HESI PN MEDICAL SURGICAL NGN EXAM STUDY GUIDE | TESTBANK | PRACTICE
QUESTIONS & ANSWERS | EXAM PREPARATION | ADVANCED REVIEW |
COMPREHENSIVE PRACTICE EXAM | LATEST UPDATE 2026/2027
Examiner:
HESI (Health Education Systems, Inc.)
TABLE OF CONTENTS
1. Adult Medical-Surgical Nursing Foundations
2. Clinical Judgment (Next Generation Nursing)
3. Cardiovascular Disorders
4. Respiratory Disorders
5. Neurological Disorders
6. Endocrine Disorders
7. Gastrointestinal Disorders
8. Renal and Genitourinary Disorders
9. Musculoskeletal Disorders
10. Hematologic and Immune Disorders
11. Integumentary Disorders
12. Infectious Diseases
13. Fluid, Electrolyte, and Acid-Base Balance
14. Perioperative Nursing
15. Pain Management
16. Pharmacologic Management
17. Patient Safety and Prioritization
18. Nursing Documentation and Professional Practice
HESI PN || MEDICAL SURGICAL || NGN || CLINICAL JUDGMENT || PRIORITIZATION
|| PATIENT SAFETY || PHARMACOLOGY || FLUID BALANCE || CARDIOVASCULAR ||
RESPIRATORY || NEUROLOGICAL || ENDOCRINE || RENAL || GASTROINTESTINAL ||
PERIOPERATIVE || INFECTION CONTROL || EVIDENCE-BASED PRACTICE ||
COMPREHENSIVE REVIEW || ADVANCED PRACTICE QUESTIONS || CERTIFICATION
EXAM PREPARATION
,QUESTION 1.
A client admitted with worsening heart failure suddenly develops increasing dyspnea,
crackles throughout both lung fields, and an oxygen saturation of 84% despite
receiving oxygen via nasal cannula. Which nursing action should be implemented
first?
A. Place the client in high-Fowler's position and notify the RN/provider immediately.
B. Encourage oral fluid intake to improve circulation.
C. Administer the scheduled oral beta blocker.
D. Prepare the client for discharge teaching.
🔴 Correct Answer: A. Place the client in high-Fowler's position and notify the
RN/provider immediately.
🔵 Explanation: Positioning the client upright reduces venous return and improves
lung expansion while urgent notification facilitates rapid intervention. Encouraging
fluids could worsen pulmonary edema, administering a beta blocker is not the priority
during acute respiratory compromise, and discharge teaching is inappropriate during
an unstable condition.
QUESTION 2.
A client with diabetic ketoacidosis is receiving continuous insulin therapy. Which
assessment finding indicates that treatment is progressing appropriately?
A. Persistent fruity breath odor with increasing respirations
B. Gradual decrease in serum glucose with improvement in mental status
C. Increasing serum potassium despite insulin therapy
D. Decreasing urine output accompanied by hypotension
🔴 Correct Answer: B. Gradual decrease in serum glucose with improvement in
mental status.
🔵 Explanation: Improvement in neurologic status together with declining blood
glucose suggests effective therapy and improving metabolic balance. Persistent
,Kussmaul respirations indicate ongoing acidosis, rising potassium is concerning, and
declining urine output with hypotension may signal worsening perfusion.
QUESTION 3.
A postoperative client suddenly reports sharp chest pain and shortness of breath.
Which finding most strongly supports suspicion of a pulmonary embolism?
A. Bradycardia with hypertension
B. Warm flushed skin
C. Sudden tachycardia with hypoxemia
D. Bilateral lower extremity edema without respiratory symptoms
🔴 Correct Answer: C. Sudden tachycardia with hypoxemia.
🔵 Explanation: Pulmonary embolism commonly presents with sudden dyspnea,
tachycardia, hypoxemia, and pleuritic chest pain. Bradycardia is uncommon, flushed
skin is nonspecific, and isolated bilateral edema does not explain the acute respiratory
symptoms.
