HESI Med-Surg Retake Review
Questions and Ansẉers with
rationales 2026\2027 update
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Guarantee passing score
Questions and Ansẉers
format set of multiple-choice
Expert-Verified rationales
Verified ẉith trusted textbooks
,───────────────────────────────────────────────────────
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1. A client is admitted with a suspected myocardial infarction (MI).
Which cardiac biomarker is the most specific and reliable indicator
of an acute MI?
A. Myoglobin
B. Creatine kinase-MB (CK-MB)
C. Troponin I
D. Lactate dehydrogenase (LDH)
Answer: C. Troponin I
Rationale: Troponin I is highly specific to cardiac muscle and rises
within 3-4 hours after myocardial injury, peaking at 10-24 hours. It
remains elevated for up to 2 weeks, making it the most reliable
indicator of an acute MI. Myoglobin rises early but is not specific to
the heart. CK-MB is specific to cardiac muscle but is no longer the
gold standard. LDH is outdated and non-specific.
2. A client with heart failure is prescribed furosemide. Which
assessment finding indicates the medication is having the desired
therapeutic effect?
A. Weight loss of 2 lbs in 24 hours
B. Decreased blood urea nitrogen (BUN)
C. Increased urine specific gravity
D. Bounding radial pulse
Answer: A. Weight loss of 2 lbs in 24 hours
Rationale: Furosemide is a loop diuretic used to reduce fluid volume
overload in heart failure. A weight loss of 2 lbs in 24 hours indicates
successful diuresis. Urine specific gravity would decrease (not
increase) with diuresis. A bounding pulse indicates fluid overload,
not a therapeutic response.
,3. A nurse is caring for a client with a ventrogluteal intramuscular
injection. To locate the ventrogluteal site, the nurse places the palm
on the greater trochanter and the index finger on the:
A. Anterior superior iliac spine
B. Posterior superior iliac spine
C. Iliac crest
D. Greater sciatic notch
Answer: A. Anterior superior iliac spine
Rationale: To locate the ventrogluteal site, the nurse places the palm
on the greater trochanter, the index finger on the anterior superior
iliac spine, and the middle finger pointing toward the iliac crest,
creating a V-shaped triangle.
4. A client with chronic obstructive pulmonary disease (COPD) is
receiving oxygen via nasal cannula at 2 L/min. The client's family
asks why the oxygen is kept so low. What is the nurse’s best
response?
A. "High oxygen levels will cause the client to hyperventilate."
B. "Low oxygen levels are all that are needed to keep the client
comfortable."
C. "High oxygen levels may decrease the client's respiratory drive."
D. "Low oxygen levels prevent the development of oxygen toxicity."
Answer: C. "High oxygen levels may decrease the client's respiratory
drive."
Rationale: In clients with COPD, the respiratory drive is often
triggered by low oxygen levels (hypoxic drive) rather than high
carbon dioxide levels. Administering high-flow oxygen can blunt
this hypoxic drive, leading to respiratory depression and
hypercapnia.
5. A client is admitted with a diagnosis of syndrome of
inappropriate antidiuretic hormone (SIADH). Which laboratory
finding should the nurse expect?
A. Serum sodium of 120 mEq/L
, B. Serum osmolality of 320 mOsm/kg
C. Urine specific gravity of 1.002
D. Serum potassium of 5.5 mEq/L
Answer: A. Serum sodium of 120 mEq/L
Rationale: SIADH causes excessive water retention, leading to
dilutional hyponatremia (serum sodium <135 mEq/L) and decreased
serum osmolality (<280 mOsm/kg). Urine specific gravity is high
(concentrated urine) due to the excess ADH.
6. A client with a peptic ulcer suddenly develops sharp, severe
abdominal pain. The abdomen is rigid and board-like. What is the
nurse's priority action?
A. Administer prescribed antacids
B. Insert a nasogastric tube
C. Notify the healthcare provider immediately
D. Encourage the client to drink water
Answer: C. Notify the healthcare provider immediately
Rationale: These signs indicate perforation of the peptic ulcer, a life-
threatening medical emergency that requires immediate surgical
intervention. The nurse must notify the provider immediately. NG
tube insertion and keeping the client NPO will be ordered, but
getting the provider is priority.
7. A client is receiving total parenteral nutrition (TPN) through a
central line. The nurse notes that the TPN bag is empty, but the next
bag is not yet available from the pharmacy. What should the nurse
do?
