Med-Surg HESI PN Final Medical-Surgical Nursing Exam 2026/2027 – Questions and Answers Covering Adult Health Nursing Domains

Med-Surg HESI PN Final Medical-Surgical Nursing EXAM 2026/2027 – Latest Version



Core Domains: Cardiovascular Disorders, Respiratory Disorders, Gastrointestinal Disorders,
Endocrine Disorders, Renal & Genitourinary Disorders, Neurological Disorders, Musculoskeletal
Disorders, Hematological & Oncological Disorders, Immunological Disorders (including HIV/AIDS),
Integumentary Disorders, Perioperative Nursing, Fluid & Electrolyte Balance, Acid-Base Balance,
Pharmacology & Medication Administration, Pain Management, Wound Care, Complications of
Immobility, Gerontological Considerations, Cultural Competence, Prioritization/Clinical Judgment, and
Delegation to Unlicensed Assistive Personnel




Exam Structure: 100-question, multiple-choice and alternate-format (select-all-that-apply, ordered
response) examination designed to evaluate clinical judgment, prioritization skills, and application of
evidence-based medical-surgical nursing care across the adult health continuum for practical nursing
candidates.




[Domain 1: Cardiovascular Disorders]




1. A client with hypertension is prescribed hydrochlorothiazide (HCTZ). Which instruction
should the PN include in client teaching?




1.​ A) "Take this medication at bedtime to prevent daytime drowsiness."
2.​ B) "Take this medication in the morning to prevent nocturia."
3.​ C) "Double the dose if you miss a day."
4.​ D) "Stop taking the medication if you feel dizzy."




"Take this medication in the morning to prevent nocturia." HCTZ is a diuretic;
morning administration reduces nighttime urination (HESI PN, 2026; JNC 8
Hypertension Guidelines).



PN Note: Always assess for orthostatic hypotension when administering diuretics.




2. A client with heart failure reports a 3 lb (1.4 kg) weight gain in 2 days. Which action
should the PN take FIRST?

, 1.​ A) Administer the prescribed diuretic
2.​ B) Notify the RN or healthcare provider
3.​ C) Restrict fluids to 1000 mL/day
4.​ D) Document the finding and continue monitoring




Notify the RN or healthcare provider Sudden weight gain indicates fluid retention and
requires RN assessment for possible medication adjustment (HESI PN, 2026; HFSA
Heart Failure Guidelines).



PN Note: Weight gain >2 lbs/day is a red flag for fluid overload in heart failure.




3. A client with atrial fibrillation is prescribed warfarin (Coumadin). Which laboratory
value should the PN monitor?




1.​ A) aPTT
2.​ B) PT
3.​ C) INR
4.​ D) Platelet count




INR is the standard for monitoring warfarin therapy; target range is 2-3 for most
indications (HESI PN, 2026; CHEST Antithrombotic Guidelines).



PN Note: Report INR >3 or <2 to the RN for further action.




4. A client with a history of myocardial infarction (MI) is prescribed aspirin 81 mg daily.
What is the purpose of this medication?




1.​ A) To reduce inflammation
2.​ B) To lower blood pressure
3.​ C) To prevent blood clots
4.​ D) To control cholesterol

, To prevent blood clots Aspirin's antiplatelet effect reduces the risk of thrombus
formation in coronary arteries (HESI PN, 2026; AHA Secondary Prevention
Guidelines).



PN Note: Teach client to report signs of bleeding (e.g., bruising, black stools).




5. A client with peripheral arterial disease (PAD) complains of leg pain during ambulation.
Which instruction should the PN provide?




1.​ A) "Avoid all physical activity to prevent pain."
2.​ B) "Walk until you feel mild pain, rest, then walk again."
3.​ C) "Take pain medication before walking."
4.​ D) "Use a wheelchair to avoid walking."




"Walk until you feel mild pain, rest, then walk again." Gradual exercise improves
circulation and reduces claudication symptoms (HESI PN, 2026; AHA PAD
Guidelines).



PN Note: Encourage smoking cessation and foot care education.




6. A client with deep vein thrombosis (DVT) is prescribed bed rest. Which intervention
should the PN implement?




1.​ A) Massage the affected leg every 4 hours
2.​ B) Elevate the affected leg above heart level
3.​ C) Apply warm compresses to the leg
4.​ D) Encourage ambulation three times daily




Elevate the affected leg above heart level Promotes venous return and reduces edema
and pain (HESI PN, 2026; CHEST Venous Thromboembolism Guidelines).



PN Note: Avoid massage to prevent dislodging the clot.

, 7. A client with a pacemaker reports dizziness. Which action should the PN take FIRST?




1.​ A) Administer PRN anti-nausea medication
2.​ B) Assess vital signs and notify the RN
3.​ C) Document the finding and continue monitoring
4.​ D) Encourage the client to lie down




Assess vital signs and notify the RN Dizziness may indicate pacemaker malfunction or
arrhythmia, requiring RN assessment (HESI PN, 2026; AHA Pacemaker Guidelines).



PN Note: Never adjust pacemaker settings; this is outside PN scope.




8. A client with hypertension is prescribed a low-sodium diet. Which food should the PN
instruct the client to avoid?




1.​ A) Fresh fruits
2.​ B) Steamed vegetables
3.​ C) Canned soups
4.​ D) Grilled chicken




Canned soups Typically high in sodium; fresh or homemade foods are preferred (HESI
PN, 2026; AHA Hypertension Guidelines).



PN Note: Teach client to read food labels for sodium content.




9. A client with heart failure is prescribed digoxin (Lanoxin). Which adverse effect should
the PN monitor for?




1.​ A) Hypernatremia
2.​ B) Bradycardia
3.​ C) Hyperglycemia
4.​ D) Diarrhea