QUESTION 4.
A client receiving intravenous potassium chloride reports burning at the infusion site.
What is the nurse's priority action?
A. Increase the infusion rate.
B. Apply a heating pad directly over the IV site.
C. Discontinue the infusion immediately and assess IV patency.
D. Flush the line rapidly with sterile water.
🔴 Correct Answer: C. Discontinue the infusion immediately and assess IV patency.
🔵 Explanation: Potassium is irritating to veins, and burning may indicate infiltration
or phlebitis. The infusion should be stopped while the IV site is assessed. Increasing the
rate or rapidly flushing the line could worsen tissue injury, and direct heat is not the
first intervention.
, QUESTION 5.
A client with chronic obstructive pulmonary disease has an oxygen saturation of 90%
while receiving low-flow oxygen and appears comfortable. Which nursing action is
most appropriate?
A. Increase oxygen to maintain saturation at 100%.
B. Remove oxygen because the saturation is below normal.
C. Continue monitoring while maintaining prescribed oxygen therapy.
D. Encourage hyperventilation exercises every five minutes.
🔴 Correct Answer: C. Continue monitoring while maintaining prescribed oxygen
therapy.
🔵 Explanation: Many clients with COPD have lower target oxygen saturations.
Maintaining prescribed oxygen while monitoring for clinical changes is appropriate.
Excessive oxygen may worsen carbon dioxide retention, removing oxygen is unsafe, and
forced hyperventilation is unnecessary.
QUESTION 6.
A client with acute kidney injury develops peaked T waves on the cardiac monitor.
Which laboratory abnormality should the nurse suspect?
A. Hyperkalemia
B. Hypocalcemia
C. Hyponatremia
D. Hypomagnesemia
🔴 Correct Answer: A. Hyperkalemia.
🔵 Explanation: Peaked T waves are a classic ECG manifestation of elevated serum
potassium. Hyperkalemia is common in acute kidney injury due to impaired potassium
excretion. The other electrolyte abnormalities produce different clinical manifestations.
QUESTIONS & ANSWERS | EXAM PREPARATION | ADVANCED REVIEW |
COMPREHENSIVE PRACTICE EXAM | LATEST UPDATE 2026/2027
Examiner:
HESI (Health Education Systems, Inc.)
TABLE OF CONTENTS
1. Adult Medical-Surgical Nursing Foundations
2. Clinical Judgment (Next Generation Nursing)
3. Cardiovascular Disorders
4. Respiratory Disorders
5. Neurological Disorders
6. Endocrine Disorders
7. Gastrointestinal Disorders
8. Renal and Genitourinary Disorders
9. Musculoskeletal Disorders
10. Hematologic and Immune Disorders
11. Integumentary Disorders
12. Infectious Diseases
13. Fluid, Electrolyte, and Acid-Base Balance
14. Perioperative Nursing
15. Pain Management
16. Pharmacologic Management
17. Patient Safety and Prioritization
18. Nursing Documentation and Professional Practice
HESI PN || MEDICAL SURGICAL || NGN || CLINICAL JUDGMENT || PRIORITIZATION
|| PATIENT SAFETY || PHARMACOLOGY || FLUID BALANCE || CARDIOVASCULAR ||
RESPIRATORY || NEUROLOGICAL || ENDOCRINE || RENAL || GASTROINTESTINAL ||
PERIOPERATIVE || INFECTION CONTROL || EVIDENCE-BASED PRACTICE ||
COMPREHENSIVE REVIEW || ADVANCED PRACTICE QUESTIONS || CERTIFICATION
EXAM PREPARATION
,QUESTION 1.
A client admitted with worsening heart failure suddenly develops increasing dyspnea,
crackles throughout both lung fields, and an oxygen saturation of 84% despite
receiving oxygen via nasal cannula. Which nursing action should be implemented
first?
