HESI Medical-Surgical V2 | 2026 Q&A with
Rationale
1. A nurse is caring for a patient who is 24 hours post-thyroidectomy. The patient reports
tingling in the fingers and around the mouth. Which action should the nurse take first?
A. Check the patient’s blood pressure.
B. Assess for Chvostek’s sign.
C. Administer a prescribed sedative.
D. Check the surgical dressing for bleeding.
Correct Answer: B
Rationale: Tingling in the extremities and circumoral area are classic signs of
hypocalcemia, which can occur if the parathyroid glands are accidentally damaged or
removed during a thyroidectomy. Assessing for Chvostek’s sign (facial twitching) or
Trousseau’s sign is a priority bedside assessment to confirm neuromuscular irritability.
This finding must be reported to the provider immediately to prevent tetany or seizures.
2. A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 L/min
via nasal cannula. The nurse notes the patient’s oxygen saturation is 89% and the patient
appears slightly short of breath. Which action is most appropriate?
A. Increase the oxygen flow to 6 L/min.
B. Change the delivery device to a non-rebreather mask.
,C. Prepare for immediate endotracheal intubation.
D. Continue to monitor the patient as this is an expected finding.
Correct Answer: D
Rationale: For patients with COPD, an oxygen saturation between 88% and 92% is often
targeted to prevent the suppression of the hypoxic drive to breathe. Increasing oxygen to
high levels can lead to CO2 retention and respiratory acidosis in this population. The nurse
should continue to monitor and encourage pursed-lip breathing unless the patient shows
signs of acute distress.
3. A patient is admitted with a diagnosis of Acute Pancreatitis. Which laboratory result should
the nurse expect to be significantly elevated?
A. Serum Calcium
B. Hemoglobin
C. Serum Potassium
D. Serum Amylase
Correct Answer: D
Rationale: Serum amylase and lipase are the primary enzymes released by the pancreas
and are significantly elevated during acute pancreatitis. Serum calcium typically decreases
(hypocalcemia) due to fat necrosis and soap formation. Monitoring these enzymes helps
confirm the diagnosis and track the progression of the inflammatory process.
,4. Which clinical manifestations should the nurse expect to find in a patient with Graves’
disease? (Select All That Apply)
A. Exophthalmos
B. Bradycardia
C. Weight gain
D. Heat intolerance
E. Fine tremors of the hands
F. Constipation
Correct Answer: A,D,E
Rationale: Graves’ disease is a form of hyperthyroidism characterized by an increased
metabolic rate. Common symptoms include bulging eyes (exophthalmos), heat intolerance,
and fine tremors due to sympathetic nervous system overstimulation. Bradycardia, weight
gain, and constipation are associated with hypothyroidism, not hyperthyroidism.
5. The nurse is monitoring a patient receiving a blood transfusion. After 15 minutes, the
patient reports a headache, chills, and lower back pain. What is the priority nursing action?
A. Slow the infusion rate and notify the provider.
B. Stop the transfusion and disconnect the tubing.
C. Administer acetaminophen for the headache.
D. Recheck the patient’s identification band and blood bag label.
, Correct Answer: B
Rationale: Chills and lower back pain are cardinal signs of a hemolytic transfusion
reaction, which is a medical emergency. The nurse must immediately stop the transfusion
and disconnect the tubing at the hub to prevent further exposure to the incompatible
blood. Following this, the nurse should maintain IV access with normal saline and notify the
provider and blood bank.
6. A patient with Type 1 Diabetes Mellitus is found unresponsive with cold, clammy skin. The
nurse should immediately perform which action?
A. Administer 10 units of regular insulin.
B. Administer 50% Dextrose IV push.
C. Give the patient a glass of orange juice.
D. Check the blood glucose level.
Correct Answer: D
Rationale: While the patient shows symptoms of hypoglycemia (cold, clammy skin), the
first step in an unresponsive patient is to quickly verify the blood glucose level if a monitor
is available. If glucose is confirmed low and the patient is unresponsive, IV Dextrose is the
treatment of choice. Administering insulin to a hypoglycemic patient would be fatal.
7. A patient with a history of atrial fibrillation is prescribed warfarin. Which statement by the
patient indicates a need for further teaching?
