bank |
Updated for 2026 Exams | 200+ Evolve HESI
Practice Questions | Latest NGN Integration
1. A patient with COPD is receiving oxygen therapy. Which intervention is most
appropriate?
A. Administer oxygen at 6 L/min via nasal cannula
s
nk
B. Encourage deep breathing exercises hourly
C. Maintain oxygen saturation between 88–92% Ba
D. Place the patient in supine position
st
Answer C
te
Rationale COPD patients rely on hypoxic drive; high oxygen levels can suppress
s
respiration. Targeting 88–92% prevents hypoventilation.
ht
ig
el
2. A nurse is caring for a post-op patient with a Jackson-Pratt drain. What is the priority
D
action?
A. Flush the drain with saline every shift
B. Empty and measure drainage output
C. Clamp the drain to prevent backflow
D. Remove the drain when output is <50 mL
Answer B
Rationale Accurate measurement helps monitor healing and detect complications. Flushing
or clamping is not routine.
3. Which lab value is most concerning in a patient receiving heparin?
A. Platelets: 90,000/mm³
Page | 1
, HESI MED -SURG EXAM
B. INR: 1.2
C. Hemoglobin: 13 g/dL
D. WBC: 11,000/mm³
Answer A
Rationale Thrombocytopenia may indicate heparin-induced thrombocytopenia (HIT), a
serious adverse effect.
4. A patient with heart failure reports weight gain of 3 kg in 2 days. What should the nurse
do first?
A. Assess for peripheral edema
B. Notify the provider
C. Review dietary sodium intake
s
nk
D. Auscultate lung sounds
Answer D
Ba
Rationale Sudden weight gain suggests fluid retention. Lung auscultation helps detect
st
pulmonary congestion.
te
s
ht
ig
5. Which finding indicates a complication of parenteral nutrition?
el
A. Blood glucose of 180 mg/dL
D
B. Weight gain of 1 kg/week
C. Temperature of 38.5°C
D. Urine output of 40 mL/hr
Answer C
Rationale Fever may indicate catheter-related bloodstream infection, a serious
complication of TPN.
6. A patient with cirrhosis has ascites. Which intervention is most appropriate?
A. Encourage fluid intake
B. Administer furosemide
Page | 2
, HESI MED -SURG EXAM
C. Provide high-protein diet
D. Position flat for comfort
Answer B
Rationale Diuretics like furosemide help reduce fluid accumulation in ascites.
7. Which assessment finding is most concerning in a patient with a chest tube?
A. Continuous bubbling in the water seal chamber
B. Drainage of 80 mL in 1 hour
C. Fluctuation of water level with respiration
D. Absence of drainage for 2 hours
Answer A
s
nk
Rationale Continuous bubbling may indicate an air leak, requiring immediate evaluation.
Ba
st
8. A patient with diabetes reports numbness in feet. What is the priority nursing action?
te
A. Refer to physical therapy
s
ht
B. Assess for foot ulcers
ig
C. Teach insulin administration
el
D. Encourage ambulation
D
Answer B
Rationale Neuropathy increases risk for ulcers; early detection prevents complications.
9. Which intervention is appropriate for a patient with a potassium level of 6.2 mEq/L?
A. Administer potassium chloride
B. Encourage potassium-rich foods
C. Administer sodium polystyrene sulfonate
D. Hold loop diuretics
Answer C
Rationale Kayexalate helps lower potassium levels in hyperkalemia.
Page | 3
, HESI MED -SURG EXAM
10. A patient with a stroke has dysphagia. What is the priority nursing action?
A. Encourage oral fluids
B. Place patient in supine position
C. Perform swallow evaluation
D. Provide thin liquids
Answer C
Rationale Swallow evaluation prevents aspiration and guides safe feeding strategies.
11. A patient with DVT is prescribed warfarin. Which lab should be monitored?
A. aPTT
s
nk
B. INR
C. Platelets Ba
D. Hemoglobin
st
Answer B
te
Rationale INR monitors warfarin therapy; therapeutic range is typically 2–3.
s
ht
ig
12. A nurse is caring for a patient with a new ileostomy. Which finding requires immediate
el
attention?
D
A. Liquid stool output
B. Stoma color is pale
C. Mild peristomal skin irritation
D. Patient reports embarrassment
Answer B
Rationale Pale stoma may indicate compromised blood flow, requiring urgent evaluation.