A. Flush the line with heparin and clamp it
B. Hang a bag of 10% dextrose in water (D10W)
C. Hang a bag of 0.9% normal saline
D. Discontinue the IV line
Answer: B. Hang a bag of 10% dextrose in water (D10W)
Rationale: TPN has a high glucose concentration. Abruptly stopping
TPN can cause severe rebound hypoglycemia. If the next TPN bag is
Questions and Ansẉers with
rationales 2026\2027 update
This Exam contains:
Guarantee passing score
Questions and Ansẉers
format set of multiple-choice
Expert-Verified rationales
Verified ẉith trusted textbooks
,───────────────────────────────────────────────────────
─
1. A client is admitted with a suspected myocardial infarction (MI).
Which cardiac biomarker is the most specific and reliable indicator
of an acute MI?
A. Myoglobin
B. Creatine kinase-MB (CK-MB)
C. Troponin I
D. Lactate dehydrogenase (LDH)
Answer: C. Troponin I
Rationale: Troponin I is highly specific to cardiac muscle and rises
within 3-4 hours after myocardial injury, peaking at 10-24 hours. It
remains elevated for up to 2 weeks, making it the most reliable
indicator of an acute MI. Myoglobin rises early but is not specific to
the heart. CK-MB is specific to cardiac muscle but is no longer the
gold standard. LDH is outdated and non-specific.
2. A client with heart failure is prescribed furosemide. Which
assessment finding indicates the medication is having the desired
therapeutic effect?
A. Weight loss of 2 lbs in 24 hours
B. Decreased blood urea nitrogen (BUN)
C. Increased urine specific gravity
D. Bounding radial pulse
Answer: A. Weight loss of 2 lbs in 24 hours
Rationale: Furosemide is a loop diuretic used to reduce fluid volume
overload in heart failure. A weight loss of 2 lbs in 24 hours indicates
successful diuresis. Urine specific gravity would decrease (not
increase) with diuresis. A bounding pulse indicates fluid overload,
not a therapeutic response.
,3. A nurse is caring for a client with a ventrogluteal intramuscular
injection. To locate the ventrogluteal site, the nurse places the palm
on the greater trochanter and the index finger on the:
A. Anterior superior iliac spine
B. Posterior superior iliac spine
C. Iliac crest
D. Greater sciatic notch
Answer: A. Anterior superior iliac spine
Rationale: To locate the ventrogluteal site, the nurse places the palm
on the greater trochanter, the index finger on the anterior superior
iliac spine, and the middle finger pointing toward the iliac crest,
creating a V-shaped triangle.
4. A client with chronic obstructive pulmonary disease (COPD) is
receiving oxygen via nasal cannula at 2 L/min. The client's family
asks why the oxygen is kept so low. What is the nurse’s best
response?
A. "High oxygen levels will cause the client to hyperventilate."
B. "Low oxygen levels are all that are needed to keep the client
comfortable."
C. "High oxygen levels may decrease the client's respiratory drive."
D. "Low oxygen levels prevent the development of oxygen toxicity."
Answer: C. "High oxygen levels may decrease the client's respiratory
drive."
Rationale: In clients with COPD, the respiratory drive is often
triggered by low oxygen levels (hypoxic drive) rather than high
carbon dioxide levels. Administering high-flow oxygen can blunt
this hypoxic drive, leading to respiratory depression and
hypercapnia.
5. A client is admitted with a diagnosis of syndrome of
inappropriate antidiuretic hormone (SIADH). Which laboratory
finding should the nurse expect?
A. Serum sodium of 120 mEq/L
, B. Serum osmolality of 320 mOsm/kg
C. Urine specific gravity of 1.002
D. Serum potassium of 5.5 mEq/L
Answer: A. Serum sodium of 120 mEq/L
Rationale: SIADH causes excessive water retention, leading to
dilutional hyponatremia (serum sodium <135 mEq/L) and decreased
serum osmolality (<280 mOsm/kg). Urine specific gravity is high
(concentrated urine) due to the excess ADH.
6. A client with a peptic ulcer suddenly develops sharp, severe
abdominal pain. The abdomen is rigid and board-like. What is the
nurse's priority action?
A. Administer prescribed antacids
B. Insert a nasogastric tube
C. Notify the healthcare provider immediately
D. Encourage the client to drink water
Answer: C. Notify the healthcare provider immediately
Rationale: These signs indicate perforation of the peptic ulcer, a life-
threatening medical emergency that requires immediate surgical
intervention. The nurse must notify the provider immediately. NG
tube insertion and keeping the client NPO will be ordered, but
getting the provider is priority.
7. A client is receiving total parenteral nutrition (TPN) through a
central line. The nurse notes that the TPN bag is empty, but the next
bag is not yet available from the pharmacy. What should the nurse
do?
A. Flush the line with heparin and clamp it
B. Hang a bag of 10% dextrose in water (D10W)
C. Hang a bag of 0.9% normal saline
D. Discontinue the IV line
Answer: B. Hang a bag of 10% dextrose in water (D10W)
Rationale: TPN has a high glucose concentration. Abruptly stopping
TPN can cause severe rebound hypoglycemia. If the next TPN bag is
