HESI MEDICAL-SURGICAL
NURSING COMPREHENSIVE
EXAM QUESTIONS AND
ANSWERS WITH
RATIONALES/GRADED A+/2026
UPDATE/100% CORRECT
/INSTANT DOWNLOAD
SECTION A: CARDIOLOGY & HEMODYNAMICS
1. A patient with heart failure presents with crackles in both lung bases, an S3
gallop, and jugular vein distention. Which medication does the nurse prepare to
administer first?
A. Digoxin 0.125 mg PO
B. Metoprolol 25 mg PO
C. Furosemide 40 mg IV (Correct: IV loop diuretics are priority to reduce preload
and pulmonary congestion.)
D. Spironolactone 25 mg PO
2. The nurse is caring for a patient 4 hours post-cardiac catheterization via the
right femoral artery. The patient reports severe pain in the right foot. The nurse
notes the foot is pale and cold. What is the priority action?
A. Administer prescribed morphine sulfate.
B. Notify the healthcare provider immediately. (Correct: Signs of acute limb
ischemia (pain, pallor, pulselessness) indicate arterial thrombosis; requires emergent
intervention.)
,C. Increase the IV fluid rate.
D. Reposition the patient flat with leg elevated.
3. A patient with atrial fibrillation is prescribed warfarin (Coumadin). Which
laboratory value indicates that the therapy is therapeutic and safe for
discharge?
A. Platelets 150,000/mm³
B. aPTT 60 seconds
C. INR 2.5 (Correct: For AFib, target INR is 2-3 to prevent stroke without excessive
bleeding risk.)
D. PT 12 seconds
4. A patient post-MI is started on a beta-blocker (metoprolol). Which
assessment finding requires immediate discontinuation of the medication?
A. Heart rate of 58 bpm
B. Blood pressure 110/70 mmHg
C. Wheezing bilaterally (Correct: Beta-blockers can cause bronchospasm in patients
with reactive airway disease; contraindicated.)
D. Fatigue
5. The nurse is teaching a patient with hypertension about the DASH diet.
Which meal choice indicates understanding?
A. Cheeseburger with fries and a milkshake
B. Grilled salmon, brown rice, steamed broccoli, and an orange (Correct: DASH
diet emphasizes low sodium, high potassium, lean protein, and whole grains.)
C. Canned vegetable soup with saltine crackers
D. Ham sandwich on white bread with potato chips
SECTION B: RESPIRATORY
6. A patient with COPD has an oxygen saturation of 88% on room air. The nurse
applies 2L nasal cannula. Ten minutes later, the patient becomes drowsy and
, lethargic. What is the nurse’s priority action?
A. Increase oxygen to 4L via nasal cannula.
B. Decrease oxygen to 1L nasal cannula and assess for carbon dioxide
retention. (Correct: COPD patients may have hypoxic drive; high O2 can decrease
respiratory drive and increase CO2.)
C. Prepare for intubation.
D. Administer Naloxone.
7. A patient with status asthmaticus is receiving continuous albuterol
nebulizers. The patient reports shakiness and a heart rate of 130 bpm. What is
the best action?
A. Stop the albuterol immediately.
B. Continue the albuterol and notify the provider for possible adjunct
therapy. (Correct: Tremor and tachycardia are common side effects of beta-agonists;
do not stop life-saving bronchodilation.)
C. Administer propranolol to lower the heart rate.
D. Switch to a metered-dose inhaler.
8. Following a right-sided thoracentesis, the patient develops sudden sharp
chest pain, shortness of breath, and absent breath sounds on the right. The
nurse suspects:
A. Pulmonary embolism
B. Tension pneumothorax (Correct: Post-procedure complication; air enters pleural
space. Absent breath sounds + sudden dyspnea = pneumothorax.)
C. Hemorrhage
D. Subcutaneous emphysema
9. The nurse is caring for a patient with a chest tube to water seal drainage for a
left hemothorax. Which finding indicates the chest tube is functioning
correctly?
A. Continuous bubbling in the water seal chamber.
B. Fluctuation (tidaling) in the water seal chamber with respirations. (Correct:
Tidaling indicates patency and intrapleural pressure changes.)