A. Place the client in high-Fowler's position and notify the RN/provider immediately.
B. Encourage oral fluid intake to improve circulation.
C. Administer the scheduled oral beta blocker.
D. Prepare the client for discharge teaching.
🔴 Correct Answer: A. Place the client in high-Fowler's position and notify the
RN/provider immediately.
🔵 Explanation: Positioning the client upright reduces venous return and improves
lung expansion while urgent notification facilitates rapid intervention. Encouraging
fluids could worsen pulmonary edema, administering a beta blocker is not the priority
during acute respiratory compromise, and discharge teaching is inappropriate during
an unstable condition.
QUESTION 2.
A client with diabetic ketoacidosis is receiving continuous insulin therapy. Which
assessment finding indicates that treatment is progressing appropriately?
A. Persistent fruity breath odor with increasing respirations
B. Gradual decrease in serum glucose with improvement in mental status
C. Increasing serum potassium despite insulin therapy
D. Decreasing urine output accompanied by hypotension
🔴 Correct Answer: B. Gradual decrease in serum glucose with improvement in
mental status.
🔵 Explanation: Improvement in neurologic status together with declining blood
glucose suggests effective therapy and improving metabolic balance. Persistent
,Kussmaul respirations indicate ongoing acidosis, rising potassium is concerning, and
declining urine output with hypotension may signal worsening perfusion.
QUESTION 3.
A postoperative client suddenly reports sharp chest pain and shortness of breath.
Which finding most strongly supports suspicion of a pulmonary embolism?
A. Bradycardia with hypertension
B. Warm flushed skin
C. Sudden tachycardia with hypoxemia
D. Bilateral lower extremity edema without respiratory symptoms
🔴 Correct Answer: C. Sudden tachycardia with hypoxemia.
🔵 Explanation: Pulmonary embolism commonly presents with sudden dyspnea,
tachycardia, hypoxemia, and pleuritic chest pain. Bradycardia is uncommon, flushed
skin is nonspecific, and isolated bilateral edema does not explain the acute respiratory
symptoms.
QUESTION 4.
A client receiving intravenous potassium chloride reports burning at the infusion site.
What is the nurse's priority action?
A. Increase the infusion rate.
B. Apply a heating pad directly over the IV site.
C. Discontinue the infusion immediately and assess IV patency.
D. Flush the line rapidly with sterile water.
🔴 Correct Answer: C. Discontinue the infusion immediately and assess IV patency.
🔵 Explanation: Potassium is irritating to veins, and burning may indicate infiltration
or phlebitis. The infusion should be stopped while the IV site is assessed. Increasing the
rate or rapidly flushing the line could worsen tissue injury, and direct heat is not the
first intervention.
, QUESTION 5.
A client with chronic obstructive pulmonary disease has an oxygen saturation of 90%
while receiving low-flow oxygen and appears comfortable. Which nursing action is
most appropriate?
A. Increase oxygen to maintain saturation at 100%.
B. Remove oxygen because the saturation is below normal.
C. Continue monitoring while maintaining prescribed oxygen therapy.
D. Encourage hyperventilation exercises every five minutes.
🔴 Correct Answer: C. Continue monitoring while maintaining prescribed oxygen
therapy.
🔵 Explanation: Many clients with COPD have lower target oxygen saturations.
Maintaining prescribed oxygen while monitoring for clinical changes is appropriate.
Excessive oxygen may worsen carbon dioxide retention, removing oxygen is unsafe, and
forced hyperventilation is unnecessary.
QUESTION 6.
A client with acute kidney injury develops peaked T waves on the cardiac monitor.
Which laboratory abnormality should the nurse suspect?
A. Hyperkalemia
B. Hypocalcemia
C. Hyponatremia
D. Hypomagnesemia
🔴 Correct Answer: A. Hyperkalemia.
🔵 Explanation: Peaked T waves are a classic ECG manifestation of elevated serum
potassium. Hyperkalemia is common in acute kidney injury due to impaired potassium
excretion. The other electrolyte abnormalities produce different clinical manifestations.