13. Which symptom is expected in a patient with hypothyroidism?
A. Tachycardia
B. Diarrhea
Page | 4
HESI Medical-Surgical Nursing 2026 Test Bank |
Updated for 2026 Exams | 200+ Evolve HESI
Practice Questions | Latest NGN Integration
1. A patient with COPD is receiving oxygen therapy. Which intervention is most
appropriate?
A. Administer oxygen at 6 L/min via nasal cannula
s
nk
B. Encourage deep breathing exercises hourly
C. Maintain oxygen saturation between 88–92% Ba
D. Place the patient in supine position
st
Answer C
te
Rationale COPD patients rely on hypoxic drive; high oxygen levels can suppress
s
respiration. Targeting 88–92% prevents hypoventilation.
ht
ig
el
2. A nurse is caring for a post-op patient with a Jackson-Pratt drain. What is the priority
D
action?
A. Flush the drain with saline every shift
B. Empty and measure drainage output
C. Clamp the drain to prevent backflow
D. Remove the drain when output is <50 mL
Answer B
Rationale Accurate measurement helps monitor healing and detect complications. Flushing
or clamping is not routine.
3. Which lab value is most concerning in a patient receiving heparin?
A. Platelets: 90,000/mm³
Page | 1
, HESI MED -SURG EXAM
B. INR: 1.2
C. Hemoglobin: 13 g/dL
D. WBC: 11,000/mm³
Answer A
Rationale Thrombocytopenia may indicate heparin-induced thrombocytopenia (HIT), a
serious adverse effect.
4. A patient with heart failure reports weight gain of 3 kg in 2 days. What should the nurse
do first?
A. Assess for peripheral edema
B. Notify the provider
C. Review dietary sodium intake
s
nk
D. Auscultate lung sounds
Answer D
Ba
Rationale Sudden weight gain suggests fluid retention. Lung auscultation helps detect
st
pulmonary congestion.
te
s
ht
ig
5. Which finding indicates a complication of parenteral nutrition?
el
A. Blood glucose of 180 mg/dL
D
B. Weight gain of 1 kg/week
C. Temperature of 38.5°C
D. Urine output of 40 mL/hr
Answer C
Rationale Fever may indicate catheter-related bloodstream infection, a serious
complication of TPN.
6. A patient with cirrhosis has ascites. Which intervention is most appropriate?
A. Encourage fluid intake
B. Administer furosemide
Page | 2
, HESI MED -SURG EXAM
C. Provide high-protein diet
D. Position flat for comfort
Answer B
Rationale Diuretics like furosemide help reduce fluid accumulation in ascites.
7. Which assessment finding is most concerning in a patient with a chest tube?
A. Continuous bubbling in the water seal chamber
B. Drainage of 80 mL in 1 hour
C. Fluctuation of water level with respiration
D. Absence of drainage for 2 hours
Answer A
s
nk
Rationale Continuous bubbling may indicate an air leak, requiring immediate evaluation.
Ba
st
8. A patient with diabetes reports numbness in feet. What is the priority nursing action?
te
A. Refer to physical therapy
s
ht
B. Assess for foot ulcers
ig
C. Teach insulin administration
el
D. Encourage ambulation
D
Answer B
Rationale Neuropathy increases risk for ulcers; early detection prevents complications.
9. Which intervention is appropriate for a patient with a potassium level of 6.2 mEq/L?
A. Administer potassium chloride
B. Encourage potassium-rich foods
C. Administer sodium polystyrene sulfonate
D. Hold loop diuretics
Answer C
Rationale Kayexalate helps lower potassium levels in hyperkalemia.
Page | 3
, HESI MED -SURG EXAM
10. A patient with a stroke has dysphagia. What is the priority nursing action?
A. Encourage oral fluids
B. Place patient in supine position
C. Perform swallow evaluation
D. Provide thin liquids
Answer C
Rationale Swallow evaluation prevents aspiration and guides safe feeding strategies.
11. A patient with DVT is prescribed warfarin. Which lab should be monitored?
A. aPTT
s
nk
B. INR
C. Platelets Ba
D. Hemoglobin
st
Answer B
te
Rationale INR monitors warfarin therapy; therapeutic range is typically 2–3.
s
ht
ig
12. A nurse is caring for a patient with a new ileostomy. Which finding requires immediate
el
attention?
D
A. Liquid stool output
B. Stoma color is pale
C. Mild peristomal skin irritation
D. Patient reports embarrassment
Answer B
Rationale Pale stoma may indicate compromised blood flow, requiring urgent evaluation.
13. Which symptom is expected in a patient with hypothyroidism?
A. Tachycardia
B. Diarrhea
Page | 4