NURSING COMPREHENSIVE
EXAM QUESTIONS AND
ANSWERS WITH
RATIONALES/GRADED A+/2026
UPDATE/100% CORRECT
/INSTANT DOWNLOAD
SECTION A: CARDIOLOGY & HEMODYNAMICS
1. A patient with heart failure presents with crackles in both lung bases, an S3
gallop, and jugular vein distention. Which medication does the nurse prepare to
administer first?
A. Digoxin 0.125 mg PO
B. Metoprolol 25 mg PO
C. Furosemide 40 mg IV (Correct: IV loop diuretics are priority to reduce preload
and pulmonary congestion.)
D. Spironolactone 25 mg PO
2. The nurse is caring for a patient 4 hours post-cardiac catheterization via the
right femoral artery. The patient reports severe pain in the right foot. The nurse
notes the foot is pale and cold. What is the priority action?
A. Administer prescribed morphine sulfate.
B. Notify the healthcare provider immediately. (Correct: Signs of acute limb
ischemia (pain, pallor, pulselessness) indicate arterial thrombosis; requires emergent
intervention.)
,C. Increase the IV fluid rate.
D. Reposition the patient flat with leg elevated.
3. A patient with atrial fibrillation is prescribed warfarin (Coumadin). Which
laboratory value indicates that the therapy is therapeutic and safe for
discharge?
A. Platelets 150,000/mm³
B. aPTT 60 seconds
C. INR 2.5 (Correct: For AFib, target INR is 2-3 to prevent stroke without excessive
bleeding risk.)
D. PT 12 seconds
4. A patient post-MI is started on a beta-blocker (metoprolol). Which
assessment finding requires immediate discontinuation of the medication?
A. Heart rate of 58 bpm
B. Blood pressure 110/70 mmHg
C. Wheezing bilaterally (Correct: Beta-blockers can cause bronchospasm in patients
with reactive airway disease; contraindicated.)
D. Fatigue
5. The nurse is teaching a patient with hypertension about the DASH diet.
Which meal choice indicates understanding?
A. Cheeseburger with fries and a milkshake
B. Grilled salmon, brown rice, steamed broccoli, and an orange (Correct: DASH
diet emphasizes low sodium, high potassium, lean protein, and whole grains.)
C. Canned vegetable soup with saltine crackers
D. Ham sandwich on white bread with potato chips
SECTION B: RESPIRATORY
6. A patient with COPD has an oxygen saturation of 88% on room air. The nurse
applies 2L nasal cannula. Ten minutes later, the patient becomes drowsy and
, lethargic. What is the nurse’s priority action?
A. Increase oxygen to 4L via nasal cannula.
B. Decrease oxygen to 1L nasal cannula and assess for carbon dioxide
retention. (Correct: COPD patients may have hypoxic drive; high O2 can decrease
respiratory drive and increase CO2.)
C. Prepare for intubation.
D. Administer Naloxone.
7. A patient with status asthmaticus is receiving continuous albuterol
nebulizers. The patient reports shakiness and a heart rate of 130 bpm. What is
the best action?
A. Stop the albuterol immediately.
B. Continue the albuterol and notify the provider for possible adjunct
therapy. (Correct: Tremor and tachycardia are common side effects of beta-agonists;
do not stop life-saving bronchodilation.)
C. Administer propranolol to lower the heart rate.
D. Switch to a metered-dose inhaler.
8. Following a right-sided thoracentesis, the patient develops sudden sharp
chest pain, shortness of breath, and absent breath sounds on the right. The
nurse suspects:
A. Pulmonary embolism
B. Tension pneumothorax (Correct: Post-procedure complication; air enters pleural
space. Absent breath sounds + sudden dyspnea = pneumothorax.)
C. Hemorrhage
D. Subcutaneous emphysema
9. The nurse is caring for a patient with a chest tube to water seal drainage for a
left hemothorax. Which finding indicates the chest tube is functioning
correctly?
A. Continuous bubbling in the water seal chamber.
B. Fluctuation (tidaling) in the water seal chamber with respirations. (Correct:
Tidaling indicates patency and intrapleural pressure changes.)