A. I will increase my intake of spinach and kale to stay healthy.
Rationale
1. A nurse is caring for a patient who is 24 hours post-thyroidectomy. The patient reports
tingling in the fingers and around the mouth. Which action should the nurse take first?
A. Check the patient’s blood pressure.
B. Assess for Chvostek’s sign.
C. Administer a prescribed sedative.
D. Check the surgical dressing for bleeding.
Correct Answer: B
Rationale: Tingling in the extremities and circumoral area are classic signs of
hypocalcemia, which can occur if the parathyroid glands are accidentally damaged or
removed during a thyroidectomy. Assessing for Chvostek’s sign (facial twitching) or
Trousseau’s sign is a priority bedside assessment to confirm neuromuscular irritability.
This finding must be reported to the provider immediately to prevent tetany or seizures.
2. A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 L/min
via nasal cannula. The nurse notes the patient’s oxygen saturation is 89% and the patient
appears slightly short of breath. Which action is most appropriate?
A. Increase the oxygen flow to 6 L/min.
B. Change the delivery device to a non-rebreather mask.
,C. Prepare for immediate endotracheal intubation.
D. Continue to monitor the patient as this is an expected finding.
Correct Answer: D
Rationale: For patients with COPD, an oxygen saturation between 88% and 92% is often
targeted to prevent the suppression of the hypoxic drive to breathe. Increasing oxygen to
high levels can lead to CO2 retention and respiratory acidosis in this population. The nurse
should continue to monitor and encourage pursed-lip breathing unless the patient shows
signs of acute distress.
3. A patient is admitted with a diagnosis of Acute Pancreatitis. Which laboratory result should
the nurse expect to be significantly elevated?
A. Serum Calcium
B. Hemoglobin
C. Serum Potassium
D. Serum Amylase
Correct Answer: D
Rationale: Serum amylase and lipase are the primary enzymes released by the pancreas
and are significantly elevated during acute pancreatitis. Serum calcium typically decreases
(hypocalcemia) due to fat necrosis and soap formation. Monitoring these enzymes helps
confirm the diagnosis and track the progression of the inflammatory process.
,4. Which clinical manifestations should the nurse expect to find in a patient with Graves’
disease? (Select All That Apply)
A. Exophthalmos
B. Bradycardia
C. Weight gain
D. Heat intolerance
E. Fine tremors of the hands
F. Constipation
Correct Answer: A,D,E
Rationale: Graves’ disease is a form of hyperthyroidism characterized by an increased
metabolic rate. Common symptoms include bulging eyes (exophthalmos), heat intolerance,
and fine tremors due to sympathetic nervous system overstimulation. Bradycardia, weight
gain, and constipation are associated with hypothyroidism, not hyperthyroidism.
5. The nurse is monitoring a patient receiving a blood transfusion. After 15 minutes, the
patient reports a headache, chills, and lower back pain. What is the priority nursing action?
A. Slow the infusion rate and notify the provider.
B. Stop the transfusion and disconnect the tubing.
C. Administer acetaminophen for the headache.
D. Recheck the patient’s identification band and blood bag label.
, Correct Answer: B
Rationale: Chills and lower back pain are cardinal signs of a hemolytic transfusion
reaction, which is a medical emergency. The nurse must immediately stop the transfusion
and disconnect the tubing at the hub to prevent further exposure to the incompatible
blood. Following this, the nurse should maintain IV access with normal saline and notify the
provider and blood bank.
6. A patient with Type 1 Diabetes Mellitus is found unresponsive with cold, clammy skin. The
nurse should immediately perform which action?
A. Administer 10 units of regular insulin.
B. Administer 50% Dextrose IV push.
C. Give the patient a glass of orange juice.
D. Check the blood glucose level.
Correct Answer: D
Rationale: While the patient shows symptoms of hypoglycemia (cold, clammy skin), the
first step in an unresponsive patient is to quickly verify the blood glucose level if a monitor
is available. If glucose is confirmed low and the patient is unresponsive, IV Dextrose is the
treatment of choice. Administering insulin to a hypoglycemic patient would be fatal.
7. A patient with a history of atrial fibrillation is prescribed warfarin. Which statement by the
patient indicates a need for further teaching?
A. I will increase my intake of spinach and kale to stay healthy.
